Drug interactions
Natalizumab + Upadacitinib
Severity: Major
Natalizumab and Upadacitinib: 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
Combining two potent immunosuppressants raises the risk of serious infections, including opportunistic infections. Natalizumab carries a risk of progressive multifocal leukoencephalopathy, which may be heightened by added immunosuppression.
What this interaction means in plain words
Natalizumab and Upadacitinib 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.
Natalizumab belongs to Gastrointestinal Tract; Upadacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression via integrin blockade and JAK inhibition.
What to do
Avoid concurrent use. If switching, follow a washout appropriate to the prior agent and monitor closely 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 Natalizumab
- Natalizumab + Vedolizumab Contraindicated
- Axicabtagene ciloleucel + Natalizumab Major
- Baricitinib + Natalizumab Major
- Belatacept + Natalizumab Major
- Brexucabtagene autoleucel + Natalizumab Major
- Cabazitaxel + Natalizumab Major
Other interactions of Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Cyclosporine + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
Frequently asked questions
Can I take Natalizumab with Upadacitinib?
MediHelp rates the interaction as major. Natalizumab and Upadacitinib 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. Combining two potent immunosuppressants raises the risk of serious infections, including opportunistic infections. Natalizumab carries a risk of progressive multifocal leukoencephalopathy, which may be heightened by added immunosuppression.
How serious is the interaction between Natalizumab and Upadacitinib?
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. If switching, follow a washout appropriate to the prior agent and monitor closely for infection.
What other medicines interact with Natalizumab?
MediHelp also lists interactions of Natalizumab with, for example, Vedolizumab, Axicabtagene ciloleucel, Baricitinib. The full list is on the Natalizumab page.
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