Drug interactions
Lomustine + Tofacitinib
Severity: Major
Lomustine and Tofacitinib: 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
Lomustine is an alkylating nitrosourea causing delayed and prolonged myelosuppression. Together with tofacitinib, the risk of serious infection and severe cytopenias increases.
What this interaction means in plain words
Lomustine and Tofacitinib 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.
Lomustine belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic immunosuppression and bone marrow suppression.
What to do
Avoid combining and hold tofacitinib during lomustine treatment. If unavoidable, monitor blood counts for several weeks and watch for infection.
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 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 Lomustine
- Adenovirus types 4 and 7 live + Lomustine Contraindicated
- Bcg vaccine live + Lomustine Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Lomustine Contraindicated
- Lomustine + Measles mumps and rubella vaccine Contraindicated
- Lomustine + Measles mumps and rubella vaccine live Contraindicated
- Lomustine + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Lomustine with Tofacitinib?
MediHelp rates the interaction as major. Lomustine and Tofacitinib 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. Lomustine is an alkylating nitrosourea causing delayed and prolonged myelosuppression. Together with tofacitinib, the risk of serious infection and severe cytopenias increases.
How serious is the interaction between Lomustine and Tofacitinib?
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 combining and hold tofacitinib during lomustine treatment. If unavoidable, monitor blood counts for several weeks and watch for infection.
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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