Drug interactions
Etanercept + Leflunomide
Severity: Major
Etanercept and Leflunomide: major interaction.
Last updated Sources: Health Canada product monograph
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
Combined use adds immunosuppression and raises the risk of serious infection and cytopenias. Leflunomide's long half-life prolongs the exposure.
What this interaction means in plain words
Etanercept and Leflunomide 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.
Etanercept belongs to Musculoskeletal; Leflunomide belongs to Musculoskeletal.
Why it happens
Additive immunosuppression through TNF blockade and inhibition of dihydroorotate dehydrogenase.
What to do
Avoid unless benefit clearly outweighs risk. Monitor for infection, CBC and liver enzymes.
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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References
Other interactions of Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Other interactions of Etanercept
- Bcg vaccine live + Etanercept Contraindicated
- Etanercept + Golimumab Contraindicated
- Etanercept + Measles mumps and rubella vaccine Contraindicated
- Etanercept + Measles mumps and rubella vaccine live Contraindicated
- Etanercept + Measles mumps rubella and varicella vaccine live Contraindicated
- Etanercept + Measles vaccine Contraindicated
Frequently asked questions
Can I take Etanercept with Leflunomide?
MediHelp rates the interaction as major. Etanercept and Leflunomide 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. Combined use adds immunosuppression and raises the risk of serious infection and cytopenias. Leflunomide's long half-life prolongs the exposure.
How serious is the interaction between Etanercept and Leflunomide?
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 unless benefit clearly outweighs risk. Monitor for infection, CBC and liver enzymes.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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