Drug interactions
Idelalisib + Tofacitinib
Severity: Major
Idelalisib 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
Idelalisib is a strong CYP3A inhibitor and may raise tofacitinib concentrations. It is also immunosuppressive and associated with serious infections, so risk is compounded.
What this interaction means in plain words
Idelalisib 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.
Idelalisib belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition reduces tofacitinib clearance, combined with additive immunosuppression from PI3K delta inhibition.
What to do
Avoid the combination if possible; otherwise reduce tofacitinib per strong CYP3A4 inhibitor labeling. Monitor closely for infection and cytopenias.
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 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 Idelalisib
- Alfuzosin + Idelalisib Contraindicated
- Cisapride + Idelalisib Contraindicated
- Dihydroergotamine + Idelalisib Contraindicated
- Dronedarone + Idelalisib Contraindicated
- Eletriptan + Idelalisib Contraindicated
- Eplerenone + Idelalisib Contraindicated
Frequently asked questions
Can I take Idelalisib with Tofacitinib?
MediHelp rates the interaction as major. Idelalisib 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. Idelalisib is a strong CYP3A inhibitor and may raise tofacitinib concentrations. It is also immunosuppressive and associated with serious infections, so risk is compounded.
How serious is the interaction between Idelalisib 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 the combination if possible; otherwise reduce tofacitinib per strong CYP3A4 inhibitor labeling. Monitor closely for infection and cytopenias.
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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