Is concomitant use of azathioprine and febuxostat safe from a bone marrow toxicity standpoint?
4 Answers
Mednet MemberInvited Expert
Rheumatology · Ohio State University
Answered on
No- Logan et al., PMID 31885095.
See evidence. If you must use both for outside reasons- start really low and slow and monitor very very closely!
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Mednet MemberInvited Expert
Rheumatology · Mobile Medical Care Inc
Answered on
There is more reason to consider a transition from azathioprine to another agent, such as mycophenolate than to take the risk of myelosuppression.
Mycophenolate is safe in combination with febuxostat.
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Mednet MemberInvited Expert
Rheumatology · UTMB Health
Answered on
Generally, I would avoid using both allopurinol (and/or febuxostat) and azathioprine (Imuran) together. The risk of course is bone marrow aplasia, as we know.
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Mednet Member
Rheumatology · Duke University Medical Center
Answered on
No, the use of the two in combination is contraindicated.
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