Drug interactions
Mercaptopurine + Zoster vaccine live
Severity: Major
Mercaptopurine and Zoster vaccine live: 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
Live zoster vaccine may cause disseminated vaccine-strain varicella zoster infection in patients taking mercaptopurine, and the immune response may be reduced.
What this interaction means in plain words
Mercaptopurine and Zoster vaccine live 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
Purine antimetabolite immunosuppression permits uncontrolled replication of live attenuated varicella zoster virus.
What to do
Avoid live zoster vaccine during mercaptopurine therapy and use the recombinant non-live zoster vaccine where indicated.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mercaptopurine and Zoster vaccine live, 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
Frequently asked questions
Can I take Mercaptopurine with Zoster vaccine live?
MediHelp rates the interaction as major. Mercaptopurine and Zoster vaccine live 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. Live zoster vaccine may cause disseminated vaccine-strain varicella zoster infection in patients taking mercaptopurine, and the immune response may be reduced.
How serious is the interaction between Mercaptopurine and Zoster vaccine live?
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 live zoster vaccine during mercaptopurine therapy and use the recombinant non-live zoster vaccine where indicated.
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.
