Acenocoumarol Adverse Effect Reduced acenocoumarol therapeutic efficacyClinical Management In patients receiving acenocoumarol therapy, the prothrombin time or INR (international normalized ratio) should be closely monitored with the addition and withdrawal of treatment with mercaptopurine, and should be reassessed periodically during concurrent therapy. Adjustments of the acenocoumarol dose may be necessary in order to maintain the desired level of anticoagulation.
Allopurinol Adverse Effect mercaptopurine toxicity (bone marrow suppression, nausea, vomiting)Clinical Management The dose of oral mercaptopurine should be reduced to 1/3 (33%) to 1/4 (25%) of the usual dose when given concomitantly with allopurinol (note that this is a 67% to 75% dose reduction).
Mesalazine - Antisecr.Adverse Effect an increased risk of bone marrow suppressionClinical Management If olsalazine and 6-mercaptopurine are coadministered, use the lowest possible doses of each drug and monitor the patient for bone marrow suppression, especially leukopenia.
Methotrexate Adverse Effect mercaptopurine toxicity (nausea, vomiting, delayed leukopenia)Clinical Management Monitor patients for increased mercaptopurine toxicity (nausea, vomiting, delayed leukopenia).
WarfarinAdverse Effect: decreased anticoagulant effectivenessClinical Management:Adjustments of the warfarin dose may be necessary in order to maintain the desired level of anticoagulation. |