Drug interactions
Dengue vaccine + Mercaptopurine
Severity: Major
Dengue vaccine and Mercaptopurine: major interaction.
Last updated Sources: UK 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
The dengue vaccine is a live attenuated vaccine, and immunosuppression from mercaptopurine can blunt the immune response and allow uncontrolled vaccine virus replication. Disease from the vaccine strain is a concern.
What this interaction means in plain words
Dengue vaccine and Mercaptopurine 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.
Why it happens
Immunosuppression impairs vaccine response and permits replication of live attenuated virus.
What to do
Avoid the live dengue vaccine in patients receiving mercaptopurine. Defer vaccination until immunosuppressive therapy has been stopped for an appropriate interval.
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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References
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 Dengue vaccine with Mercaptopurine?
MediHelp rates the interaction as major. Dengue vaccine and Mercaptopurine 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. The dengue vaccine is a live attenuated vaccine, and immunosuppression from mercaptopurine can blunt the immune response and allow uncontrolled vaccine virus replication. Disease from the vaccine strain is a concern.
How serious is the interaction between Dengue vaccine and Mercaptopurine?
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 the live dengue vaccine in patients receiving mercaptopurine. Defer vaccination until immunosuppressive therapy has been stopped for an appropriate interval.
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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