Actemra has possible interactions with some other drugs. Examples include atorvastatin and warfarin. Talk with your doctor to avoid potentially harmful effects from Actemra interactions.
Actemra is prescribed for certain conditions that affect the immune system, including:
- moderate to severe rheumatoid arthritis (RA) that hasn’t improved enough with other treatments in adults
- giant cell arteritis (GCA) in adults
- interstitial lung disease associated with systemic sclerosis (SSc-ILD) in adults
- cytokine release syndrome caused by treatment with chimeric antigen receptor (CAR)-T cell therapy in adults and children ages 2 years and older
- polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older
- systemic juvenile idiopathic arthritis (SJIA) in children ages 2 years and older
An interaction occurs when one substance causes another substance to have a different effect than expected.
Actemra comes as solution that can be given as an intravenous (IV) infusion or a subcutaneous injection.
By learning about possible Actemra interactions, you can work with your doctor to ensure Actemra will be safe and effective for you to take.
Before you start treatment with Actemra, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.
To learn whether Actemra interacts with supplements, herbs, or vitamins, see the “Actemra and other interactions” section.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Actemra. Keep in mind this table doesn’t include all drugs that may interact with Actemra. Some of these interactions are described in detail in “Drug interactions in depth.”
| Drug class or drug name | Drug examples | Interaction result with Actemra |
|---|---|---|
| biologic disease-modifying antirheumatic drugs (DMARDs) | • adalimumab (Humira) • anakinra (Kineret) • rituximab (Rituxan) | may increase the risk of infections |
| Janus kinase (JAK) inhibitors | • upadacitinib (Rinvoq) • baricitinib (Olumiant) • tofacitinib (Xeljanz) | may increase the risk of infections |
| HMG co-reductase inhibitors (statins) | • simvastatin (Zocor) • atorvastatin (Lipitor) • lovastatin (Mevacor) | can make statins less effective |
| hormonal birth control pills | • desogestrel/ethinyl estradiol (Viorele, others) • norethindrone (Errin, others) • drospirenone/estetrol (Nextstellis) | can make birth control pills less effective |
| calcineurin inhibitors | • cyclosporine (Neoral, Sandimmune, Gengraf) • tacrolimus (Prograf, Astagraf XL) | can make certain calcineurin inhibitors less effective and increase the risk of infections |
| drugs that suppress the immune system | • methotrexate • corticosteroids • azathioprine (Imuran, Azasan) | may increase the risk of infections |
| omeprazole (Prilosec) | — | can make omeprazole less effective |
| warfarin (Jantoven) | — | can make warfarin less effective |
| theophylline (Theo-24, Elixophyllin) | — | can make theophylline less effective |
In some cases, factors or conditions could prevent your doctor from prescribing Actemra due to the risk of harm. These are known as contraindications.
The contraindications of Actemra include:
Having had an allergic reaction to Actemra or any of its ingredients
If you’ve had an allergic reaction to Actemra or any of its ingredients, your doctor will likely not prescribe Actemra. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.
Note:Before you start treatment with Actemra, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Actemra.
There are no known interactions between Actemra and alcohol.
If you have questions about drinking alcohol while receiving Actemra, talk with your doctor or pharmacist.
Here’s a closer look at certain drug interactions of Actemra.
Biologic DMARDs
Using Actemra with biologic DMARDs can increase your risk of getting a serious infection.
Actemra has not been studied in combination with biologic DMARDs. Both Actemra and biologic DMARDs can make your immune system weaker. Taking them together can further weaken your immune system. This makes it harder for your body to fight off an infection. You may be more likely to get an infection when using these drugs together.
Here are some biologic DMARDs that may interact with Actemra:
Steps you or your doctor may take:
Before starting treatment with Actemra, be sure to tell your doctor if you are taking any other biologic DMARDs for your condition. Because of this interaction, your doctor won’t likely prescribe these drugs together. They can determine the best treatment plan for you.
Hormonal birth control
Using Actemra with hormonal birth control pills may make birth control less effective.
Actemra can cause your body to break down hormonal birth control faster than it should. This could lead to lower levels of hormones in your system. Having a lower level of these hormones may cause your birth control to be less effective. This can increase your chances of becoming pregnant.
Here are some hormonal birth control drugs that may interact with Actemra:
- desogestrel/ethinyl estradiol (Viorele, others)
- drospirenone/estetrol (Nextstellis)
- norethindrone (Errin, others)
- levonorgestrel/ethinyl estradiol (Seasonale, others)
- norelgestromin/ethinyl estradiol (Zafemy, Xulane)
Steps you or your doctor may take
If you are able to become pregnant, talk with your doctor about birth control options before starting Actemra. They may recommend a different form of birth control that isn’t affected by Actemra. This may include an intrauterine device (IUD) or barrier methods, such as condoms or diaphragms.
