Drug interactions
Canakinumab + Tocilizumab
Severity: Major
Canakinumab 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
Both drugs inhibit interleukin signalling and combining them increases the risk of serious infection. Labeling for interleukin-1 blockers advises against combination with other biologic immunosuppressants.
What this interaction means in plain words
Canakinumab 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.
Canakinumab belongs to Miscellaneous; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from IL-6 receptor blockade and IL-1 beta neutralisation.
What to do
Avoid concurrent use where possible and choose a single biologic. If combined, monitor closely for infection and stop at the first sign of serious 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 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 Canakinumab
- Adalimumab + Canakinumab Major
- Anakinra + Canakinumab Major
- Baricitinib + Canakinumab Major
- Basiliximab + Canakinumab Major
- Canakinumab + Etanercept Major
- Canakinumab + Golimumab Major
Frequently asked questions
Can I take Canakinumab with Tocilizumab?
MediHelp rates the interaction as major. Canakinumab 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. Both drugs inhibit interleukin signalling and combining them increases the risk of serious infection. Labeling for interleukin-1 blockers advises against combination with other biologic immunosuppressants.
How serious is the interaction between Canakinumab 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 concurrent use where possible and choose a single biologic. If combined, monitor closely for infection and stop at the first sign of serious infection.
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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