Drug interactions
Hydroxyurea + Mercaptopurine
Severity: Moderate
Hydroxyurea 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
Both agents suppress bone marrow, so using them together can cause deeper and more prolonged leukopenia, anemia and thrombocytopenia. This increases the risk of infection and bleeding.
What this interaction means in plain words
Hydroxyurea 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.
Hydroxyurea belongs to Miscellaneous; Mercaptopurine belongs to Oncology.
Why it happens
Additive myelosuppression from inhibition of DNA synthesis by two different antimetabolites.
What to do
Monitor complete blood counts frequently and reduce the dose of one or both drugs if counts fall. Hold treatment for severe neutropenia or thrombocytopenia.
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 Hydroxyurea
Frequently asked questions
Can I take Hydroxyurea with Mercaptopurine?
MediHelp rates the interaction as moderate. Hydroxyurea 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. Both agents suppress bone marrow, so using them together can cause deeper and more prolonged leukopenia, anemia and thrombocytopenia. This increases the risk of infection and bleeding.
How serious is the interaction between Hydroxyurea 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 complete blood counts frequently and reduce the dose of one or both drugs if counts fall. Hold treatment for severe neutropenia or thrombocytopenia.
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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