Drug interactions
Fluconazole + Tofacitinib
Severity: Moderate
Fluconazole 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
Fluconazole inhibits CYP3A4 moderately and CYP2C19 strongly, the two pathways clearing tofacitinib. Exposure to tofacitinib rises, increasing the risk of infections and cytopenias.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Tofacitinib belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4 and CYP2C19 metabolism of tofacitinib.
What to do
Reduce tofacitinib dose as per labeling (for example, halve the total daily dose, or give once daily if on twice daily 5 mg). Monitor for infection and lymphocyte and neutrophil counts.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Tofacitinib?
MediHelp rates the interaction as moderate. Fluconazole 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. Fluconazole inhibits CYP3A4 moderately and CYP2C19 strongly, the two pathways clearing tofacitinib. Exposure to tofacitinib rises, increasing the risk of infections and cytopenias.
How serious is the interaction between Fluconazole 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: Reduce tofacitinib dose as per labeling (for example, halve the total daily dose, or give once daily if on twice daily 5 mg). Monitor for infection and lymphocyte and neutrophil counts.
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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