Drug interactions
Fingolimod + Mercaptopurine
Severity: Major
Fingolimod and Mercaptopurine: major 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
Both drugs suppress immune function, so combined use increases the risk of serious infection. Fingolimod's effect on lymphocytes persists for weeks after stopping, extending the period of risk.
What this interaction means in plain words
Fingolimod 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.
Fingolimod belongs to Central Nervous System; Mercaptopurine belongs to Oncology.
Why it happens
Additive immunosuppression from purine antimetabolite myelosuppression and fingolimod lymphocyte sequestration.
What to do
Avoid combining where possible; if used, monitor blood counts and closely watch for infection, allowing for the prolonged fingolimod pharmacodynamic effect when switching.
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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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 Fingolimod
- Adenovirus types 4 and 7 live + Fingolimod Contraindicated
- Bcg vaccine live + Fingolimod Contraindicated
- Fingolimod + Pimozide Contraindicated
- Fingolimod + Ponesimod Contraindicated
- Fingolimod + Quinidine Contraindicated
- Fingolimod + Siponimod Contraindicated
Frequently asked questions
Can I take Fingolimod with Mercaptopurine?
MediHelp rates the interaction as major. Fingolimod 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. Both drugs suppress immune function, so combined use increases the risk of serious infection. Fingolimod's effect on lymphocytes persists for weeks after stopping, extending the period of risk.
How serious is the interaction between Fingolimod 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 combining where possible; if used, monitor blood counts and closely watch for infection, allowing for the prolonged fingolimod pharmacodynamic effect when switching.
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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