TNF Blockers/Azathioprine; Mercaptopurine
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
How this interaction occurs is not known.
What might happen:
Taking these medicines together may increase your risk of developing a rare, but usually fatal, cancer called hepatosplenic T-cell lymphoma (HSTCL).
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Discuss the risks and benefits of therapy with your doctor. Report any usual symptoms to your doctor right away, especially abdominal pain, persistent fevers, night sweats, and unexplained weight loss.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.US Food and Drug Administration (FDA). FDA Drug Safety Communication: Safety Review update on reports of Hepatosplenic T-Cell Lymphoma in adolescents and young adults receiving tumor necrosis factor (TNF) blockers, azathioprine and/or mercaptopurine. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm250913.htm April 14, 2011.
2.Remicade (infliximab) US prescribing information. Janssen Biotech, Inc. March, 2013.
3.Humira (adalimumab) US prescribing information. Abbott Laboratories May, 2012.
4.Mackey AC, Green L, Liang LC, Dinndorf P, Avigan M. Hepatosplenic T cell lymphoma associated with infliximab use in young patients treated for inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2007 Feb; 44(2):265-7.
