Drug interactions
Axicabtagene ciloleucel + Leflunomide
Severity: Major
Axicabtagene ciloleucel and Leflunomide: major 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
Leflunomide's immunosuppressive effects could impair the expansion and persistence of CAR T cells and add to infection risk. Its long-lasting active metabolite makes the effect difficult to reverse quickly.
What this interaction means in plain words
Axicabtagene ciloleucel and Leflunomide 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.
Axicabtagene ciloleucel belongs to Oncology; Leflunomide belongs to Musculoskeletal.
Why it happens
Inhibition of dihydroorotate dehydrogenase suppresses activated lymphocyte proliferation, potentially blunting CAR T-cell expansion.
What to do
Avoid leflunomide around CAR T-cell therapy; if it has been used, consider accelerated elimination with cholestyramine before cell infusion and monitor 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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Other interactions of Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Other interactions of Axicabtagene ciloleucel
Frequently asked questions
Can I take Axicabtagene ciloleucel with Leflunomide?
MediHelp rates the interaction as major. Axicabtagene ciloleucel and Leflunomide 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. Leflunomide's immunosuppressive effects could impair the expansion and persistence of CAR T cells and add to infection risk. Its long-lasting active metabolite makes the effect difficult to reverse quickly.
How serious is the interaction between Axicabtagene ciloleucel and Leflunomide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid leflunomide around CAR T-cell therapy; if it has been used, consider accelerated elimination with cholestyramine before cell infusion and monitor for infection.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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