Drug & supplement interaction

Blue-green Algae + Azathioprine

Azathioprine brand names: Imuran, Azamune.

Moderate Interaction
The bottom line Moderate

Blue-green Algae has a moderate interaction with Azathioprine. Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Blue-green Algae and Azathioprine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Azathioprine

Azathioprine falls under IMMUNOSUPPRESSANTS — the group Blue-green Algae interacts with.

Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind this one. Azathioprine works by calming down your immune system, which is exactly what you need after a kidney transplant or for tough rheumatoid arthritis. Blue-green algae, like spirulina, may do the opposite and gently rev the immune system up. If that happens, the two could be working against each other, and in theory azathioprine might not hold your immune system back as well.

I want to be honest with you, though: this concern comes only from lab and animal studies, not from real patients, so it's more of a caution than a proven problem. Still, because the stakes (like organ rejection or a flare) are high, I wouldn't add this supplement on your own. Please run it by your transplant team or pharmacist first.

References
  1. Jensen GS, Ginsberg DJ, Huerta P, et al. Consumption of Aphanizomenon flos-aquae has rapid effects on the circulation and function of immune cells in humans. A novel approach to nutritional mobilization of the immune system. JANA 2000;2:50-6.
  2. Hayashi O, Katoh T, Okuwaki Y. Enhancement of antibody production in mice by dietary Spirulina platensis. J Nutr Sci Vitaminol (Tokyo) 1994;40:431-41.. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Blue-green Algae Also Interacts With Other Medications

Blue-green Algae has 326 moderate known drug interactions in our database — the Azathioprine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Blue-green Algae

Covers the 2,830 medications we’ve checked against Blue-green Algae. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Azathioprine

This page covers Blue-green Algae only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azathioprine page lists 106 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 4 major · 92 moderate · 10 minor.

From our pharmacist’s overview on the Azathioprine page

“Azathioprine (Imuran) quiets an overactive immune system, which is why people take it after a transplant or for autoimmune disease, and it is also why I read this interaction list with real caution. Fully half of the 106 supplements on file, 53 of them, appear because they stimulate immunity and could blunt the very effect you depend on.”

Reviewed by 2 · Jul 18, 2026

Open the Azathioprine interaction page

One more smart check

Taking Blue-green Algae as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,180 real supplement products containing Blue-green Algae, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Blue-green Algae. Your product may carry other ingredients that interact with Azathioprine too, on top of Blue-green Algae — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Blue-green Algae and Azathioprine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Blue-green Algae
Top 10%

#78 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Azathioprine
Top 25%

#607 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Blue-green Algae

What is Blue-green Algae?

Blue-green Algae
  • General nutrition and energy
  • Antioxidant support
  • Cholesterol and metabolic health
  • Immune support
  • Weight management

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most health claims is limited, and some products can be contaminated with toxins or heavy metals, so quality testing matters. Talk to your pharmacist or doctor before using, especially during pregnancy or breastfeeding.

Read the full Blue-green Algae monograph & all interactions
Medication

About Azathioprine

What Is Azathioprine Used For?

Brand names: Imuran, Azamune

Azathioprine is used alongside other medications to help prevent the body from rejecting a kidney transplant (renal homotransplantation). It is also used to treat active rheumatoid arthritis — reducing signs and symptoms in adults who have not responded well enough to other treatments.

Other pain relievers such as aspirin, NSAIDs, or low-dose steroids may be continued alongside azathioprine for rheumatoid arthritis. Combining azathioprine with disease-modifying antirheumatic drugs (DMARDs) has not been well studied and is not recommended.

See full Azathioprine drug information
Keep checking

Other Drugs & Blue-green Algae

Browse every other medication we’ve checked against Blue-green Algae — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
326Moderate
0Minor
2,503No known interaction
Moderate

326 interactions

Showing 60 of 326 moderate interactions — see all 326 on the Blue-green Algae page.

No interaction 2,503 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Blue-green Algae and Azathioprine Together: Common Questions

Can you take Blue-green Algae with Azathioprine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Blue-green Algae and Azathioprine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Azathioprine and Blue-green Algae?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.