Drug interactions
Tocilizumab + Upadacitinib
Severity: Major
Tocilizumab 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 an interleukin-6 receptor antagonist with a JAK inhibitor produces additive immunosuppression and raises the risk of serious infections. Labeling advises against use with other potent immunosuppressants and biologic DMARDs.
What this interaction means in plain words
Tocilizumab 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.
Tocilizumab belongs to Musculoskeletal; Upadacitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from IL-6 receptor blockade and JAK inhibition.
What to do
Avoid concurrent use and choose a single agent; if switching, monitor closely for infection and cytopenias during the transition.
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 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
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 Tocilizumab with Upadacitinib?
MediHelp rates the interaction as major. Tocilizumab 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 an interleukin-6 receptor antagonist with a JAK inhibitor produces additive immunosuppression and raises the risk of serious infections. Labeling advises against use with other potent immunosuppressants and biologic DMARDs.
How serious is the interaction between Tocilizumab 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 and choose a single agent; if switching, monitor closely for infection and cytopenias during the transition.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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