Drug interactions
Duvelisib + Tofacitinib
Severity: Major
Duvelisib 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
Duvelisib inhibits CYP3A4, the main enzyme clearing tofacitinib, and may increase its exposure. Duvelisib is itself immunosuppressive with serious infection risk, so combined effects are a concern.
What this interaction means in plain words
Duvelisib 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.
Duvelisib belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Duvelisib inhibits CYP3A4, reducing tofacitinib metabolism, with additive immunosuppression.
What to do
Reduce the tofacitinib dose as advised in labeling for CYP3A4 inhibitors, and monitor closely for infection and cytopenias. Avoid the combination if possible.
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 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 Duvelisib
- Duvelisib + Ergotamine Contraindicated
- Alfuzosin + Duvelisib Major
- Apalutamide + Duvelisib Major
- Avanafil + Duvelisib Major
- Carbamazepine + Duvelisib Major
- Chloramphenicol + Duvelisib Major
Frequently asked questions
Can I take Duvelisib with Tofacitinib?
MediHelp rates the interaction as major. Duvelisib 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. Duvelisib inhibits CYP3A4, the main enzyme clearing tofacitinib, and may increase its exposure. Duvelisib is itself immunosuppressive with serious infection risk, so combined effects are a concern.
How serious is the interaction between Duvelisib 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: Reduce the tofacitinib dose as advised in labeling for CYP3A4 inhibitors, and monitor closely for infection and cytopenias. Avoid the combination if possible.
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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