Drug interactions
Cholera vaccine + Mercaptopurine
Severity: Moderate
Cholera vaccine and Mercaptopurine: 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
Mercaptopurine suppresses lymphocyte proliferation, which can blunt the antibody response to cholera vaccine. Protection may be incomplete in treated patients. The vaccine is not a live-replicating product in the same sense as other live vaccines, so the main concern is reduced efficacy.
What this interaction means in plain words
Cholera vaccine and Mercaptopurine 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.
Why it happens
Antimetabolite-induced immunosuppression reduces B- and T-cell responses to vaccine antigens.
What to do
Where possible, give the vaccine before starting mercaptopurine or during a period of lower immunosuppression. Continue standard hygiene and food and water precautions in endemic areas, since immunity may be reduced.
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 Mercaptopurine
- Adenovirus types 4 and 7 live + Mercaptopurine Contraindicated
- Azathioprine + Mercaptopurine Contraindicated
- Bcg vaccine live + Mercaptopurine Contraindicated
- Febuxostat + Mercaptopurine Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Mercaptopurine Contraindicated
- Mercaptopurine + Smallpox vaccine live Contraindicated
Frequently asked questions
Can I take Cholera vaccine with Mercaptopurine?
MediHelp rates the interaction as moderate. Cholera vaccine and Mercaptopurine 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. Mercaptopurine suppresses lymphocyte proliferation, which can blunt the antibody response to cholera vaccine. Protection may be incomplete in treated patients. The vaccine is not a live-replicating product in the same sense as other live vaccines, so the main concern is reduced efficacy.
How serious is the interaction between Cholera vaccine and Mercaptopurine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible, give the vaccine before starting mercaptopurine or during a period of lower immunosuppression. Continue standard hygiene and food and water precautions in endemic areas, since immunity may be reduced.
What other medicines interact with Mercaptopurine?
MediHelp also lists interactions of Mercaptopurine with, for example, Adenovirus types 4 and 7 live, Azathioprine, Bcg vaccine live. The full list is on the Mercaptopurine page.
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