Drug Interactions between deucravacitinib and moxifloxacin / triamcinolone

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.

GENERALLY AVOID: Coadministration of deucravacitinib with other immunosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies. Serious infections have been reported in patients with psoriasis who received deucravacitinib. The most common serious infections reported with deucravacitinib included pneumonia and COVID-19. Herpes zoster and herpes simplex viral reactivation were also reported during clinical studies with deucravacitinib, as well as malignancies including lymphoma.

MANAGEMENT: The safety and efficacy of deucravacitinib in combination with immunosuppressive agents has not been evaluated. The manufacturer recommends that the concomitant use of deucravacitinib with potent immunosuppressants (e.g., azathioprine, cyclosporine) should be avoided. Patients receiving deucravacitinib should be closely monitored for the development of signs and symptoms of infection during and after treatment, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy. If a serious infection develops, deucravacitinib should be interrupted until the infection is controlled.