Adalimumab interactions

Adalimumab (Humira), an immunosuppressant has 121 documented interactions across the FDA labels and fact sheets we index: 60 major, 48 moderate, 12 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (60)

  • AbataceptimmunosuppressantMajor

    The concomitant use of a TNF blocker and abatacept or anakinra was associated with a higher risk of serious infections in patients with rheumatoid arthritis (RA); therefore, the concomitant use of Adalimumab-fkjp and these biologic products is not recommended in the treatment of patients with RA [see Warnings and Precautions (5.7 , 5.11) and Drug Interactions… (Adalimumab label, Warnings and precautions)

  • AbrocitinibJAK inhibitorMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • AlemtuzumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • AzathioprineimmunosuppressantMajor

    Almost all these patients had received treatment with azathioprine or 6-mercaptopurine (6–MP) concomitantly with a TNF blocker at or prior to diagnosis. (Adalimumab label, Boxed warning)

  • Azelastine and fluticasoneantihistamineMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • BaricitinibJAK inhibitorMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • BeclomethasonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • BetamethasonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • BudesonidecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • Budesonide and formoterolcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • CaptoprilACE inhibitorMajor

    About 13 percent of the cases of neutropenia have ended fatally, but almost all fatalities were in patients with serious illness, having collagen vascular disease, renal failure, heart failure or immunosuppressant therapy, or a combination of these complicating factors. (Captopril label, Warnings)

  • CiclesonidecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • CladribineantimetaboliteMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • ClobetasolcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • CyclophosphamideimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • CyclosporineimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • DarunavirantiretroviralMajor

    Immunosuppressant/neoplastic: everolimus Co-administration of everolimus and PREZISTA/ritonavir is not recommended. irinotecan Discontinue PREZISTA/ritonavir at least 1 week prior to starting irinotecan therapy. (Darunavir label, Drug interactions)

  • DeflazacortcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • DesonidecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • DexamethasonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • Dimethyl fumarateimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • EtanerceptimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • EverolimusimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • FingolimodimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • FludrocortisonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • FlunisolidecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • FluocinonidecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • FluticasonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • Fluticasone and salmeterolcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • GuselkumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • HalobetasolcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • HydrocortisonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • InfliximabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • Itraconazoleazole antifungalMajor

    Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

  • LeflunomideimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • MercaptopurineantimetaboliteMajor

    Almost all these patients had received treatment with azathioprine or 6-mercaptopurine (6–MP) concomitantly with a TNF blocker at or prior to diagnosis. (Adalimumab label, Boxed warning)

  • MethotrexateimmunosuppressantMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • MethylprednisolonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • MometasonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • MycophenolateimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • NatalizumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • …methylergonovine • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use [see Table 2 , Drug Interactions (7.3) ] ) • Immunosuppressants: voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists:… (Nirmatrelvir and ritonavir label, Contraindications)

  • OcrelizumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • Olopatadine and mometasoneantihistamineMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • Pimecrolimuscalcineurin inhibitorMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • PonesimodimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • PrednisolonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • PrednisonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • RitlecitinibJAK inhibitorMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • RituximabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • RuxolitinibJAK inhibitorMajor

    Major Adverse Cardiovascular Events (MACE) Another JAK inhibitor has increased the risk of MACE, including cardiovascular death, myocardial infarction, and stroke (compared to those treated with TNF blockers) in patients with rheumatoid arthritis, a condition for which JAKAFI/JAKAFI XR is not indicated. (Ruxolitinib label, Warnings and precautions)

  • SecukinumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • SirolimusimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • TacrolimusimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • TeriflunomideimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • TocilizumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • TofacitinibimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • TriamcinolonecorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)

  • UpadacitinibimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • UstekinumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

Moderate interactions (48)

  • Allopurinolxanthine oxidase inhibitorModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • AminophyllinemethylxanthineModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Amlodipinedihydropyridine calcium channel blockerModerate

    Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine label, Drug interactions)

  • Amlodipine and atorvastatindihydropyridine calcium channel blockerModerate

    Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

  • Amlodipine and olmesartandihydropyridine calcium channel blockerModerate

    Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and olmesartan label, Drug interactions)

  • Amlodipine and valsartandihydropyridine calcium channel blockerModerate

    Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. (Amlodipine and valsartan label, Drug interactions)

  • AtazanavirantiretroviralModerate

    Immunosuppressants: cyclosporine, sirolimus, tacrolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for these immunosuppressants when coadministered with REYATAZ. (Atazanavir label, Drug interactions)

  • BendamustineModerate

    Consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. (Bendamustine label, Warnings and precautions)

  • Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Clotrimazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • Darunavir and cobicistatantiretroviralModerate

    Therapeutic drug monitoring is recommended with concomitant use Immunosuppressant /neoplastic: everolimus ↑ immunosuppressants Co-administration of everolimus and PREZCOBIX or PREZCOBIX PED is not recommended. irinotecan Discontinue PREZCOBIX or PREZCOBIX PED at least 1 week prior to starting irinotecan therapy. (Darunavir and cobicistat label, Drug interactions)

  • DenosumabModerate

    Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (Denosumab label, Warnings and precautions)

  • Econazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • EfavirenzantiretroviralModerate

    Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Efavirenz label, Drug interactions)

  • Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

  • Immuno-suppressants: e.g., cyclosporine (CsA) sirolimus tacrolimus ↑ immuno-suppressants ↑ elvitegravir (with CsA) ↑ cobicistat (with CsA) Therapeutic monitoring of the immunosuppressive agents is recommended upon coadministration with GENVOYA. (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Drug interactions)

  • Ergotamine and caffeineergot alkaloidModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • EtravirineantiretroviralModerate

    Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (Etravirine label, Drug interactions)

