Drug interactions
Mercaptopurine + Sirolimus
Severity: Moderate
Mercaptopurine and Sirolimus: 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 drugs suppress immune function, so combined use increases the risk of infection and may add to myelosuppression. The combination is sometimes used in transplantation.
What this interaction means in plain words
Mercaptopurine and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression via mTOR inhibition and thiopurine inhibition of lymphocyte proliferation.
What to do
Monitor for infection and blood counts, and check sirolimus trough levels as per transplant protocol. Reduce doses if cytopenias develop.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mercaptopurine and Sirolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Mercaptopurine with Sirolimus?
MediHelp rates the interaction as moderate. Mercaptopurine and Sirolimus 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 drugs suppress immune function, so combined use increases the risk of infection and may add to myelosuppression. The combination is sometimes used in transplantation.
How serious is the interaction between Mercaptopurine and Sirolimus?
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 for infection and blood counts, and check sirolimus trough levels as per transplant protocol. Reduce doses if cytopenias develop.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
