Drug interactions
Azathioprine + Ustekinumab
Severity: Moderate
Azathioprine and Ustekinumab: moderate 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
Ustekinumab is commonly used alongside thiopurines in inflammatory bowel disease, but together they add to immunosuppression and may raise infection risk. The clinical increment appears modest compared with other biologic combinations.
What this interaction means in plain words
Azathioprine and Ustekinumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Azathioprine belongs to Gastrointestinal Tract; Ustekinumab belongs to Gastrointestinal Tract.
Why it happens
Additive immunosuppression from IL-12/23 blockade and purine antimetabolite activity.
What to do
Screen for latent tuberculosis before treatment and monitor for infections and blood count changes. Reassess the need for the thiopurine regularly and withdraw it if not required.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
Frequently asked questions
Can I take Azathioprine with Ustekinumab?
MediHelp rates the interaction as moderate. Azathioprine and Ustekinumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ustekinumab is commonly used alongside thiopurines in inflammatory bowel disease, but together they add to immunosuppression and may raise infection risk. The clinical increment appears modest compared with other biologic combinations.
How serious is the interaction between Azathioprine and Ustekinumab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Screen for latent tuberculosis before treatment and monitor for infections and blood count changes. Reassess the need for the thiopurine regularly and withdraw it if not required.
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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