Drug interactions
Tofacitinib + Upadacitinib
Severity: Contraindicated
Tofacitinib and Upadacitinib: contraindicated 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
Two JAK inhibitors together duplicate pharmacology and give additive immunosuppression, increasing the risk of serious infection, cytopenias and other class adverse effects. There is no evidence of benefit from combining them.
What this interaction means in plain words
Tofacitinib and Upadacitinib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Tofacitinib belongs to Musculoskeletal; Upadacitinib belongs to Musculoskeletal.
Why it happens
Duplicate JAK inhibition leads to additive immunosuppression.
What to do
Do not use together; use one JAK inhibitor only, and stop the first before starting the other.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
- Antithymocyte globulin rabbit + Tofacitinib 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 Tofacitinib with Upadacitinib?
MediHelp rates the interaction as contraindicated. Tofacitinib and Upadacitinib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Two JAK inhibitors together duplicate pharmacology and give additive immunosuppression, increasing the risk of serious infection, cytopenias and other class adverse effects. There is no evidence of benefit from combining them.
How serious is the interaction between Tofacitinib and Upadacitinib?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; use one JAK inhibitor only, and stop the first before starting the other.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Abatacept. The full list is on the Tofacitinib page.
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