Drug interactions
Mercaptopurine + Tocilizumab
Severity: Major
Mercaptopurine and Tocilizumab: 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
Both agents impair immune defenses, so combined use raises the risk of serious infection. Tocilizumab may also blunt acute-phase signs of infection, making it harder to detect.
What this interaction means in plain words
Mercaptopurine and Tocilizumab 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 belongs to Oncology; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from IL-6 receptor blockade and purine antimetabolite activity.
What to do
Use only when clearly needed and monitor closely for infection, including with low-grade symptoms. Check neutrophil counts and liver enzymes periodically.
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
Other interactions of Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab Contraindicated
Frequently asked questions
Can I take Mercaptopurine with Tocilizumab?
MediHelp rates the interaction as major. Mercaptopurine and Tocilizumab 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. Both agents impair immune defenses, so combined use raises the risk of serious infection. Tocilizumab may also blunt acute-phase signs of infection, making it harder to detect.
How serious is the interaction between Mercaptopurine and Tocilizumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only when clearly needed and monitor closely for infection, including with low-grade symptoms. Check neutrophil counts and liver enzymes periodically.
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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