Drug interactions
Fludarabine + Tofacitinib
Severity: Major
Fludarabine 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
Fludarabine causes profound lymphopenia and T-cell depletion, and tofacitinib adds JAK-mediated immunosuppression. The combination markedly raises the risk of serious and opportunistic infections.
What this interaction means in plain words
Fludarabine 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.
Fludarabine belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic immunosuppression and lymphocyte depletion.
What to do
Avoid concurrent use and hold tofacitinib during fludarabine therapy. If combined, monitor lymphocyte counts and consider antimicrobial prophylaxis.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fludarabine and Tofacitinib, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Fludarabine
- Adenovirus types 4 and 7 live + Fludarabine Contraindicated
- Fludarabine + Pentostatin Contraindicated
- Belatacept + Fludarabine Major
- Dengue vaccine + Fludarabine Major
- Etrasimod + Fludarabine Major
- Fingolimod + Fludarabine Major
Frequently asked questions
Can I take Fludarabine with Tofacitinib?
MediHelp rates the interaction as major. Fludarabine 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. Fludarabine causes profound lymphopenia and T-cell depletion, and tofacitinib adds JAK-mediated immunosuppression. The combination markedly raises the risk of serious and opportunistic infections.
How serious is the interaction between Fludarabine 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: Avoid concurrent use and hold tofacitinib during fludarabine therapy. If combined, monitor lymphocyte counts and consider antimicrobial prophylaxis.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
