Drug interactions
Isoniazid + Ruxolitinib
Severity: Moderate
Isoniazid and Ruxolitinib: 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
Ruxolitinib is metabolised mainly by CYP3A4, and strong inhibitors of this enzyme increase its exposure, which can deepen thrombocytopenia and neutropenia. Isoniazid is a weaker inhibitor than the agents named in the labeling, so the effect is probably smaller but not well characterised.
What this interaction means in plain words
Isoniazid and Ruxolitinib 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.
Isoniazid belongs to Anti Bacterial; Ruxolitinib belongs to Oncology.
Why it happens
Isoniazid inhibits CYP3A4, which may reduce ruxolitinib clearance.
What to do
Monitor complete blood counts more often after starting or stopping isoniazid and reduce the ruxolitinib dose if cytopenias develop. Follow labeled dose reductions if the patient is also taking a strong CYP3A4 inhibitor.
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 Isoniazid
Other interactions of Ruxolitinib
Frequently asked questions
Can I take Isoniazid with Ruxolitinib?
MediHelp rates the interaction as moderate. Isoniazid and Ruxolitinib 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. Ruxolitinib is metabolised mainly by CYP3A4, and strong inhibitors of this enzyme increase its exposure, which can deepen thrombocytopenia and neutropenia. Isoniazid is a weaker inhibitor than the agents named in the labeling, so the effect is probably smaller but not well characterised.
How serious is the interaction between Isoniazid and Ruxolitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor complete blood counts more often after starting or stopping isoniazid and reduce the ruxolitinib dose if cytopenias develop. Follow labeled dose reductions if the patient is also taking a strong CYP3A4 inhibitor.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Benzhydrocodone / acetaminophen, Carbamazepine. The full list is on the Isoniazid page.
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