Compatibility «Cyclosporin» and «Тофацитиниб»

• Interactions Cyclosporin with Тофацитиниб

  • Dangerous interactions
    • ⓘ There is a risk of additive immunosuppression with the combined use of tofacitinib and strong immunosuppressants (e.g. azathioprine, tacrolimus, cyclosporine).
  • Negative interactions
    • ⓘ Ciclosporin and Tofacitinib belong to the same pharmaceutical group: Immunosuppressants.
    • ⓘ Since tofacitinib is metabolized by the action of the CYP3A4 isoenzyme, interaction with drugs that inhibit or induce this isoenzyme is very likely.
    • ⓘ When used concomitantly with potent inhibitors of the CYP3A4 isoenzyme (e.g. ketoconazole), as well as when used concomitantly with one or more moderate inhibitors of the CYP3A4 isoenzyme and potent inhibitors of the CYP2C19 isoenzyme (e.g. fluconazole), the exposure of tofacitinib increases.
    • ⓘ Concomitant use of ketoconazole (a potent inhibitor of the CYP3A4 isoenzyme) and a single dose of tofacitinib increases the AUC and C_max of tofacitinib by 103 and 16%, respectively.
    • ⓘ Concomitant use of fluconazole (a moderate inhibitor of the CYP3A4 isoenzyme, as well as a powerful inhibitor of the CYP2C19 isoenzyme) increases the AUC and C_max of tofacitinib by 79 and 27%, respectively.
    • ⓘ When used concomitantly with powerful inducers of the CYP3A4 isoenzyme (e.g. rifampicin), the exposure of tofacitinib decreases.
    • ⓘ Simultaneous use of rifampicin (a powerful inducer of the CYP3A4 isoenzyme) reduces the AUC and C_max of tofacitinib by 84 and 74%, respectively.
    • ⓘ Concomitant use of tacrolimus (a weak inhibitor of the CYP3A4 isoenzyme) increases the AUC of tofacitinib by 21% and reduces C_max by 9%.
    • ⓘ Concomitant use of cyclosporine (a moderate inhibitor of the CYP3A4 isoenzyme) increases the AUC of tofacitinib by 73% and reduces C_max by 17%.
    • ⓘ In vitro studies have shown that tofacitinib in concentrations even more than 150 times higher than _max, established with the use of recommended therapeutic dosages, does not significantly inhibit or induce the activity of the main drugs metabolized by CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4.
    • ⓘ Tofacitinib exposure increases when it is co-administered with strong CYP3A4 inhibitors (e.g. ketonazole).
    • ⓘ The exposure of tofacitinib increases when it is co-administered with drugs that are both moderate CYP3A4 inhibitors and strong CYP2C19 inhibitors (for example, fluconazole).
    • ⓘ The exposure of tofacitinib decreases when it is co-administered with strong CYP3A4 inducers (e.g. rifampicin).
    • ⓘ It is not recommended to use tofacitinib in combination with biological HDL or strong immunosuppressants such as azathioprine and cyclosporine.
  • No interactions
    • ⓘ These results were confirmed by in vitro studies of drug interaction, which showed no changes in the pharmacokinetics of midazolam, a highly selective substrate of the CYP3A4 isoenzyme, when used concomitantly with tofacitinib.
  • Unclear interactions
    • ⓘ Strong CYP3A4 inhibitors.
    • ⓘ Moderate CYP3A4 inhibitors and strong CYP2C19 inhibitors.
    • ⓘ Strong inducers of CYP3A4.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,025,223 possible combinations of drugs and their components were found 412,561 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2025-12-11

Category - medicine