Drug Interaction Report

Patients that have been treated with tofacitinib should let their doctor know before receiving allogeneic processed thymus tissue. Depending on the dose and length of time they have been on tofacitinib, they may be at risk for reduced effects of allogeneic processed thymus tissue. Their doctor may already be aware of the risks, but has determined that this is the best course of treatment and has taken appropriate precautions and is monitoring closely for any potential complications. Patients should contact their doctor if their symptoms worsen or their condition changes during treatment with these medications. 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.