Etanercept interactions

Etanercept (Enbrel), an immunosuppressant has 55 documented interactions across the FDA labels and fact sheets we index: 29 major, 14 moderate, 11 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.

Major interactions (29)

  • AbataceptimmunosuppressantMajor

    Not Recommended for Use with Anakinra or Abatacept Use of Enbrel with anakinra or abatacept is not recommended [see Drug Interactions (7.2) ] . (Etanercept label, Warnings and precautions)

  • AdalimumabimmunosuppressantMajor

    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. (Etanercept label, Boxed warning)

  • BetamethasonecorticosteroidMajor

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

  • BudesonidecorticosteroidMajor

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

  • Budesonide and formoterolcorticosteroidMajor

    Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Etanercept 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)

  • ClobetasolcorticosteroidMajor

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

  • CyclosporineimmunosuppressantMajor

    In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (Cyclosporine label, Boxed warning)

  • DesonidecorticosteroidMajor

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

  • DexamethasonecorticosteroidMajor

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

  • FludrocortisonecorticosteroidMajor

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

  • FluocinonidecorticosteroidMajor

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

  • FluticasonecorticosteroidMajor

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

  • Fluticasone and salmeterolcorticosteroidMajor

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

  • HalobetasolcorticosteroidMajor

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

  • HydrocortisonecorticosteroidMajor

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

  • Itraconazoleazole antifungalMajor

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

  • MethotrexateimmunosuppressantMajor

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

  • MethylprednisolonecorticosteroidMajor

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

  • MometasonecorticosteroidMajor

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

  • Nirmatrelvir and ritonavirantiviralMajor

    …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)

  • PrednisolonecorticosteroidMajor

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

  • PrednisonecorticosteroidMajor

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

  • RituximabimmunosuppressantMajor

    The use of RIABNI in patients with RA who have not had prior inadequate response to one or more TNF antagonists is not recommended [see Clinical Studies (14.6) ] . (Rituximab label, Warnings and precautions)

  • TacrolimusimmunosuppressantMajor

    …IN TRANSPLANT PATIENTS; AND INCREASED MORTALITY IN FEMALE LIVER TRANSPLANT PATIENTS • Increased risk for developing serious infections and malignancies with ASTAGRAF XL ® or other immunosuppressants that may lead to hospitalization or death. [see Warnings and Precautions ( 5.1 , 5.2 )] • Increased mortality in female liver transplant patients with ASTAGRAF XL. (Tacrolimus label, Boxed warning)

  • TofacitinibimmunosuppressantMajor

    • Higher rate of all-cause mortality, including sudden cardiovascular (CV) death with XELJANZ vs. TNF blockers in rheumatoid arthritis (RA) patients. (Tofacitinib label, Boxed warning)

  • TriamcinolonecorticosteroidMajor

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

  • UpadacitinibimmunosuppressantMajor

    …safety study in rheumatoid arthritis (RA) patients 50 years of age and older with at least one cardiovascular risk factor comparing another Janus kinase (JAK) inhibitor to tumor necrosis factor (TNF) blockers, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor [see Warnings and Precautions ( 5.2 )] . (Upadacitinib label, Boxed warning)

Moderate interactions (14)

  • Amlodipinedihydropyridine calcium channel blockerModerate

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

  • EverolimusimmunosuppressantModerate

    Lymphomas and Other Malignancies Patients receiving immunosuppressants, including Zortress, are at increased risk of developing lymphomas and other malignancies, particularly of the skin. (Everolimus label, Warnings and precautions)

  • 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)

  • InfliximabimmunosuppressantModerate

    When treating patients, consideration of whether to use RENFLEXIS alone or in combination with other immunosuppressants such as azathioprine or 6-mercaptopurine should take into account a possibility that there is a higher risk of HSTCL with combination therapy versus an observed increased risk of immunogenicity and hypersensitivity reactions with infliximab… (Infliximab label, Warnings and precautions)

  • Ketoconazoleazole antifungalModerate

    Immunosuppressants everolimus, rapamycin (also known as sirolimus), temsirolimus budesonide, ciclesonide, cyclosporine, dexamethasone, fluticasone, methylprednisolone, tacrolimus Rapamycin (sirolimus): Ketoconazole tablets 200 mg daily for 10 days increased the C max and AUC of a single 5 mg dose of sirolimus by 4.3 fold and 10.9 fold, respectively in 23 healthy… (Ketoconazole label, Drug interactions)

  • LeflunomideimmunosuppressantModerate

    If used with concomitant methotrexate and/or other potential immunosuppressive agents, chronic monitoring should be monthly. (Leflunomide label, Warnings and precautions)

  • MycophenolateimmunosuppressantModerate

    Lymphoma and Other Malignancies Patients receiving immunosuppressants, including MYHIBBIN, are at increased risk of developing lymphomas and other malignancies, particularly of the skin [see Adverse Reactions ( 6.1 )]. (Mycophenolate 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)

  • RitonavirantiretroviralModerate

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

  • Sofosbuvir and velpatasvirantiviralModerate

    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)

  • SulfasalazinesulfonamideModerate

    Sulfasalazine Patients in a clinical study who were on established therapy with sulfasalazine, to which Enbrel was added, were noted to develop a mild decrease in mean neutrophil counts in comparison to groups treated with either Enbrel or sulfasalazine alone. (Etanercept label, Drug interactions)

  • TinidazoleantibioticModerate

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

  • TocilizumabimmunosuppressantModerate

    Tocilizumab products have not been studied in combination with biological DMARDs such as TNF antagonists [see Dosage and Administration (2.2) ] . (Tocilizumab label, Drug interactions)

Minor mentions (11)

  • 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)

  • Ezetimibe and 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. (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)

  • 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)

  • Posaconazoleazole antifungalMinor

    CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (Posaconazole label, Drug interactions)

  • 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.