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Can I take Azathioprine and Biktarvy together?

Drug interaction guide

Both azathioprine and the components of Biktarvy (specifically tenofovir alafenamide) can lower your white blood cell count. Taking them together may increase the risk of your immune system becoming too weak, making you more likely to pick up infections. There is also a potential for increased stress on the liver.

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Why this happens

This is an 'additive' effect. Azathioprine is an immunosuppressant that can cause bone marrow suppression (lowering blood cell production). While Biktarvy is generally well-tolerated, some of its components can occasionally affect blood counts or liver enzymes. When used together, these side effects may be more likely to occur.

You can usually take these medicines together, but you must have regular blood tests. Your doctor will want to monitor your full blood count (FBC) and liver function closely, especially when starting treatment or changing doses. If you develop a fever, sore throat, unusual bruising, or extreme tiredness, contact your doctor immediately.

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Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 14 Mar 2026 | Originally published
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