Drug interactions
Azathioprine + Tisagenlecleucel
Severity: Major
Azathioprine and Tisagenlecleucel: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Azathioprine may impair CAR T-cell expansion and persistence, potentially reducing efficacy of tisagenlecleucel. Together they also add to infection risk in patients already immunocompromised.
What this interaction means in plain words
Azathioprine and Tisagenlecleucel can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Azathioprine belongs to Gastrointestinal Tract; Tisagenlecleucel belongs to Oncology.
Why it happens
Antimetabolite-driven lymphocyte suppression may blunt CAR T-cell proliferation, and the effects add to the immune deficiency caused by the therapy.
What to do
Avoid azathioprine around lymphodepletion and CAR T infusion unless essential, and follow the product labeling for washout. Monitor closely for infection and cytopenias if it must be used.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Azathioprine
- Adenovirus types 4 and 7 live + Azathioprine Contraindicated
- Azathioprine + Bcg vaccine live Contraindicated
- Azathioprine + Febuxostat Contraindicated
- Azathioprine + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Azathioprine + Measles mumps and rubella vaccine Contraindicated
- Azathioprine + Measles mumps and rubella vaccine live Contraindicated
Other interactions of Tisagenlecleucel
Frequently asked questions
Can I take Azathioprine with Tisagenlecleucel?
MediHelp rates the interaction as major. Azathioprine and Tisagenlecleucel can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Azathioprine may impair CAR T-cell expansion and persistence, potentially reducing efficacy of tisagenlecleucel. Together they also add to infection risk in patients already immunocompromised.
How serious is the interaction between Azathioprine and Tisagenlecleucel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid azathioprine around lymphodepletion and CAR T infusion unless essential, and follow the product labeling for washout. Monitor closely for infection and cytopenias if it must be used.
What other medicines interact with Azathioprine?
MediHelp also lists interactions of Azathioprine with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Febuxostat. The full list is on the Azathioprine page.
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