Drug interactions
Cyclosporin + Tofacitinib
Severity: Major
Cyclosporin 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
Cyclosporine combined with tofacitinib produces additive immunosuppression, and tofacitinib labeling advises against use with potent immunosuppressants. Cyclosporine also raises tofacitinib exposure, increasing the risk of serious infection and cytopenias.
What this interaction means in plain words
Cyclosporin 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.
Cyclosporin belongs to Miscellaneous; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression plus CYP3A4 inhibition by cyclosporine, which raises tofacitinib levels.
What to do
Avoid concomitant use; if unavoidable, monitor closely for infection and blood count abnormalities and reduce the tofacitinib dose as per labeling.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cyclosporin and Tofacitinib, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
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 Cyclosporin with Tofacitinib?
MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporine combined with tofacitinib produces additive immunosuppression, and tofacitinib labeling advises against use with potent immunosuppressants. Cyclosporine also raises tofacitinib exposure, increasing the risk of serious infection and cytopenias.
How serious is the interaction between Cyclosporin 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 concomitant use; if unavoidable, monitor closely for infection and blood count abnormalities and reduce the tofacitinib dose as per labeling.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
