Drug interactions
Erythromycin lactobionate + Tofacitinib
Severity: Moderate
Erythromycin lactobionate 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
Erythromycin is a moderate CYP3A4 inhibitor and can raise tofacitinib exposure. The increase is modest, but it may add to dose-related adverse effects such as infection, cytopenias and lipid changes, particularly if a CYP2C19 inhibitor is also given.
What this interaction means in plain words
Erythromycin lactobionate 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.
Erythromycin lactobionate belongs to Anti Bacterial; Tofacitinib belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated tofacitinib metabolism reduces its clearance.
What to do
No routine dose change is needed with a moderate CYP3A4 inhibitor alone; monitor for infections and blood count abnormalities. Reduce the tofacitinib dose if the patient also takes a potent CYP2C19 inhibitor.
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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Erythromycin lactobionate with Tofacitinib?
MediHelp rates the interaction as moderate. Erythromycin lactobionate 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. Erythromycin is a moderate CYP3A4 inhibitor and can raise tofacitinib exposure. The increase is modest, but it may add to dose-related adverse effects such as infection, cytopenias and lipid changes, particularly if a CYP2C19 inhibitor is also given.
How serious is the interaction between Erythromycin lactobionate 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 with a moderate CYP3A4 inhibitor alone; monitor for infections and blood count abnormalities. Reduce the tofacitinib dose if the patient also takes a potent CYP2C19 inhibitor.
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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