Can you take Guselkumab with Upadacitinib?

Upadacitinib has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of upadacitinib is associated with an increase incidence of neutropenia, lymphopenia, and anemia. Avoid initiation or interrupt treatment with upadacitinib in patients with low neutrophil counts (i.e., ANC less than 1000 cells/mm3), lymphocyte counts (i.e., less than 500 cells/mm3) and low hemoglobin levels (i.e., less than 8 g/dL). It is recommended to evaluate patients for abnormal blood cell counts at baseline and thereafter according to routine patient management.

Upadacitinib has a major potential interaction with Cardiovascular Conditions and Disorders.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Upadacitinib has a moderate potential interaction with Gastrointestinal Diverticula.

Gastrointestinal perforation has been reported with the use of upadacitinib. This agent should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs). It is recommended to monitor for new onset abdominal symptoms for early identification of gastrointestinal perforation.

Upadacitinib has a moderate potential interaction with Gastrointestinal Perforation.

Gastrointestinal perforation has been reported with the use of upadacitinib. This agent should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs). It is recommended to monitor for new onset abdominal symptoms for early identification of gastrointestinal perforation.

Upadacitinib has a moderate potential interaction with High Cholesterol.

Treatment with upadacitinib is associated with increases in lipid parameters, including total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. Care should be exercised when using this agent in patients with hyperlipidemia. It is recommended to monitor patients after initiation of treatment, and thereafter according to the clinical guidelines and to manage patients accordingly.

Guselkumab has a moderate potential interaction with History, Tuberculosis.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Upadacitinib has a major potential interaction with Infection.

Serious and sometimes fatal infections, including opportunistic and reactivation of infections have been reported in patients receiving upadacitinib treatment. It is recommended to avoid the use of upadacitinib in patients with an active, serious infection, including localized infections. Closely monitor patients for the development of signs and symptoms of infection during and after treatment with upadacitinib. Interrupt therapy if a patient develops a new infection or an opportunistic infection and appropriate antimicrobial therapy should be initiated. Treatment with upadacitinib may be resumed once the infection is controlled.

Guselkumab has a moderate potential interaction with Infection.

There have been reports of serious infections, including infections with opportunistic pathogens, and reactivation of latent infections in patients receiving interleukin inhibitors. Treatment with these agents should not be initiated in patients with an active infection until the infection resolves or is adequately treated. Caution is recommended when considering the use of interleukin inhibitors in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections.

Upadacitinib has a moderate potential interaction with Liver Disease.

The use of upadacitinib is not recommended in patients with severe hepatic impairment. No dose adjustment is required in patients with mild or moderate hepatic impairment. Treatment with upadacitinib is associated with increased incidence of liver enzyme elevation. Evaluate baseline liver function and thereafter according to routine patient management. Treatment should be interrupted if drug-induced liver injury is suspected.

Upadacitinib has a major potential interaction with Smoking.

Malignancies (including lymphomas and solid tumors) have been reported in patients treated with tofacitinib, baricitinib, upadacitinib, deuruxolitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory conditions. Patients who are current or past smokers are at additional increased risk of malignancies. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, pacritinib, and fedratinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with a known malignancy (other than successfully treated nonmelanoma skin cancer), patients who develop a malignancy during therapy, and patients who are current or past smokers. Periodic skin examination is recommended for patients who are at increased risk for skin cancer.

Upadacitinib has a major potential interaction with Smoking.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Upadacitinib has a major potential interaction with Thrombotic/Thromboembolic Disorder.

Thrombosis (including deep venous thrombosis, pulmonary embolism, cerebral venous sinus thrombosis, and arterial thrombosis) has occurred in patients treated for inflammatory conditions with Janus kinase (JAK) inhibitors, including baricitinib, tofacitinib, deuruxolitinib and upadacitinib. Many of these adverse events were serious and some resulted in death. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, fedratinib, and pacritinib. In general, JAK inhibitors should be avoided in patients who may be at increased risk of thrombosis. Tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve/maintain therapeutic response when treating ulcerative colitis. If symptoms of thrombosis occur in any patients receiving JAK inhibitors, treatment should be discontinued and patients should be evaluated promptly and treated appropriately.

Guselkumab has a moderate potential interaction with Tuberculosis, Active.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Upadacitinib has a major potential interaction with Tuberculosis, Latent.

Serious and sometimes fatal infections, including opportunistic and reactivation of infections have been reported in patients receiving upadacitinib treatment. It is recommended to avoid the use of upadacitinib in patients with an active, serious infection, including localized infections. Closely monitor patients for the development of signs and symptoms of infection during and after treatment with upadacitinib. Interrupt therapy if a patient develops a new infection or an opportunistic infection and appropriate antimicrobial therapy should be initiated. Treatment with upadacitinib may be resumed once the infection is controlled.

Guselkumab has a moderate potential interaction with Tuberculosis, Latent.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Upadacitinib has a moderate potential interaction with Vaccination.

Use of live, attenuated vaccines during, or immediately prior to, upadacitinib therapy is not recommended. Prior to initiating treatment with upadacitinib, it is recommended that patients be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.