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Drug Interactions between Proloprim and Purixan

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

trimethoprim mercaptopurine

Applies to: Proloprim (trimethoprim) and Purixan (mercaptopurine)

MONITOR: Even though the combination is used in clinical practice, the risk of bone marrow suppression may be increased when azathioprine or mercaptopurine is coadministered with trimethoprim or sulfamethoxazole-trimethoprim (co-trimoxazole). The risk may be increased when concurrent therapy is longer than 3 weeks. Thrombocytopenia and neutropenia have been reported; however, data have been conflicting. The mechanism is unknown, but may be related to additive myelosuppressive effects and hemodialysis-induced folate depletion.

MANAGEMENT: Close clinical and laboratory monitoring for the development of hematologic adverse effects is recommended both during and after discontinuation of therapy. Dosage adjustment of azathioprine or mercaptopurine may be considered if an interaction is suspected. Patients should be advised to promptly report symptoms such as chills, fever, malaise, sore throat, mouth sores, unusual fatigue, bruising, or bleeding.

References

  1. Berg KJ, Gjellestad A, Nordby G, et al. (1989) "Renal effects of trimethoprim in ciclosporin- and azathioprine-treated kidney-allografted patients." Nephron, 53, p. 218-22
  2. Bailey RR (1984) "Leukopenia due to a trimethoprim-azathioprine interaction." N Z Med J, 97, p. 739
  3. (2002) "Product Information. Imuran (azathioprine)." Glaxo Wellcome
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  6. Cerner Multum, Inc. "Australian Product Information."
View all 6 references

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Drug and food interactions

Moderate

mercaptopurine food

Applies to: Purixan (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

  1. Schmidt LE, Dalhoff K (2002) "Food-drug interactions." Drugs, 62, p. 1481-502

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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

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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