Can you take Azathioprine with Myhibbin?

azaTHIOprine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Azathioprine may cause severe leukopenia, thrombocytopenia, macrocytic anemia, severe bone marrow depression and, rarely, pure red cell aplasia. Therapy with azathioprine should be administered cautiously in patients with bone marrow depression. Hematological toxicities are dose related. Caution and routine monitoring of blood counts and platelets is recommended. Patients should report any unusual bleeding or bruising.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Gastrointestinal Hemorrhage.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

azaTHIOprine has a major potential interaction with Infection.

Serious infections, including reactivation of latent infections have been reported with the use of azathioprine. Cases of JC virus-associated infection resulting in progressive multifocal leukoencephalopathy (PML), sometimes fatal, have been reported in patients treated with immunosuppressants, including azathioprine. A diagnosis of PML should be considered in any patient presenting with new-onset neurological manifestations and a consultation with a neurologist is recommended. Consider reducing the amount of immunosuppression in patients who develop PML, and in transplant patients, consider the risk that the reduced immunosuppression represents to the graft.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Inflammatory Bowel Disease.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Lesch-Nyhan Syndrome.

Mycophenolate mofetil is an inosine monophosphate dehydrogenase (IMPDH) inhibitor; therefore it should be avoided in patients with hereditary deficiencies of hypoxanthine-guanine phosphoribosyl-transferase (HGPRT) such as Lesch-Nyhan and Kelley-Seegmiller syndromes because it may cause an exacerbation of disease symptoms characterized by the overproduction and accumulation of uric acid leading to symptoms associated with gout such as acute arthritis, tophi, nephrolithiasis or urolithiasis and renal disease including renal failure.

azaTHIOprine has a moderate potential interaction with Liver Disease.

Azathioprine is metabolically converted to the pharmacologically active 6-mercaptopurine (6-MP). Conversion to 6-MP and metabolism of 6-MP may be impaired in patients with liver disease. Therapy with azathioprine should be administered cautiously in patients with liver disease. Monitoring liver function is recommended in these patients.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Liver Disease.

Mycophenolate mofetil (inactive) undergoes complete presystemic metabolism to active MPA , further metabolism to inactive forms, some of which undergo enterohepatic circulation producing a second peak of MPA. Alcoholic cirrhosis (parenchymal cell damage) does not appear to affect the metabolism of MPA to inactive forms. Hepatic disease/dysfunction due to other etiologies may induce different effects.

The mycophenolate mofetil in Myhibbin has a major potential interaction with Neutropenia.

Severe neutropenia has occurred in up to 2% of patients administered mycophenolate. Therapy with mycophenolate should be administered cautiously in patients with or predisposed to neutropenia. Mycophenolate should be discontinued or the dose reduced in patients who develop neutropenia (absolute neutrophil count <1300/mm3). Clinical monitoring of hematopoietic function is recommended. Complete blood counts should be performed weekly during the first month, two times a month during the second and third months, and monthly for the remainder of the first year of treatment.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Peptic Ulcer.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

azaTHIOprine has a major potential interaction with Renal Dysfunction.

Azathioprine may accumulate in patients with impaired renal function. Therapy with azathioprine should be administered cautiously and may need dosage reduction in patients with impaired renal function.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Renal Dysfunction.

Mycophenolate undergoes complete presystemic metabolism to its active form, MPA . Less than 1% of MPA is excreted in the urine. In a single-dose study, the area under the curve (AUC) for MPA in patients with severe chronic renal impairment (creatinine clearance <25 mL/min) was approximately 75% greater than those of healthy volunteers (creatinine clearance >80 mL/min). The AUC for the inactive metabolite was 3 to 6 times higher. Multiple dose studies have not been performed. No data are available for cardiac transplant patients with severe renal impairment and when benefit outweighs risk, therapy with mycophenolate should be administered with extreme caution.

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Vaccination.

During treatment with mycophenolate mofetil, the use of live attenuated vaccines should be avoided and patients should be advised that vaccinations may be less effective. Advise patients to discuss with the physician before seeking any immunizations.