Drug interactions
Denosumab + Mercaptopurine
Severity: Moderate
Denosumab 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
Denosumab labeling warns of increased serious infection risk in patients with impaired immunity or on immunosuppressants. Mercaptopurine adds to this immunosuppression, so infections such as skin infections may be more likely.
What this interaction means in plain words
Denosumab 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.
Denosumab belongs to Oncology; Mercaptopurine belongs to Oncology.
Why it happens
Additive effect on immune function; denosumab inhibits RANKL, which is also involved in immune signaling, while mercaptopurine suppresses lymphocytes.
What to do
Monitor for signs of infection and counsel the patient to report fever or skin changes promptly. Reassess the need for denosumab if serious infection occurs.
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
Other interactions of Denosumab
- Abatacept + Denosumab Moderate
- Adalimumab + Denosumab Moderate
- Alefacept + Denosumab Moderate
- Alemtuzumab + Denosumab Moderate
- Anakinra + Denosumab Moderate
- Azacitidine + Denosumab Moderate
Frequently asked questions
Can I take Denosumab with Mercaptopurine?
MediHelp rates the interaction as moderate. Denosumab 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. Denosumab labeling warns of increased serious infection risk in patients with impaired immunity or on immunosuppressants. Mercaptopurine adds to this immunosuppression, so infections such as skin infections may be more likely.
How serious is the interaction between Denosumab 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: Monitor for signs of infection and counsel the patient to report fever or skin changes promptly. Reassess the need for denosumab if serious infection occurs.
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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