Mercaptopurine

Febuxostat is contraindicated in patients being treated with mercaptopurine. Concomitant administration could increase plasma concentrations resulting in severe toxicity.

Febuxostat is contraindicated with mercaptopurine. Concomitant use could increase plasma concentrations resulting in severe toxicity.

Should not be used concomitantly with natalizumab due to potential increased risk of PML and other infections.

Should not be used concomitantly with natalizumab due to increased risk of PML and other infections in Crohn's disease patients.

Concomitant use requires dose reduction of mercaptopurine as recommended in its prescribing information.

Allopurinol inhibits xanthine oxidase-mediated metabolism, increasing mercaptopurine exposure and risk of adverse effects. Reduce dose.

Concurrent use may increase risk for blood disorders, bone marrow failure, and associated complications. Monitor blood tests including complete blood cell counts and platelet counts.

Aspirin causes bone marrow toxicity and blood dyscrasias by displacing from secondary binding sites.

Doxorubicin may potentiate 6-mercaptopurine-induced hepatotoxicity, resulting in hepatic dysfunction manifested by increased total serum bilirubin, alkaline phosphatase, and aspartate aminotransferase.

Doxorubicin may potentiate 6-mercaptopurine-induced hepatotoxicity, resulting in hepatic dysfunction with elevated bilirubin, alkaline phosphatase, and transaminases.

Increased risk of blood disorders and bone marrow failure; monitor complete blood cell counts and platelet counts if concurrent use unavoidable.

May increase methotrexate plasma concentrations, increasing risk of severe adverse reactions. Monitor closely for methotrexate adverse reactions.

May inhibit TPMT enzyme, increasing risk of myelosuppression when coadministered with mercaptopurine. Use lowest possible doses and monitor frequently for myelosuppression.

Concurrent use may increase risk of blood dyscrasias, bone marrow failure, and associated complications. Monitor complete blood cell counts and platelet counts.

Enhanced myelosuppression noted when coadministered with mercaptopurine. Monitor CBC and adjust mercaptopurine dose for excessive myelosuppression.

May inhibit TPMT enzyme, increasing risk of myelosuppression when coadministered with mercaptopurine. Use lowest possible doses and monitor frequently for myelosuppression.

Complete cross-resistance between mercaptopurine and thioguanine; concurrent use not recommended.

May increase methotrexate plasma concentrations, increasing risk of severe adverse reactions. Monitor closely.

Immunomodulator used concomitantly in approximately 30% of CD/UC subjects; safety and efficacy not adversely affected by combination.

Immunomodulator used concomitantly in approximately 30% of Crohn's disease and ulcerative colitis subjects. Use did not appear to influence overall safety or efficacy of ustekinumab.

Immunomodulator used concomitantly in approximately 30% of Crohn's disease and ulcerative colitis subjects. Use did not appear to influence overall safety or efficacy of ustekinumab.

Immunomodulator used concomitantly in approximately 30% of Crohn's disease and ulcerative colitis subjects; did not appear to influence overall safety or efficacy.

Used concomitantly in approximately 30% of Crohn's disease and ulcerative colitis subjects; did not appear to influence overall safety or efficacy.

Immunomodulator used concomitantly in approximately 30% of Crohn's disease and ulcerative colitis subjects; did not appear to influence overall safety or efficacy.

Immunomodulator used concomitantly in ~30% of CD/UC subjects; did not appear to influence overall safety or efficacy of ustekinumab.

Mercaptopurine may decrease anticoagulant effectiveness of warfarin. Monitor INR and adjust warfarin dosage as appropriate.

Enhanced myelosuppression has been noted in some patients receiving trimethoprim-sulfamethoxazole.