Drug interactions
Mercaptopurine + Tacrolimus
Severity: Moderate
Mercaptopurine and Tacrolimus: 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 possibly malignancy. Myelosuppression from mercaptopurine adds to the burden.
What this interaction means in plain words
Mercaptopurine and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression via calcineurin inhibition and thiopurine inhibition of lymphocyte proliferation.
What to do
Monitor blood counts, signs of infection and tacrolimus trough levels. Adjust doses based on counts and clinical response.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Mercaptopurine with Tacrolimus?
MediHelp rates the interaction as moderate. Mercaptopurine and Tacrolimus 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 possibly malignancy. Myelosuppression from mercaptopurine adds to the burden.
How serious is the interaction between Mercaptopurine and Tacrolimus?
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 blood counts, signs of infection and tacrolimus trough levels. Adjust doses based on counts and clinical response.
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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