Drug interactions
Mercaptopurine + Yellow fever vaccine
Severity: Major
Mercaptopurine and Yellow fever vaccine: 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
Yellow fever vaccine is a live attenuated virus that can cause serious viscerotropic or neurotropic disease in immunosuppressed patients. Mercaptopurine also reduces the likelihood of a protective antibody response.
What this interaction means in plain words
Mercaptopurine and Yellow fever vaccine 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.
Why it happens
Immunosuppression permits replication of live attenuated yellow fever virus and impairs immune response.
What to do
Avoid vaccination while on mercaptopurine and advise on travel avoidance or mosquito protection. If travel is unavoidable, seek specialist advice and consider a medical exemption letter.
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
Frequently asked questions
Can I take Mercaptopurine with Yellow fever vaccine?
MediHelp rates the interaction as major. Mercaptopurine and Yellow fever vaccine 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. Yellow fever vaccine is a live attenuated virus that can cause serious viscerotropic or neurotropic disease in immunosuppressed patients. Mercaptopurine also reduces the likelihood of a protective antibody response.
How serious is the interaction between Mercaptopurine and Yellow fever vaccine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid vaccination while on mercaptopurine and advise on travel avoidance or mosquito protection. If travel is unavoidable, seek specialist advice and consider a medical exemption letter.
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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