Drug Interactions between Mifeprex and tofacitinib

Food increases the blood levels of this medication. If you are only receiving one or two doses, you may take it without regard to meals. However, if you are receiving the medication for long-term treatment, you should take it with food at the same time everyday to maintain consistent blood levels and effects. Avoid consuming grapefruit or grapefruit juice during treatment, as it may increase blood levels of the medication to undesirable levels and increase the risk of side effects, including headache, dizziness, fatigue, nausea, vomiting, cramping, diarrhea, hypokalemia (low blood potassium), fluid retention, swelling, and high blood pressure. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Grapefruit juice may increase the plasma concentrations of tofacitinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, some authorities recommend avoiding consumption of grapefruit juice during tofacitinib therapy (Canada). Patients receiving tofacitinib therapy who ingest grapefruits or grapefruit juice should be monitored for adverse effects and undue fluctuations in plasma drug levels.