The haematological effects of azathioprine are markedly increased by the concurrent use of allopurinol. Azathioprine is rapidly and extensively metabolised to mercapto- purine. Mercaptopurine is therefore expected to share the interactions of azathioprine.
The dosage of azathioprine or mercaptopurine should be reduced by two-thirds to three-quarters to minimise the risk of toxicity. Despite taking these precautions toxicity may still be seen and very close haematological monitoring is advisable if concurrent use is necessary.
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