Drug interactions
Baricitinib + Tocilizumab
Severity: Major
Baricitinib and Tocilizumab: 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
Baricitinib is not recommended with biologic DMARDs such as tocilizumab because of added immunosuppression. The combination raises the risk of serious infections including opportunistic and tuberculous infection.
What this interaction means in plain words
Baricitinib and Tocilizumab 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.
Baricitinib belongs to Musculoskeletal; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from IL-6 receptor blockade and JAK inhibition.
What to do
Avoid combining these drugs and use only one for the rheumatic indication. If overlap occurs, monitor for infection and stop both if a serious infection develops.
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 Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab Contraindicated
Other interactions of Baricitinib
- Adenovirus types 4 and 7 live + Baricitinib Contraindicated
- Baricitinib + Bcg vaccine live Contraindicated
- Baricitinib + Tofacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Abatacept + Baricitinib Major
- Adalimumab + Baricitinib Major
Frequently asked questions
Can I take Baricitinib with Tocilizumab?
MediHelp rates the interaction as major. Baricitinib and Tocilizumab 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. Baricitinib is not recommended with biologic DMARDs such as tocilizumab because of added immunosuppression. The combination raises the risk of serious infections including opportunistic and tuberculous infection.
How serious is the interaction between Baricitinib and Tocilizumab?
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 combining these drugs and use only one for the rheumatic indication. If overlap occurs, monitor for infection and stop both if a serious infection develops.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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