Drug interactions
Istradefylline + Tofacitinib
Severity: Moderate
Istradefylline and Tofacitinib: 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
At 40 mg daily istradefylline raises exposure to CYP3A4 substrates, which may increase tofacitinib levels. This was not seen at 20 mg daily. The result could be more dose-related adverse effects of tofacitinib.
What this interaction means in plain words
Istradefylline and Tofacitinib 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.
Istradefylline belongs to Central Nervous System; Tofacitinib belongs to Musculoskeletal.
Why it happens
Istradefylline at higher doses inhibits CYP3A4, reducing tofacitinib clearance.
What to do
Monitor for tofacitinib adverse effects such as infection and cytopenias, particularly if istradefylline is given at 40 mg daily.
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 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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Tofacitinib?
MediHelp rates the interaction as moderate. Istradefylline and Tofacitinib 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. At 40 mg daily istradefylline raises exposure to CYP3A4 substrates, which may increase tofacitinib levels. This was not seen at 20 mg daily. The result could be more dose-related adverse effects of tofacitinib.
How serious is the interaction between Istradefylline and Tofacitinib?
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 for tofacitinib adverse effects such as infection and cytopenias, particularly if istradefylline is given at 40 mg daily.
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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