after therapy is discontinued if immune competence has been restored.heparinMonitor Closely (1)azathioprine decreases effects of heparin by unknown mechanism. Use Caution/Monitor.hepatitis A vaccine inactivatedSerious - Use Alternative (1)azathioprine decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/b vaccineSerious - Use Alternative (1)azathioprine decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/typhoid vaccineSerious - Use Alternative (1)azathioprine decreases effects of hepatitis a/typhoid vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis b vaccineSerious - Use Alternative (1)azathioprine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.human papillomavirus vaccine, nonavalentSerious - Use Alternative (1)azathioprine decreases effects of human papillomavirus vaccine, nonavalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.human papillomavirus vaccine, quadrivalentSerious - Use Alternative (1)azathioprine decreases effects of human papillomavirus vaccine, quadrivalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.hydroxychloroquine sulfateSerious - Use Alternative (1)azathioprine and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.hydroxyureaMonitor Closely (1)azathioprine, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.idecabtagene vicleucelSerious - Use Alternative (1)azathioprine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ifosfamideMonitor Closely (1)ifosfamide, azathioprine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with ifosfamide may increase the risk of immunosuppression and myelosuppression.imidaprilMonitor Closely (1)imidapril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.infliximabSerious - Use Alternative (1)azathioprine and infliximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.influenza virus vaccine quadrivalentSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine quadrivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine quadrivalent, adjuvantedSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.influenza virus vaccine quadrivalent, cell-culturedSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine quadrivalent, cell-cultured by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine quadrivalent, intranasalSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine quadrivalent, intranasal by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine quadrivalent, recombinantMonitor Closely (1)azathioprine decreases effects of influenza virus vaccine quadrivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.influenza virus vaccine trivalentSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine trivalent, adjuvantedSerious - Use Alternative (1)azathioprine decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.influenza virus vaccine trivalent, recombinantMonitor Closely (1)azathioprine decreases effects of influenza virus vaccine trivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.isavuconazonium sulfateMonitor Closely (1)azathioprine and isavuconazonium sulfate both decrease immunosuppressive effects; risk of infection. Use Caution/Monitor.Japanese encephalitis virus vaccineSerious - Use Alternative (1)azathioprine decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.leflunomideSerious - Use Alternative (1)azathioprine and leflunomide both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.lisinoprilMonitor Closely (1)lisinopril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.lisocabtagene maraleucelSerious - Use Alternative (1)azathioprine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.lomustineMonitor Closely (1)lomustine and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.maitakeMonitor Closely (1)azathioprine increases and maitake decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.measles (rubeola) vaccineSerious - Use Alternative (1)azathioprine decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.measles mumps and rubella vaccine, liveSerious - Use Alternative (1)azathioprine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.measles, mumps, rubella and varicella vaccine, liveSerious - Use Alternative (1)azathioprine decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.meningococcal A C Y and W-135 polysaccharide vaccine combinedSerious - Use Alternative (1)azathioprine decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.meningococcal group B vaccineMonitor Closely (1)azathioprine decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.mercaptopurineMonitor Closely (1)azathioprine and mercaptopurine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.mesalamineMonitor Closely (1)mesalamine increases toxicity of azathioprine by Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Increased risk for blood disorders.mipomersenMonitor Closely (1)mipomersen, azathioprine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.moexiprilMonitor Closely (1)moexipril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.muromonab CD3Serious - Use Alternative (1)azathioprine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.mycophenolateSerious - Use Alternative (1)azathioprine and mycophenolate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ocrelizumabMonitor Closely (1)azathioprine and ocrelizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration of ocrelizumab with immunosuppessants is expected to increase the risk of immunosuppression.olaparibMonitor Closely (1)azathioprine and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity. oxaliplatinMonitor Closely (1)oxaliplatin and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.ozanimodMonitor Closely (1)ozanimod, azathioprine. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration with immunosuppressive therapies may increase the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs in order to avoid unintended additive immunosuppressive effects.perindoprilMonitor Closely (1)perindopril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.pexidartinibSerious - Use Alternative (1)azathioprine and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.phenindioneMonitor Closely (1)azathioprine decreases effects of phenindione by unknown mechanism. Use Caution/Monitor.pneumococcal vaccine 13-valentSerious - Use Alternative (1)azathioprine decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine heptavalentSerious - Use Alternative (1)azathioprine decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine polyvalentSerious - Use Alternative (1)azathioprine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.poliovirus vaccine inactivatedMonitor Closely (1)azathioprine decreases effects of poliovirus vaccine inactivated by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .ponesimodMonitor Closely (1)ponesimod and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.pretomanidSerious - Use Alternative (1)azathioprine, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.protamineMonitor Closely (1)azathioprine decreases effects of protamine by unknown mechanism. Use Caution/Monitor.quinaprilMonitor Closely (1)quinapril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.rabies vaccineSerious - Use Alternative (1)azathioprine decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.rabies vaccine chick embryo cell derivedSerious - Use Alternative (1)azathioprine decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.ramiprilMonitor Closely (1)ramipril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.rilonaceptSerious - Use Alternative (1)azathioprine and rilonacept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.rotavirus oral vaccine, liveSerious - Use Alternative (1)azathioprine decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.rubella vaccineSerious - Use Alternative (1)azathioprine decreases effects of rubella vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.siponimodMonitor Closely (1)siponimod and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.sipuleucel-TMonitor Closely (1)azathioprine decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.sirolimusSerious - Use Alternative (1)azathioprine and sirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.smallpox (vaccinia) vaccine, liveSerious - Use Alternative (1)azathioprine decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.sulfamethoxazoleMinor (1)sulfamethoxazole, azathioprine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Leukopenia due to additive myelosuppression.tacrolimusSerious - Use Alternative (1)azathioprine and tacrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.temsirolimusSerious - Use Alternative (1)azathioprine and temsirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tetanus toxoid adsorbed or fluidSerious - Use Alternative (1)azathioprine decreases effects of tetanus toxoid adsorbed or fluid by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tick-borne encephalitis vaccineSerious - Use Alternative (1)azathioprine decreases effects of tick-borne encephalitis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tisagenlecleucelSerious - Use Alternative (1)azathioprine, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tocilizumabSerious - Use Alternative (1)tocilizumab and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tofacitinibSerious - Use Alternative (1)azathioprine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tongkat aliSerious - Use Alternative (1)azathioprine and tongkat ali both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.trandolaprilMonitor Closely (1)trandolapril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.trastuzumabMonitor Closely (1)trastuzumab, azathioprine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .trastuzumab deruxtecanMonitor Closely (1)trastuzumab deruxtecan, azathioprine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .travelers diarrhea and cholera vaccine inactivatedSerious - Use Alternative (1)azathioprine decreases effects of travelers diarrhea and cholera vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.typhoid polysaccharide vaccineSerious - Use Alternative (1)azathioprine decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.typhoid vaccine liveSerious - Use Alternative (1)azathioprine decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.ublituximabMonitor Closely (1)ublituximab and azathioprine both increase immunosuppressive effects; risk