Drug interactions
Mercaptopurine + Palifermin
Severity: Moderate
Mercaptopurine and Palifermin: 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
Palifermin given close to cytotoxic chemotherapy has been associated with worse and longer oral mucositis, because it stimulates proliferation of epithelial cells that are then exposed to cytotoxic drugs. Relevance to continuous low-dose oral mercaptopurine is uncertain, but the labeled timing restriction applies to antineoplastic agents.
What this interaction means in plain words
Mercaptopurine and Palifermin 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.
Mercaptopurine belongs to Oncology; Palifermin belongs to Miscellaneous.
Why it happens
Palifermin stimulates epithelial cell proliferation, which may increase sensitivity of mucosal cells to antimetabolite cytotoxicity.
What to do
Do not give palifermin within 24 hours before, during, or after cytotoxic chemotherapy. For continuous mercaptopurine dosing, discuss timing with the oncology team and monitor the oral mucosa.
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 Palifermin
Frequently asked questions
Can I take Mercaptopurine with Palifermin?
MediHelp rates the interaction as moderate. Mercaptopurine and Palifermin 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. Palifermin given close to cytotoxic chemotherapy has been associated with worse and longer oral mucositis, because it stimulates proliferation of epithelial cells that are then exposed to cytotoxic drugs. Relevance to continuous low-dose oral mercaptopurine is uncertain, but the labeled timing restriction applies to antineoplastic agents.
How serious is the interaction between Mercaptopurine and Palifermin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give palifermin within 24 hours before, during, or after cytotoxic chemotherapy. For continuous mercaptopurine dosing, discuss timing with the oncology team and monitor the oral mucosa.
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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