Drug interactions
Antithymocyte globulin equine + Ustekinumab
Severity: Major
Antithymocyte globulin equine and Ustekinumab: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Equine antithymocyte globulin causes profound T-cell depletion and increases risk of serious and opportunistic infections. Adding ustekinumab may increase infection risk further.
What this interaction means in plain words
Antithymocyte globulin equine and Ustekinumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive immunosuppression from T-cell depletion and IL-12/IL-23 blockade.
What to do
Hold ustekinumab during ATG treatment unless clearly needed. Monitor closely for infection.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Otulfi 130 mg concentrate for solution for infusion - SmPC sections 4.3/4.5 (class statement: immunosuppressants; "In psoriasis studies, the safety and efficacy of ustekinumab in combination with immunosuppressants, including biologics, or phototherapy have not been evaluate") — electronic medicines compendium (UK SmPC)
Other interactions of Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
Frequently asked questions
Can I take Antithymocyte globulin equine with Ustekinumab?
MediHelp rates the interaction as major. Antithymocyte globulin equine and Ustekinumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Equine antithymocyte globulin causes profound T-cell depletion and increases risk of serious and opportunistic infections. Adding ustekinumab may increase infection risk further.
How serious is the interaction between Antithymocyte globulin equine and Ustekinumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Hold ustekinumab during ATG treatment unless clearly needed. Monitor closely for infection.
What other medicines interact with Ustekinumab?
MediHelp also lists interactions of Ustekinumab with, for example, Bcg vaccine live, Typhoid vaccine live, Adalimumab. The full list is on the Ustekinumab page.
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