Drug interactions
Posaconazole + Tofacitinib
Severity: Major
Posaconazole and Tofacitinib: major interaction.
Last updated Sources: US FDA label
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
Posaconazole is a potent CYP3A4 inhibitor and raises tofacitinib exposure. This increases the risk of infection, cytopenias and other dose-related adverse effects.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Tofacitinib belongs to Musculoskeletal.
Why it happens
Potent CYP3A4 inhibition reduces tofacitinib clearance.
What to do
Reduce the tofacitinib dose per labeling (for example, once daily when on 5 mg twice daily). Monitor for infection and blood count changes.
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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References
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Posaconazole with Tofacitinib?
MediHelp rates the interaction as major. Posaconazole 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. Posaconazole is a potent CYP3A4 inhibitor and raises tofacitinib exposure. This increases the risk of infection, cytopenias and other dose-related adverse effects.
How serious is the interaction between Posaconazole 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: Reduce the tofacitinib dose per labeling (for example, once daily when on 5 mg twice daily). Monitor for infection and blood count changes.
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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