Drug interactions
Ceritinib + Tofacitinib
Severity: Major
Ceritinib 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
Ceritinib is a strong CYP3A4 inhibitor and may raise tofacitinib exposure. Higher tofacitinib levels increase the risk of infections, cytopenias and lipid changes.
What this interaction means in plain words
Ceritinib 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.
Ceritinib belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Ceritinib inhibits CYP3A4, the main metabolic pathway of tofacitinib, reducing its clearance.
What to do
Reduce the tofacitinib dose in line with labeling for strong CYP3A4 inhibitors (for example to once daily where twice daily is standard), or choose an alternative to ceritinib. Monitor for infection and blood count abnormalities.
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 Ceritinib
- Ceritinib + Cisapride Contraindicated
- Ceritinib + Eletriptan Contraindicated
- Ceritinib + Flibanserin Contraindicated
- Ceritinib + Pimozide Contraindicated
- Ceritinib + Thioridazine Contraindicated
- Ceritinib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Ceritinib with Tofacitinib?
MediHelp rates the interaction as major. Ceritinib 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. Ceritinib is a strong CYP3A4 inhibitor and may raise tofacitinib exposure. Higher tofacitinib levels increase the risk of infections, cytopenias and lipid changes.
How serious is the interaction between Ceritinib 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: Reduce the tofacitinib dose in line with labeling for strong CYP3A4 inhibitors (for example to once daily where twice daily is standard), or choose an alternative to ceritinib. Monitor for infection and blood count abnormalities.
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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