Is concomitant use of azathioprine and febuxostat safe from a bone marrow toxicity standpoint?
4 Answers
Mednet Member
Rheumatology · Ohio State University
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!
Mednet Member
Rheumatology · Mobile Medical Care Inc
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.
Mednet Member
Rheumatology · UTMB Health
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.