Drug interactions
Aprepitant + Tofacitinib
Severity: Moderate
Aprepitant and Tofacitinib: moderate interaction.
Last updated
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
Tofacitinib is cleared mainly by CYP3A4 with a smaller CYP2C19 contribution, so aprepitant may modestly raise its levels. This could increase the risk of infection and cytopenias, particularly if a CYP2C19 inhibitor is also being taken.
What this interaction means in plain words
Aprepitant and Tofacitinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aprepitant belongs to Gastrointestinal Tract; Tofacitinib belongs to Musculoskeletal.
Why it happens
Aprepitant inhibits CYP3A4, reducing tofacitinib clearance.
What to do
No routine dose change is needed with a moderate CYP3A4 inhibitor alone, but monitor for infection and cytopenias. Reduce the tofacitinib dose if a potent CYP2C19 inhibitor is also being used.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
Frequently asked questions
Can I take Aprepitant with Tofacitinib?
MediHelp rates the interaction as moderate. Aprepitant and Tofacitinib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tofacitinib is cleared mainly by CYP3A4 with a smaller CYP2C19 contribution, so aprepitant may modestly raise its levels. This could increase the risk of infection and cytopenias, particularly if a CYP2C19 inhibitor is also being taken.
How serious is the interaction between Aprepitant and Tofacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed with a moderate CYP3A4 inhibitor alone, but monitor for infection and cytopenias. Reduce the tofacitinib dose if a potent CYP2C19 inhibitor is also being used.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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