  • Febuxostatxanthine oxidase inhibitorModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • FenofibratefibrateModerate

    Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including fenofibrate, there is a risk that an interaction will lead to deterioration of renal… (Fenofibrate label, Drug interactions)

  • Fenofibric acidfibrateModerate

    Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route… (Fenofibric acid label, Drug interactions)

  • Fluconazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • FosamprenavirantiretroviralModerate

    Immunosuppressants: Cyclosporine, tacrolimus, sirolimus ↑ Immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents. (Fosamprenavir label, Drug interactions)

  • Ketoconazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • Ledipasvir and sofosbuvirantiviralModerate

    HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Lopinavir and ritonavirantiretroviralModerate

    Immunosuppressants: e.g. cyclosporine, tacrolimus, sirolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with KALETRA. (Lopinavir and ritonavir label, Drug interactions)

  • Miconazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • NefazodoneantidepressantModerate

    Immunosuppressive Agents There have been reports of increased blood concentrations of cyclosporine and tacrolimus into toxic ranges when patients received these drugs concomitantly with nefazodone. (Nefazodone label, Drug interactions)

  • NevirapineantiretroviralModerate

    Immunosuppressants: Cyclosporine, tacrolimus, sirolimus Plasma concentrations may be decreased. (Nevirapine label, Drug interactions)

  • Olmesartan, amlodipine, and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Olmesartan, amlodipine, and hydrochlorothiazide label, Drug interactions)

  • Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Treatment has consisted of high doses of corticosteroids alone or, in some cases, concomitantly with an immunosuppressant. (Penicillamine label, Warnings)

  • PentoxifyllinemethylxanthineModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • Posaconazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • RifampinantibioticModerate

    Glipizide Decrease exposure Immunosuppressive Agents Cyclosporine Decrease exposure Tacrolimus Prevention or Management: Monitoring of whole blood concentrations and appropriate dosage adjustments of tacrolimus are recommended when rifampin and tacrolimus are used concomitantly. (Rifampin label, Drug interactions)

  • RifapentineantibioticModerate

    …Digoxin Corticosteroids Prednisone Fibrates Clofibrate Oral Hypoglycemics Sulfonylureas (e.g., glyburide, glipizide) Hormonal Contraceptives/Progestins Ethinyl estradiol, levonorgestrel Immunosuppressants Cyclosporine, tacrolimus Methylxanthines Theophylline Narcotic analgesics Methadone Phosphodiesterase-5 (PDE-5) Inhibitors Sildenafil Thyroid preparations Levothyroxine… (Rifapentine label, Drug interactions)

  • RitonavirantiretroviralModerate

    Immunosuppressants: cyclosporine, tacrolimus, sirolimus (rapamycin) ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with ritonavir. (Ritonavir label, Drug interactions)

  • HBV reactivation has also been reported in patients receiving certain immunosuppressant or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Sofosbuvir and velpatasvir label, Warnings and precautions)

  • Telmisartan and amlodipineangiotensin II receptor blocker (ARB)Moderate

    Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Telmisartan and amlodipine label, Drug interactions)

  • TemsirolimusModerate

    Prophylaxis of PJP should be considered when concomitant use of corticosteroids or other immunosuppressive agents are required. (Temsirolimus label, Warnings and precautions)

  • TheophyllinemethylxanthineModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

  • TinidazoleantibioticModerate

    Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (Tinidazole label, Drug interactions)

  • Tobacco and smokingTobacco and cannabisModerate

    In controlled trials of other TNF blockers in adult patients at higher risk for malignancies (i.e., patients with COPD with a significant smoking history and cyclophosphamide-treated patients with Wegener’s granulomatosis), a greater portion of malignancies occurred in the TNF blocker group compared to the control group. (Adalimumab label, Warnings and precautions)

  • Voriconazoleazole antifungalModerate

    • Invasive fungal infections: For patients who develop a systemic illness on Adalimumab-fkjp, consider empiric antifungal therapy for those who reside or travel to regions where mycoses are endemic. (Adalimumab label, Warnings and precautions)

  • WarfarinanticoagulantModerate

    Upon initiation or discontinuation of Adalimumab-fkjp in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. (Adalimumab label, Drug interactions)

Minor mentions (12)

  • AtorvastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persists despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Atorvastatin label, Warnings and precautions)

  • Thirty-four patients were treated with corticosteroids and one patient was treated with a non-steroidal immunosuppressant. (Axitinib label, Warnings and precautions)

  • IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (Ezetimibe and simvastatin label, Warnings and precautions)

  • FluvastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum CK, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody, muscle biopsy showing necrotizing myopathy, and improvement with immunosuppressive agents. (Fluvastatin label, Warnings and precautions)

  • LovastatinstatinMinor

    IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Lovastatin label, Warnings)

  • Methimazoleantithyroid drugMinor

    In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Methimazole label, Warnings)

  • Nifedipinedihydropyridine calcium channel blockerMinor

    Immunosuppressive Drugs Tacrolimus: Tacrolimus has been shown to be metabolized via the CYP3A system. (Nifedipine label, Precautions)

  • PitavastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Pitavastatin label, Warnings and precautions)

  • PravastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Pravastatin label, Warnings and precautions)

  • Propylthiouracilantithyroid drugMinor

    In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Propylthiouracil label, Warnings)

  • RosuvastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Rosuvastatin label, Warnings and precautions)

  • SimvastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (Simvastatin label, Warnings and precautions)

No significant interaction reported (1)

  • Clarithromycinmacrolide antibioticNo interaction

    …Repaglinide, Rosiglitazone: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Insulin Insulin: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Immunosuppressants: Cyclosporine Use With Caution Cyclosporine: There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine. (Clarithromycin label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.