Drug interactions
Measles mumps rubella and varicella vaccine live + Mercaptopurine
Severity: Major
Measles mumps rubella and varicella vaccine live 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
Mercaptopurine impairs lymphocyte-mediated immunity, which can reduce the response to MMRV vaccine. The live viruses, including varicella, may replicate unchecked and cause serious disseminated disease.
What this interaction means in plain words
Measles mumps rubella and varicella vaccine live 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
Purine antimetabolite immunosuppression reduces vaccine immunogenicity and permits uncontrolled replication of live attenuated viruses.
What to do
Avoid giving MMRV vaccine to patients on mercaptopurine; vaccinate at least 4 weeks before starting when possible. Otherwise defer until immunosuppression has resolved, per local guidance.
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
Frequently asked questions
Can I take Measles mumps rubella and varicella vaccine live with Mercaptopurine?
MediHelp rates the interaction as major. Measles mumps rubella and varicella vaccine live 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. Mercaptopurine impairs lymphocyte-mediated immunity, which can reduce the response to MMRV vaccine. The live viruses, including varicella, may replicate unchecked and cause serious disseminated disease.
How serious is the interaction between Measles mumps rubella and varicella vaccine live 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 giving MMRV vaccine to patients on mercaptopurine; vaccinate at least 4 weeks before starting when possible. Otherwise defer until immunosuppression has resolved, per local guidance.
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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