Drug interactions
Azathioprine + Yellow fever vaccine
Severity: Contraindicated
Azathioprine and Yellow fever vaccine: contraindicated interaction.
Last updated Sources: EMA SmPC
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
Yellow fever vaccine is a live attenuated virus vaccine, and in patients taking azathioprine it can cause vaccine-associated viscerotropic or neurotropic disease. Antibody response may also be diminished.
What this interaction means in plain words
Azathioprine and Yellow fever vaccine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Immunosuppression by azathioprine allows enhanced replication of the live attenuated virus and impairs immune clearance.
What to do
Avoid the vaccine during azathioprine therapy; if travel to an endemic area is unavoidable, advise a medical exemption letter and mosquito-avoidance measures, or defer travel. Vaccinate before starting immunosuppression when feasible.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Azathioprine and Yellow fever vaccine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
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
Frequently asked questions
Can I take Azathioprine with Yellow fever vaccine?
MediHelp rates the interaction as contraindicated. Azathioprine and Yellow fever vaccine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Yellow fever vaccine is a live attenuated virus vaccine, and in patients taking azathioprine it can cause vaccine-associated viscerotropic or neurotropic disease. Antibody response may also be diminished.
How serious is the interaction between Azathioprine and Yellow fever vaccine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the vaccine during azathioprine therapy; if travel to an endemic area is unavoidable, advise a medical exemption letter and mosquito-avoidance measures, or defer travel. Vaccinate before starting immunosuppression when feasible.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
