Drug interactions
Mercaptopurine + Ustekinumab
Severity: Moderate
Mercaptopurine and Ustekinumab: 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
Ustekinumab blocks IL-12 and IL-23 signaling and mercaptopurine suppresses lymphocytes, so combined use may increase the risk of infection. Clinical studies in inflammatory bowel disease have not shown a large increase in serious infections.
What this interaction means in plain words
Mercaptopurine and Ustekinumab 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; Ustekinumab belongs to Gastrointestinal Tract.
Why it happens
Additive immunosuppression through cytokine blockade and thiopurine-mediated lymphocyte suppression.
What to do
Monitor for infection and check blood counts and liver tests periodically. Screen for tuberculosis before starting ustekinumab.
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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
Frequently asked questions
Can I take Mercaptopurine with Ustekinumab?
MediHelp rates the interaction as moderate. Mercaptopurine and Ustekinumab 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. Ustekinumab blocks IL-12 and IL-23 signaling and mercaptopurine suppresses lymphocytes, so combined use may increase the risk of infection. Clinical studies in inflammatory bowel disease have not shown a large increase in serious infections.
How serious is the interaction between Mercaptopurine and Ustekinumab?
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 check blood counts and liver tests periodically. Screen for tuberculosis before starting ustekinumab.
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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