Drug interactions
Denosumab + Tocilizumab
Severity: Moderate
Denosumab and Tocilizumab: moderate 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
Tocilizumab causes substantial immunosuppression through IL-6 blockade and denosumab labeling warns of serious infections in patients on immunosuppressants. The combination may increase the risk of serious infection.
What this interaction means in plain words
Denosumab and Tocilizumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Denosumab belongs to Oncology; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive infection risk from IL-6 receptor blockade and RANKL inhibition; no pharmacokinetic mechanism.
What to do
Monitor for infection. Note that tocilizumab can mask fever and CRP elevation, so use a low threshold for evaluation; interrupt if a serious infection develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab Contraindicated
Other interactions of Denosumab
- Abatacept + Denosumab Moderate
- Adalimumab + Denosumab Moderate
- Alefacept + Denosumab Moderate
- Alemtuzumab + Denosumab Moderate
- Anakinra + Denosumab Moderate
- Azacitidine + Denosumab Moderate
Frequently asked questions
Can I take Denosumab with Tocilizumab?
MediHelp rates the interaction as moderate. Denosumab and Tocilizumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tocilizumab causes substantial immunosuppression through IL-6 blockade and denosumab labeling warns of serious infections in patients on immunosuppressants. The combination may increase the risk of serious infection.
How serious is the interaction between Denosumab and Tocilizumab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for infection. Note that tocilizumab can mask fever and CRP elevation, so use a low threshold for evaluation; interrupt if a serious infection develops.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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