Drug interactions
Mechlorethamine + Tofacitinib
Severity: Major
Mechlorethamine 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
Mechlorethamine is a cytotoxic alkylating agent that causes myelosuppression. With tofacitinib, it increases infection risk. The legacy pharmacokinetic wording is unsupported, as the concern is pharmacodynamic.
What this interaction means in plain words
Mechlorethamine 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.
Mechlorethamine belongs to Oncology; Tofacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression and bone marrow suppression from alkylating chemotherapy and JAK inhibition.
What to do
Avoid concurrent systemic use where possible and consider holding tofacitinib during chemotherapy. Monitor blood counts 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 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 Mechlorethamine
Frequently asked questions
Can I take Mechlorethamine with Tofacitinib?
MediHelp rates the interaction as major. Mechlorethamine 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. Mechlorethamine is a cytotoxic alkylating agent that causes myelosuppression. With tofacitinib, it increases infection risk. The legacy pharmacokinetic wording is unsupported, as the concern is pharmacodynamic.
How serious is the interaction between Mechlorethamine 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 concurrent systemic use where possible and consider holding tofacitinib during chemotherapy. Monitor blood counts and infection signs.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
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