Drug interactions
Leflunomide + Tocilizumab
Severity: Major
Leflunomide 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
Combined use adds immunosuppression, raising the risk of serious infections, neutropenia and liver enzyme elevations, both drugs being hepatotoxic.
What this interaction means in plain words
Leflunomide 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.
Leflunomide belongs to Musculoskeletal; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression via IL-6 receptor blockade and DHODH inhibition, with overlapping hepatotoxicity.
What to do
Avoid unless clearly needed. Monitor neutrophils, ALT/AST and infection signs.
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 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 Leflunomide with Tocilizumab?
MediHelp rates the interaction as major. Leflunomide 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. Combined use adds immunosuppression, raising the risk of serious infections, neutropenia and liver enzyme elevations, both drugs being hepatotoxic.
How serious is the interaction between Leflunomide 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 unless clearly needed. Monitor neutrophils, ALT/AST and infection signs.
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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