Drug interactions
Infliximab + Tocilizumab
Severity: Major
Infliximab and Tocilizumab: 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
Combining two biologic immunosuppressants increases the risk of serious infection without proven added benefit. Tocilizumab can also mask fever and CRP elevation, delaying infection recognition.
What this interaction means in plain words
Infliximab and Tocilizumab 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.
Infliximab belongs to Musculoskeletal; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from TNF-alpha and IL-6 receptor blockade.
What to do
Avoid concurrent use; use a single biologic and switch if response is inadequate.
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 Infliximab
- Bcg vaccine live + Infliximab Contraindicated
- Infliximab + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Infliximab + Measles mumps and rubella vaccine Contraindicated
- Infliximab + Measles mumps and rubella vaccine live Contraindicated
- Infliximab + Measles mumps rubella and varicella vaccine live Contraindicated
- Infliximab + Measles vaccine Contraindicated
Other interactions of Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab Contraindicated
Frequently asked questions
Can I take Infliximab with Tocilizumab?
MediHelp rates the interaction as major. Infliximab and Tocilizumab 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. Combining two biologic immunosuppressants increases the risk of serious infection without proven added benefit. Tocilizumab can also mask fever and CRP elevation, delaying infection recognition.
How serious is the interaction between Infliximab and Tocilizumab?
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; use a single biologic and switch if response is inadequate.
What other medicines interact with Infliximab?
MediHelp also lists interactions of Infliximab with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine. The full list is on the Infliximab page.
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