Drug interactions
Tofacitinib + Tucatinib
Severity: Major
Tofacitinib and Tucatinib: 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
Tucatinib inhibits CYP3A4 and may increase tofacitinib exposure. Higher levels increase the risk of infection and cytopenias.
What this interaction means in plain words
Tofacitinib and Tucatinib 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.
Tofacitinib belongs to Musculoskeletal; Tucatinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated tofacitinib metabolism.
What to do
Reduce the tofacitinib dose as recommended for CYP3A4 inhibitors. 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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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 Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Tofacitinib with Tucatinib?
MediHelp rates the interaction as major. Tofacitinib and Tucatinib 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. Tucatinib inhibits CYP3A4 and may increase tofacitinib exposure. Higher levels increase the risk of infection and cytopenias.
How serious is the interaction between Tofacitinib and Tucatinib?
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 as recommended for CYP3A4 inhibitors. 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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