Étanercept : interactions médicamenteuses

Not Recommended for Use with Anakinra or Abatacept Use of Enbrel with anakinra or abatacept is not recommended [see Drug Interactions (7.2) ] . (notice Étanercept, Mises en garde et précautions)

• Higher rate of all-cause mortality, including sudden cardiovascular death, with another JAK inhibitor vs. TNF blockers in rheumatoid arthritis (RA) patients. (notice Abrocitinib, Mise en garde encadrée)

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) ] . (notice Adalimumab, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Higher rate of all-cause mortality, including sudden cardiovascular death with another Janus kinase inhibitor (JAK) vs. TNF blockers in rheumatoid arthritis (RA) patients. (notice Baricitinib, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

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. (notice Captopril, Mises en garde)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (notice Ciclosporine, Mise en garde encadrée)

Prevention or Management Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. (notice Cladribine, Interactions médicamenteuses)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Cyclophosphamide – Not recommended for use with Enbrel. (notice Étanercept, Interactions médicamenteuses)

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. (notice Darunavir, Interactions médicamenteuses)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (notice Itraconazole, Interactions médicamenteuses)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

…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:… (notice Nirmatrelvir et ritonavir, Contre-indications)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

• Higher rate of all-cause mortality, including sudden cardiovascular death with another Janus kinase inhibitor (JAK) vs. TNF blockers in rheumatoid arthritis (RA) patients. (notice Ritlécitinib, Mise en garde encadrée)

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) ] . (notice Rituximab, Mises en garde et précautions)

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. (notice Ruxolitinib, Mises en garde et précautions)

…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. (notice Tacrolimus, Mise en garde encadrée)

• Higher rate of all-cause mortality, including sudden cardiovascular (CV) death with XELJANZ vs. TNF blockers in rheumatoid arthritis (RA) patients. (notice Tofacitinib, Mise en garde encadrée)

Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (notice Étanercept, Mise en garde encadrée)

…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 )] . (notice Upadacitinib, Mise en garde encadrée)

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… (notice Acide fénofibrique, Interactions médicamenteuses)

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

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (notice Amlodipine et atorvastatine, Interactions médicamenteuses)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (notice Amlodipine et olmésartan, Interactions médicamenteuses)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. (notice Amlodipine et valsartan, Interactions médicamenteuses)

Immunosuppressants: cyclosporine, sirolimus, tacrolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for these immunosuppressants when coadministered with REYATAZ. (notice Atazanavir, Interactions médicamenteuses)

Consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. (notice Bendamustine, Mises en garde et précautions)

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. (notice Darunavir et cobicistat, Interactions médicamenteuses)

Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (notice Dénosumab, Mises en garde et précautions)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (notice Éfavirenz, Interactions médicamenteuses)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (notice Éfavirenz, lamivudine et ténofovir, Interactions médicamenteuses)

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. (notice Elvitégravir, cobicistat, emtricitabine et ténofovir, Interactions médicamenteuses)

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. (notice Étravirine, Interactions médicamenteuses)

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… (notice Fénofibrate, Interactions médicamenteuses)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus ↑ Immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents. (notice Fosamprénavir, Interactions médicamenteuses)

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… (notice Infliximab, Mises en garde et précautions)

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… (notice Kétoconazole, Interactions médicamenteuses)

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. (notice Lédipasvir et sofosbuvir, Mises en garde et précautions)

If used with concomitant methotrexate and/or other potential immunosuppressive agents, chronic monitoring should be monthly. (notice Léflunomide, Mises en garde et précautions)

Immunosuppressants: e.g. cyclosporine, tacrolimus, sirolimus ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with KALETRA. (notice Lopinavir et ritonavir, Interactions médicamenteuses)

A treatment regimen containing multiple immunosuppressants (including thiopurines) should therefore be used with caution as this could lead to lymphoproliferative disorders, some with reported fatalities. (notice Mercaptopurine, Mises en garde et précautions)

Lymphoma and Other Malignancies Patients receiving immunosuppressants, including mycophenolate mofetil, are at increased risk of developing lymphomas and other malignancies, particularly of the skin [see Adverse Reactions ( 6.1 )]. (notice Mycophénolate, Mises en garde et précautions)

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. (notice Néfazodone, Interactions médicamenteuses)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus Plasma concentrations may be decreased. (notice Névirapine, Interactions médicamenteuses)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (notice Olmésartan, amlodipine et hydrochlorothiazide, Interactions médicamenteuses)

Treatment has consisted of high doses of corticosteroids alone or, in some cases, concomitantly with an immunosuppressant. (notice Pénicillamine, Mises en garde)

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. (notice Rifampicine, Interactions médicamenteuses)

…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… (notice Rifapentine, Interactions médicamenteuses)

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

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. (notice Sofosbuvir et velpatasvir, Mises en garde et précautions)

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. (notice Étanercept, Interactions médicamenteuses)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (notice Telmisartan et amlodipine, Interactions médicamenteuses)

Prophylaxis of PJP should be considered when concomitant use of corticosteroids or other immunosuppressive agents are required. (notice Temsirolimus, Mises en garde et précautions)

Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (notice Tinidazole, Interactions médicamenteuses)

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

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. (notice Atorvastatine, Mises en garde et précautions)

Thirty-four patients were treated with corticosteroids and one patient was treated with a non-steroidal immunosuppressant. (notice Axitinib, Mises en garde et précautions)

Administer prophylaxis for PJP when concomitant use of corticosteroids or other immunosuppressive agents are required. (notice Évérolimus, Mises en garde et précautions)

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. (notice Ézétimibe et simvastatine, Mises en garde et précautions)

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. (notice Fluvastatine, Mises en garde et précautions)

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. (notice Lovastatine, Mises en garde)

Immunosuppressive Drugs Tacrolimus: Tacrolimus has been shown to be metabolized via the CYP3A system. (notice Nifédipine, Précautions)

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. (notice Pitavastatine, Mises en garde et précautions)

CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (notice Posaconazole, Interactions médicamenteuses)

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. (notice Pravastatine, Mises en garde et précautions)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (notice Propylthiouracile, Mises en garde)

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. (notice Rosuvastatine, Mises en garde et précautions)

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. (notice Simvastatine, Mises en garde et précautions)

In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (notice Thiamazole, Mises en garde)

…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. (notice Clarithromycine, Interactions médicamenteuses)