Drug interactions
Leflunomide + Melphalan
Severity: Major
Leflunomide and Melphalan: 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
Melphalan causes myelosuppression and immunosuppression, and leflunomide may add to this effect. The risk of cytopenias and serious infection is increased.
What this interaction means in plain words
Leflunomide and Melphalan 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.
Leflunomide belongs to Musculoskeletal; Melphalan belongs to Oncology.
Why it happens
Additive myelosuppressive and immunosuppressive effects.
What to do
Check blood counts at least monthly and omit the leflunomide loading dose. Use accelerated elimination if serious toxicity occurs.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Other interactions of Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + Melphalan Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Melphalan Contraindicated
- Measles mumps and rubella vaccine live + Melphalan Contraindicated
- Measles mumps and rubella vaccine + Melphalan Contraindicated
- Measles mumps rubella and varicella vaccine live + Melphalan Contraindicated
Frequently asked questions
Can I take Leflunomide with Melphalan?
MediHelp rates the interaction as major. Leflunomide and Melphalan 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. Melphalan causes myelosuppression and immunosuppression, and leflunomide may add to this effect. The risk of cytopenias and serious infection is increased.
How serious is the interaction between Leflunomide and Melphalan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check blood counts at least monthly and omit the leflunomide loading dose. Use accelerated elimination if serious toxicity occurs.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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