Drug interactions between Colazal and mercaptopurine
| Results for the following 2 drugs: |
|---|
| Colazal (balsalazide) |
| mercaptopurine |
Interactions between your selected drugs
mercaptopurine ↔ balsalazide
Applies to:mercaptopurine and Colazal (balsalazide)
MONITOR: Aminosalicylate derivatives (e.g., balsalazide, mesalamine, olsalazine, sulfasalazine) may potentiate the pharmacologic effects of purine antagonist antimetabolites (e.g., azathioprine, mercaptopurine, thioguanine). In vitro evidence indicates that aminosalicylate derivatives inhibit thiopurine methyltransferase (TPMT), the enzyme responsible for the metabolic clearance of cytotoxic thioguanine nucleotides that are formed from the antimetabolites in vivo. The interaction may be particularly severe in patients with low red blood cell TPMT activity. Even in the absence of an interaction, individuals with an inherited deficiency of TPMT are unusually sensitive to the myelosuppressive effects of purine antagonist antimetabolites and prone to developing rapid bone marrow suppression following the initiation of treatment with standard dosages. Between 0.3% to 1% of the population are TPMT-deficient and have low or no detectable TPMT activity (i.e. homozygous for low-activity alleles). Approximately 10% have intermediate TPMT activity (i.e. heterozygous for low-activity alleles), and they also tend to experience more bone marrow suppression than the majority of patients on usual dosages of the antimetabolites.
MANAGEMENT: Caution is advised if aminosalicylate derivatives must be used concomitantly with purine antagonist antimetabolites. Patients receiving the combination should be closely monitored for hematologic toxicity, and the antimetabolite dosage adjusted accordingly.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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