This article lists drugs that interact with azathioprine and increase the risk of myelosuppression (or other adverse effects): 1. Allopurinol, used in the treatment of gout, inhibits azathioprine metabolism; when both must be taken together, the azathioprine dose should be reduced to 1/4. If allopurinol is prescribed by a physician in another department, it is necessary to inform us promptly so that the dose can be adjusted accordingly The dose of azathioprine or 6 mercaptopurine should be adjusted accordingly. 2. Compounded sulfamethoxazole, ACE inhibitor, cimetidine, indomethacin (anti-inflammatory pain): increased risk of bone marrow suppression. 3, Warfarin: Azathioprine inhibits warfarin anticoagulation. 4.General anesthetic drugs, azathioprine affects the action of a variety of muscle relaxants; anesthesiologists should be informed in the use of azathioprine. 5.Infliximab and other immunosuppressants: may increase the risk of myelosuppression; increase the risk of lymphoma and infection. 6. Aminosalicylic acids such as mesalazine, olsalazine, and salazosulfapyridine. Combination with aminosalicylic acid (especially salazosulfapyridine) may increase the risk of bone marrow suppression. 7. Live vaccines are contraindicated! Azathioprine and other immunosuppressants can cause atypical and dangerous vaccination reactions that can make you get this disease you want to prevent. 8. Live attenuated vaccines. May not be very effective, because immunosuppressants may prevent your organism from reacting as it should have done. For example, the hepatitis B vaccine. Other drugs that may interact with each other: 1. Ribavirin. A retrospective study found that eight patients treated with azathioprine, ribavirin, and interferon experienced severe allogeneic cytopenia. Ribavirin inhibits an enzyme in the metabolic bypass of azathioprine. Patients treated with both drugs should be monitored more frequently (every 2 weeks) for blood work. 2. Drugs that cause granulocyte deficiency or allocytopenia (e.g., clozapine, aniracetam) and concomitant azathioprine increase the risk of bone marrow suppression and require frequent monitoring of blood work. Also, if you drink large amounts of milk daily, it may interfere with the effects of 6 mercaptopurine or azathioprine. Therefore, do not consume milk at the same time as taking the medication.