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Drug Interactions With Mercaptopurine
A wide variety of products may cause drug interactions when used in combination with mercaptopurine. For instance, if this chemotherapy medicine is used with certain immunosuppressant medications, vaccinations, or echinacea, it may increase your risk for dangerous infections, serious bleeding problems, or other potentially serious complications. To avoid these and other potential problems, give your healthcare provider a list of all products you are taking.
Mercaptopurine (Purinethol®) may interact with a number of other medications. Some of the drugs that may react with mercaptopurine include but are not limited to:
- 5-aminosalicylic acid (5-ASA) derivatives, such as:
- Balsalazide disodium (Colazal®)
- Mesalamine (Apriso™, Asacol®, Asacol® HD, Canasa®, Lialda®, Pentasa®, Rowasa®)
- Olsalazine sodium (Dipentum®)
- Sulfasalazine (Azulfidine®)
- Sulfasalazine delayed-release (Azulfidine EN-tabs®)
- Allopurinol (Zyloprim®)
- Amphotericin B (Abelcet®, AmBisome®, Amphotec®)
- Azathioprine (Azasan®, Imuran®)
- Certain biologic and immunologic medications, such as:
- Denosumab (Prolia®)
- Leflunomide (Arava®)
- Natalizumab (Tysabri®)
- Pimecrolimus (Elidel®)
- Tacrolimus (Prograf®, Protopic®)
- Trastuzumab (Herceptin®)
- Clozapine (Clozaril®, FazaClo®)
- Doxorubicin (Adriamycin®, Doxil®)
- Echinacea
- Febuxostat (Uloric®)
- "Live" vaccinations, such as:
- Chickenpox vaccine (varicella vaccine)
- FluMist® (the nasal vaccine for influenza; the injected vaccine is not live)
- MMR vaccine (measles, mumps, rubella vaccine)
- Polio vaccine
- Rotavirus vaccine
- Smallpox vaccine
- Yellow fever vaccine
- BCG vaccine (used in some countries for tuberculosis)
- Roflumilast (Daliresp®)
- Sipuleucel-T (Provenge®)
- Trimethoprim (Primsol®) and sulfamethoxazole/trimethoprim (Bactrim®, Bactrim® DS, Septra®, Septra® DS, Sulfatrim®)
Written by/reviewed by: Susan Lakey, PharmD, MPH, BCPP
Last reviewed by: Kristi Monson, PharmD