Drug interactions
Hydrocortisone + Tofacitinib
Severity: Major
Hydrocortisone 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
Both drugs suppress immune function, and combined use increases the risk of serious infections. Tofacitinib is commonly given with corticosteroids, but the infection risk rises with higher steroid doses.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression through different pathways (glucocorticoid effects and JAK inhibition).
What to do
Use the lowest effective hydrocortisone dose for the shortest duration and monitor closely for infection. Screen for latent tuberculosis and hepatitis before therapy.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
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
Frequently asked questions
Can I take Hydrocortisone with Tofacitinib?
MediHelp rates the interaction as major. Hydrocortisone 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. Both drugs suppress immune function, and combined use increases the risk of serious infections. Tofacitinib is commonly given with corticosteroids, but the infection risk rises with higher steroid doses.
How serious is the interaction between Hydrocortisone 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: Use the lowest effective hydrocortisone dose for the shortest duration and monitor closely for infection. Screen for latent tuberculosis and hepatitis before therapy.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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