Drug interactions
Certolizumab pegol + Rituximab-hyaluronidase
Severity: Major
Certolizumab pegol and Rituximab-hyaluronidase: 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
Rituximab depletes B cells and certolizumab pegol blocks TNF, so together they produce greater immunosuppression. This raises the risk of serious infection, including opportunistic and hepatitis B reactivation. Evidence comes mostly from rheumatology experience with sequential or combined use.
What this interaction means in plain words
Certolizumab pegol and Rituximab-hyaluronidase 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.
Why it happens
Additive immunosuppression from B-cell depletion and TNF inhibition.
What to do
Avoid combining where an alternative exists. If both are needed, screen for hepatitis B and monitor closely for infection, including immunoglobulin levels.
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 Certolizumab pegol
- Adenovirus types 4 and 7 live + Certolizumab pegol Contraindicated
- Bcg intravesical live + Certolizumab pegol Contraindicated
- Bcg vaccine live + Certolizumab pegol Contraindicated
- Certolizumab pegol + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Certolizumab pegol + Measles mumps and rubella vaccine Contraindicated
- Certolizumab pegol + Measles mumps and rubella vaccine live Contraindicated
Frequently asked questions
Can I take Certolizumab pegol with Rituximab-hyaluronidase?
MediHelp rates the interaction as major. Certolizumab pegol and Rituximab-hyaluronidase 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. Rituximab depletes B cells and certolizumab pegol blocks TNF, so together they produce greater immunosuppression. This raises the risk of serious infection, including opportunistic and hepatitis B reactivation. Evidence comes mostly from rheumatology experience with sequential or combined use.
How serious is the interaction between Certolizumab pegol and Rituximab-hyaluronidase?
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 where an alternative exists. If both are needed, screen for hepatitis B and monitor closely for infection, including immunoglobulin levels.
What other medicines interact with Certolizumab pegol?
MediHelp also lists interactions of Certolizumab pegol with, for example, Adenovirus types 4 and 7 live, Bcg intravesical live, Bcg vaccine live. The full list is on the Certolizumab pegol page.
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