Drug interactions
Axicabtagene ciloleucel + Tofacitinib
Severity: Major
Axicabtagene ciloleucel and Tofacitinib: 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
Tofacitinib's immunosuppression may impair CAR-T expansion and efficacy, and adds to the infection risk that follows lymphodepletion and CAR-T therapy. Prior use of immunosuppressants is generally minimized around infusion.
What this interaction means in plain words
Axicabtagene ciloleucel and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
JAK inhibition suppresses T-cell signalling and may reduce CAR-T activity, with additive immunosuppression.
What to do
Hold tofacitinib around leukapheresis and infusion as advised by the treating team. 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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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
Other interactions of Axicabtagene ciloleucel
Frequently asked questions
Can I take Axicabtagene ciloleucel with Tofacitinib?
MediHelp rates the interaction as major. Axicabtagene ciloleucel and Tofacitinib 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. Tofacitinib's immunosuppression may impair CAR-T expansion and efficacy, and adds to the infection risk that follows lymphodepletion and CAR-T therapy. Prior use of immunosuppressants is generally minimized around infusion.
How serious is the interaction between Axicabtagene ciloleucel and Tofacitinib?
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 tofacitinib around leukapheresis and infusion as advised by the treating team. Monitor closely for infection.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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