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Drug interactions

Leflunomide + Ocrelizumab

Severity: Major

Leflunomide and Ocrelizumab: 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

Combined use of leflunomide and the B-cell depleting antibody ocrelizumab may add to immunosuppression and hematologic toxicity, including infections and cytopenias.

What this interaction means in plain words

Leflunomide and Ocrelizumab 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; Ocrelizumab belongs to Central Nervous System.

Evidence level: Low

Why it happens

Additive immunosuppressive and myelosuppressive effects.

What to do

Avoid concurrent use where possible, and monitor complete blood counts and signs of infection if combined. Consider leflunomide washout with accelerated elimination when switching.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Leflunomide with Ocrelizumab?

MediHelp rates the interaction as major. Leflunomide and Ocrelizumab 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. Combined use of leflunomide and the B-cell depleting antibody ocrelizumab may add to immunosuppression and hematologic toxicity, including infections and cytopenias.

How serious is the interaction between Leflunomide and Ocrelizumab?

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 where possible, and monitor complete blood counts and signs of infection if combined. Consider leflunomide washout with accelerated elimination when switching.

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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