Drug interactions
Carbamazepine + Tofacitinib
Severity: Major
Carbamazepine and Tofacitinib: major interaction.
Last updated Sources: US FDA label
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
Carbamazepine is a strong CYP3A4 inducer and can substantially reduce tofacitinib exposure. This may lead to loss of therapeutic effect in inflammatory disease.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Tofacitinib belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 by carbamazepine accelerates tofacitinib clearance.
What to do
Avoid the combination where possible, using an alternative anticonvulsant. If it is unavoidable, monitor clinical response closely and consider alternative therapy if efficacy is lost.
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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References
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Tofacitinib?
MediHelp rates the interaction as major. Carbamazepine 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. Carbamazepine is a strong CYP3A4 inducer and can substantially reduce tofacitinib exposure. This may lead to loss of therapeutic effect in inflammatory disease.
How serious is the interaction between Carbamazepine 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: Avoid the combination where possible, using an alternative anticonvulsant. If it is unavoidable, monitor clinical response closely and consider alternative therapy if efficacy is lost.
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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