Drug interactions
Chlorambucil + Tofacitinib
Severity: Major
Chlorambucil and Tofacitinib: major interaction.
Last updated Sources: Base de donnees publique des medicaments (France)
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
Tofacitinib used with a cytotoxic immunosuppressant such as chlorambucil increases the risk of serious and opportunistic infections. Additive myelosuppression may also occur.
What this interaction means in plain words
Chlorambucil 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.
Chlorambucil belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from JAK inhibition and alkylating agent-induced bone marrow suppression.
What to do
Avoid concurrent use. If necessary, monitor blood counts and watch closely for signs of 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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References
Other interactions of Chlorambucil
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
Frequently asked questions
Can I take Chlorambucil with Tofacitinib?
MediHelp rates the interaction as major. Chlorambucil 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. Tofacitinib used with a cytotoxic immunosuppressant such as chlorambucil increases the risk of serious and opportunistic infections. Additive myelosuppression may also occur.
How serious is the interaction between Chlorambucil 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 concurrent use. If necessary, monitor blood counts and watch closely for signs of infection.
What other medicines interact with Chlorambucil?
MediHelp also lists interactions of Chlorambucil with, for example, Adenovirus types 4 and 7 live, Axicabtagene ciloleucel, Belatacept. The full list is on the Chlorambucil page.
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