Drug Interactions between mercaptopurine and ponesimod
This report displays the potential drug interactions for the following 2 drugs:
- mercaptopurine
- ponesimod
Interactions between your drugs
mercaptopurine ponesimod
Applies to: mercaptopurine and ponesimod
MONITOR CLOSELY: Coadministration of ponesimod with antineoplastic, immunosuppressive, or other immune-modulating therapies may increase the risk of unintended additive immunosuppressive effects. Ponesimod causes reversible sequestration of lymphocytes in lymphoid tissues. When administered daily, ponesimod produces a dose-dependent reduction in peripheral lymphocyte count to 30% to 40% of baseline values, which may increase the risk of infections. Life-threatening and rare fatal infections have been reported in association with sphingosine 1-phosphate (S1P) receptor modulators. Decreased lymphocyte counts persist during chronic daily dosing and generally return to normal within 1 week after stopping the medication. Because residual pharmacodynamic effects, such as decreased peripheral lymphocytes, may persist for 1 to 2 weeks after the last dose, use of immunosuppressants during this time may also lead to additive immune effects.
MANAGEMENT: The safety and efficacy of ponesimod in combination with antineoplastic, immunosuppressive, or immune-modulating agents have not been evaluated. Caution is advised during coadministration and for 1 to 2 weeks after the last dose of ponesimod. When switching from drugs with prolonged immune effects to ponesimod, the half-life and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects while at the same time minimizing risk of disease reactivation.
References
- (2021) "Product Information. Ponvory (ponesimod)." Janssen Pharmaceuticals
Drug and food interactions
mercaptopurine food
Applies to: mercaptopurine
ADJUST DOSING INTERVAL: Limited data suggest that food may decrease the oral bioavailability of 6-mercaptopurine (6-MP). In one study, the pharmacokinetics of 6-MP were studied on two separate occasions in seven patients. A single dose of 6-MP was administered after an overnight fast on one occasion and 15 minutes after a standard breakfast on the other. The authors reported that peak plasma levels of 6-MP were lower and took longer to reach following administration in the fed state. In addition, plasma levels were undetectable (less than 20 ng/mL) in two patients.
MANAGEMENT: Until more information is available regarding the effect of food on 6-MP absorption, it may be advisable to take 6-MP on an empty stomach 1 hour before or 2 hours after a meal.
References
- Schmidt LE, Dalhoff K (2002) "Food-drug interactions." Drugs, 62, p. 1481-502
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Check Interactions
To view an interaction report containing 4 (or more) medications, please sign in or create an account.
Save Interactions List
Sign in to your account to save this drug interaction list.