Drug interactions
Cyclophosphamide + Tofacitinib
Severity: Major
Cyclophosphamide and Tofacitinib: 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
Tofacitinib combined with potent immunosuppressants such as cyclophosphamide increases the risk of serious infections, including opportunistic infections. Its labeling advises against use with potent immunosuppressives.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression through JAK inhibition and cytotoxic suppression of lymphocytes.
What to do
Avoid the combination. If it cannot be avoided, monitor closely for infection and consider prophylaxis and lymphocyte counts.
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 Cyclophosphamide
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 Cyclophosphamide with Tofacitinib?
MediHelp rates the interaction as major. Cyclophosphamide 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 combined with potent immunosuppressants such as cyclophosphamide increases the risk of serious infections, including opportunistic infections. Its labeling advises against use with potent immunosuppressives.
How serious is the interaction between Cyclophosphamide 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. If it cannot be avoided, monitor closely for infection and consider prophylaxis and lymphocyte counts.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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