lamivudine and Thioguanine Interactions

Interactions between lamivudine and Thioguanine (thioguanine)

thioguanine and lamivudine (Moderate Drug-Drug)

MONITOR: The concomitant or sequential use of thioguanine with agents known to induce hepatotoxicity may potentiate the risk of liver injury. Thioguanine has been associated with hepatotoxicity including elevated liver transaminases, hyperbilirubinemia, hepatomegaly, portal hypertension, hepatoportal sclerosis, peliosis hepatitis, and fibrosis.

MANAGEMENT: The use of thioguanine in combination with other potentially hepatotoxic agents (e.g., alcohol; androgens and anabolic steroids; antituberculous agents; azole antifungal agents; ACE inhibitors; endothelin receptor antagonists; interferons; nucleoside reverse transcriptase inhibitors; thiazolidinediones; anticonvulsants such as carbamazepine, hydantoins, felbamate, and valproic acid; lipid-lowering medications such as fenofibrate, HMG-CoA reductase inhibitors, and niacin; herbal products such as kava and echinacea) should be approached with caution. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Periodic monitoring of hepatic function is advisable.