Drug interactions
Mercaptopurine + Muromonab cd3
Severity: Major
Mercaptopurine and Muromonab cd3: 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
Muromonab-CD3 produces profound T-cell depletion, and adding a thiopurine antimetabolite deepens overall immunosuppression. This raises the risk of serious bacterial, viral and opportunistic infections and of lymphoproliferative disorders.
What this interaction means in plain words
Mercaptopurine and Muromonab cd3 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
Additive pharmacodynamic immunosuppression from T-cell depletion plus inhibition of purine synthesis and lymphocyte proliferation.
What to do
Review the need for the combination and use the lowest effective immunosuppressant doses. Monitor closely for infection and check blood counts regularly.
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 Mercaptopurine with Muromonab cd3?
MediHelp rates the interaction as major. Mercaptopurine and Muromonab cd3 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. Muromonab-CD3 produces profound T-cell depletion, and adding a thiopurine antimetabolite deepens overall immunosuppression. This raises the risk of serious bacterial, viral and opportunistic infections and of lymphoproliferative disorders.
How serious is the interaction between Mercaptopurine and Muromonab cd3?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review the need for the combination and use the lowest effective immunosuppressant doses. Monitor closely for infection and check blood counts regularly.
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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