Drug interactions
Diltiazem + Tofacitinib
Severity: Moderate
Diltiazem and Tofacitinib: 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
Diltiazem is a moderate CYP3A4 inhibitor and can increase tofacitinib exposure. The increase is generally modest but may add to infection and cytopenia risk.
What this interaction means in plain words
Diltiazem and Tofacitinib 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.
Diltiazem belongs to Cardiovascular; Tofacitinib belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4 by diltiazem decreases tofacitinib clearance.
What to do
No routine dose change is needed for a moderate CYP3A4 inhibitor alone; monitor for adverse effects and reduce the tofacitinib dose if a potent CYP2C19 inhibitor is also used.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Frequently asked questions
Can I take Diltiazem with Tofacitinib?
MediHelp rates the interaction as moderate. Diltiazem and Tofacitinib 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. Diltiazem is a moderate CYP3A4 inhibitor and can increase tofacitinib exposure. The increase is generally modest but may add to infection and cytopenia risk.
How serious is the interaction between Diltiazem and Tofacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed for a moderate CYP3A4 inhibitor alone; monitor for adverse effects and reduce the tofacitinib dose if a potent CYP2C19 inhibitor is also used.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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