AdultPediatricDosage Forms & Strengths tablet 50mg 75mg 100mg powder for injection 100mg/vial Kidney Transplantation Prevention of transplant rejection 3-5 mg/kg/day IV/PO initially on day of transplant; 1 to 3 days prior to transplantation also reported (rare) Maintenance: 1-3 mg/kg/day IV/PO Rheumatoid Arthritis 1 mg/kg/day IV/PO initially in single daily dose or divided q12hr; after 6-8 weeks, increase by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached Lupus Nephritis (Off-label) Induction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines) 2 mg/kg/day PO with or without low-dose corticosteroids Crohn Disease (Off-label) Maintenance, remission, or reduction of steroid 2-3 mg/kg PO once daily Ulcerative Colitis (Off-label) Maintenance, remission, or reduction of steroid 1.5-2.5 mg/kg PO once daily Chronic Refractory Thrombocytopenic Purpura (Off-label) 1-2 mg/kg PO once daily to maximum daily dose of 150 mg for at least 3-6 months before typical response is observed Dosing considerations Lower dosage (100 mg/day) is reported effective in some patients Longer treatment duration (up to 84 months) is reported in some patients Dosage Forms & Strengths tablet 50mg 75mg 100mg powder for injection 100mg/vial Juvenile Idiopathic Arthritis 1 mg/kg/day IV/PO initially in single daily dose or divided q12hr; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached Transplantation (Off-label) Prevention of transplant rejection 3-5 mg/kg/day IV/PO initially on day of transplant or 3 days before transplant (rare) Maintenance: 1-3 mg/kg/day IV/PO Lupus Nephritis (Off-label) Induction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines) <12 years: Safety and efficacy not established >12 years: 2 mg/kg/day PO with or without low-dose corticosteroidsInteraction CheckerEnter a drug name and azathioprineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (2)febuxostatfebuxostat increases levels of azathioprine by decreasing metabolism. Contraindicated.upadacitinibazathioprine, upadacitinib. Either increases effects of the other by immunosuppressive effects; risk of infection. Contraindicated.Serious - Use Alternative (73)adalimumabadalimumab and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.adenovirus types 4 and 7 live, oralazathioprine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.alefaceptalefacept and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.allopurinolallopurinol increases levels of azathioprine by decreasing metabolism. Avoid or Use Alternate Drug. Increased risk of bone marrow toxicity.anakinraanakinra and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.anthrax vaccineazathioprine decreases effects of anthrax vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin equineantithymocyte globulin equine and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.antithymocyte globulin rabbitantithymocyte globulin rabbit and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.axicabtagene ciloleucelazathioprine, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.baricitinibbaricitinib, azathioprine. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Baricitinib is not recommended in combination with other JAK inhibitors, biologic DMARDs, or potent immunosuppressives.basiliximabazathioprine and basiliximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.BCG vaccine liveazathioprine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.brexucabtagene autoleucelazathioprine, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.canakinumabazathioprine and canakinumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ciltacabtagene autoleucelazathioprine, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.diphtheria & tetanus toxoidsazathioprine decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/ acellular pertussis vaccineazathioprine decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccineazathioprine decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.etanerceptazathioprine and etanercept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.everolimusazathioprine and everolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.glatiramerazathioprine and glatiramer both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.golimumabazathioprine and golimumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.hepatitis A vaccine inactivatedazathioprine decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/b vaccineazathioprine decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/typhoid vaccineazathioprine decreases effects of hepatitis a/typhoid vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis b vaccineazathioprine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.human papillomavirus vaccine, nonavalentazathioprine 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, quadrivalentazathioprine 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 sulfateazathioprine and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.idecabtagene vicleucelazathioprine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.infliximabazathioprine and infliximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.influenza virus vaccine quadrivalentazathioprine 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, adjuvantedazathioprine 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-culturedazathioprine 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, intranasalazathioprine 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 trivalentazathioprine 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, adjuvantedazathioprine 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.Japanese encephalitis virus vaccineazathioprine decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.leflunomideazathioprine and leflunomide both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.lisocabtagene maraleucelazathioprine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.measles (rubeola) vaccineazathioprine 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, liveazathioprine 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, liveazathioprine 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 combinedazathioprine 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.muromonab CD3azathioprine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.mycophenolateazathioprine and mycophenolate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.pexidartinibazathioprine 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.pneumococcal vaccine 13-valentazathioprine decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine heptavalentazathioprine decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine polyvalentazathioprine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pretomanidazathioprine, 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.rabies vaccineazathioprine decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.rabies vaccine chick embryo cell derivedazathioprine decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.rilonaceptazathioprine and rilonacept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.rotavirus oral vaccine, liveazathioprine decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.rubella vaccineazathioprine decreases effects of rubella vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.sirolimusazathioprine and sirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.smallpox (vaccinia) vaccine, liveazathioprine decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tacrolimusazathioprine and tacrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.temsirolimusazathioprine and temsirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tetanus toxoid adsorbed or fluidazathioprine 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 vaccineazathioprine decreases effects of tick-borne encephalitis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tisagenlecleucelazathioprine, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tocilizumabtocilizumab and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tofacitinibazathioprine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tongkat aliazathioprine and tongkat ali both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.travelers diarrhea and cholera vaccine inactivatedazathioprine 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 vaccineazathioprine decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.typhoid vaccine liveazathioprine decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.ustekinumabazathioprine and ustekinumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.varicella virus vaccine liveazathioprine decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.yellow fever vaccineazathioprine decreases effects of yellow fever vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.zoster vaccine liveazathioprine decreases effects of zoster vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.Monitor Closely (56)antithrombin alfaazathioprine decreases effects of antithrombin alfa by unknown mechanism. Use Caution/Monitor.antithrombin IIIazathioprine decreases effects of antithrombin III by unknown mechanism. Use Caution/Monitor.argatrobanazathioprine decreases effects of argatroban by unknown mechanism. Use Caution/Monitor.astragalusazathioprine increases and astragalus decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.belataceptbelatacept and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.bemiparinazathioprine decreases effects of bemiparin by unknown mechanism. Use Caution/Monitor.benazeprilbenazepril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.bivalirudinazathioprine decreases effects