When co-administration is necessary, the dose of 6-mercaptopurine
This dosage reduction does not appear to be necessary when intravenous 6-MP is given. Do not start, stop, or change the dosage of any medicine before checking with them first.Selected from data included with permission and copyrighted by First Databank, Inc. a report of an interaction between azathioprine and allopurinol. Manufacturer advises adjust azathioprine dose. In contrast, two pharmacokinetic studies in man as well as two toxicologic studies in animals detected no differences for intravenous thiopurines combined with allopurinol. A Serious and Known Drug Interaction6‐MP metabolite profiles provide a biochemical explanation for 6‐MP resistance in patients with inflammatory bowel diseaseSevere hepatotoxicity with high 6‐methylmercaptopurine nucleotide concentrations after thiopurine dose escalation due to low 6‐thioguanine nucleotidesEffect of allopurinol on clinical outcomes in inflammatory bowel disease nonresponders to azathioprine or 6‐mercaptopurineAllopurinol safely and effectively optimizes tioguanine metabolites in inflammatory bowel disease patients not responding to azathioprine and mercaptopurineLow‐dose allopurinol plus azathioprine/cyclosporin/prednisolone, a novel immunosuppressive regimenThiopurine hepatotoxicity in inflammatory bowel disease: the role for adding allopurinolLong term efficacy and safety of allopurinol and azathioprine or 6‐mercaptopurine in patients with inflammatory bowel diseaseUse of allopurinol with low‐dose 6‐mercaptopurine in inflammatory bowel disease to achieve optimal active metabolite levels: a review of four cases and the literatureInitial clinical experience with allopurinol‐thiopurine combination therapy in pediatric inflammatory bowel diseaseLong‐term outcome of using allopurinol co‐therapy as a strategy for overcoming thiopurine hepatotoxicity in treating inflammatory bowel diseaseAzathioprine and 6‐mercaptopurine pharmacogenetics and metabolite monitoring in inflammatory bowel diseaseThe frequency and distribution of thiopurine methyltransferase alleles in Caucasian and Asian populationsDistribution of TPMT risk alleles for thiopurine [correction of thioupurine] toxicity in the Israeli populationEthnic variation of thiopurine S‐methyltransferase activity: a large, prospective population studyFunctional characterization of human xanthine oxidase allelic variantsSafety of systemic treatments for Behçet’s syndrome, Journal of the European Academy of Dermatology and Venereology, Evidence‐based Gastroenterology and Hepatology 4e, Pharmacological urate-lowering approaches in chronic kidney disease, The Impact of Thiopurine Metabolite Monitoring on the Durability of Thiopurine Monotherapy in Pediatric IBD, Side Effects and Interactions of the Xanthine Oxidase Inhibitor Febuxostat, Life‐threatening drug interactions: what the physician needs to know, Role of Allopurinol in Optimizing Thiopurine Therapy in Patients with Autoimmune Hepatitis: A Review, Therapeutic Drug Monitoring in Pediatric Inflammatory Bowel Disease, Therapeutic Drug Monitoring in Inflammatory Bowel Disease, Evaluation of a New Molecular Entity as a Victim of Metabolic Drug-Drug Interactions--an Industry Perspective, Allopurinol enhanced thiopurine treatment for inflammatory bowel disease: safety considerations and guidelines for use, Tumor Lysis Syndrome: New Challenges and Recent Advances, Practical guidelines for the use of steroid‐sparing agents in the treatment of chronic pruritus, Allopurinol use in pregnancy in three women with inflammatory bowel disease: safety and outcomes: a case series, Thiopurine metabolite measurement leads to changes in management of inflammatory bowel disease, Nuclear receptors in the multidrug resistance through the regulation of drug-metabolizing enzymes and drug transporters, Review article: the benefits of pharmacogenetics for improving thiopurine therapy in inflammatory bowel disease, Pharmacology of Immunosuppressive Medications in Solid Organ Transplantation, Febuxostat for the treatment of hyperuricemia in patients with gout, Gout and Transplantation: New Treatment Option—Same Old Drug Interaction, Drug Monitoring in Systemic Lupus Erythematosus: A Systematic Review, }", This means your immune system becomes weaker. This substantiates the clinical significance of this important drug interaction. It does this by blocking one of the enzymes used to break down azathioprine. the patient about 6 months to feel well again.Azathioprine is an immunosuppressive agent. By continuing to browse this site, you agree to its use of cookies as described in our I have read and accept the Wiley Online Library Terms and Conditions of UseNSW Health Safety Notice. Manufacturer advises adjust azathioprine dose. %> 6-mercaptopurine, which in turn is converted to inactive products by xanthine
MMF, which blocks de novo purine synthesis by inhibiting inosine monophosphate dehydrogenase, has been reported to induce bone marrow toxicity albeit to a lesser extent than azathioprine . We have recently observed a patient who experienced profound myelosuppression while inadvertently receiving azathioprine and allopurinol as immunosuppressive therapy.