Warfarin
Using Actemra with warfarin may make warfarin less effective.
Actemra can cause your body to break down warfarin faster than it should. This could lead to lower levels of warfarin in your system. Having a lower level of warfarin may cause the drug to not work as well to prevent blood clots.
Steps you or your doctor may take
Tell your doctor if you are taking warfarin before starting treatment with Actemra. They may want to check your international normalized ratio (INR) more frequently while you’re using Actemra. INR is a measure of how long it takes your blood to clot. An INR test will tell your doctor how well warfarin is working. They may need to adjust the dose of warfarin if your INR is too low.
Actemra may have other interactions, such as with supplements, foods, vaccines, or lab tests.
Here are some potential interactions with Actemra. Keep in mind that the following information does not include all possible Actemra interactions.
Actemra interactions with supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Actemra interactions with herbs
There are no specific reports of herbs interacting with Actemra. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Actemra treatment.
Actemra interactions with vitamins
There are no specific reports of vitamins interacting with Actemra. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Actemra.
Actemra interactions with food
There were no reports of food interactions with Actemra. If you’d like to learn more about eating certain foods during treatment with Actemra, talk with your doctor.
Actemra interactions with vaccines
Actemra is known to interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.
But Actemra works by weakening your immune system. If you get a live vaccine, your immune system may not be able to fight the virus or bacteria. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.
Live vaccines to avoid during Actemra treatment include:
- measles, mumps, rubella (MMR)
- chickenpox
- the nasal spray form of the flu vaccine (FluMist)
Before starting Actemra, talk with your doctor or pharmacist about any vaccines you may need.
Actemra interactions with lab tests
Actemra isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
ACTEMRA INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Actemra. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Actemra. The impact of cannabis may affect how well you stick to your Actemra treatment plan.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Actemra. Before you take this drug, be sure to talk with your doctor about your health history. Actemra may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Actemra include:
- Infections: Before starting treatment with Actemra, tell your doctor If you are receiving treatment for an infection. Also, tell them if you have a history of getting a lot of infections or infections that keep coming back. Your doctor may want to wait until your infection is managed before prescribing Actemra. Or they may decide on a different treatment option.
- Liver problems: Treatment with Actemra can affect the liver, leading to liver damage. If you have a liver problem, such as liver failure, talk with your doctor before starting treatment. They can decide whether Actemra is a safe treatment option for you.
- Problems in your stomach or intestines: Actemra can cause ulcers (tears or holes) in the stomach or intestines. You may have an increased risk of having them if you also take corticosteroids, methotrexate, or nonsteroidal anti-inflammatory drugs (NSAIDs). Tell your doctor if you have a history of diverticulitis (inflammation in the intestine) or ulcers in your stomach or intestines. They can tell you whether Actemra is a safe treatment option.
- Nervous system conditions: Some people have been diagnosed with nervous system conditions, such as multiple sclerosis, during treatment with Actemra. It isn’t known whether Actemra can cause other nervous system disorders or make them worse. Tell your doctor if you have any conditions that affect your nervous system before starting Actemra treatment.
- Tuberculosis (TB): Actemra may increase the risk of serious infections, including TB. Tell your doctor if you have TB or have had it in the past. Your doctor will likely test you for TB before starting Actemra and occasionally while you are using the drug.
- Hepatitis B virus (HBV): Before starting treatment with Actemra, tell your doctor if you have hepatitis B or have had it in the past. Actemra could cause hepatitis B to become active again. Your doctor may test you for hepatitis B before prescribing Actemra.
- Allergic reaction: If you’ve had an allergic reaction to Actemra or any of its ingredients, your doctor will likely not prescribe Actemra. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
- Breastfeeding: It’s not known whether it’s safe to use Actemra while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Actemra may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Actemra. They can talk with you about treatment options and ways to feed your child other than breastfeeding.
- Pregnancy: There haven’t been enough clinical trials to determine whether Actemra is safe to use while pregnant. Animal studies show that the drug may cause pregnancy loss. However, it’s important to note that animal studies do not always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Actemra. They can advise you on the right treatment plan for you.
Here are some frequently asked questions about Actemra and possible interactions.
What antibiotics can I take with Actemra?
There are no known reports of Actemra interacting with antibiotics, so you don’t need to avoid specific antibiotics during your treatment with Actemra.
If you develop a bacterial infection while using Actemra, your doctor may prescribe antibiotics to treat it. They’ll also advise you on whether to continue Actemra or temporarily stop treatment until the infection is resolved.
Can you take Actemra with ibuprofen?
Yes. There are no drug interactions reported between Actemra and ibuprofen. Actemracan generally be taken with ibuprofen or other NSAIDs. They are often used together in conditions like RA to manage pain and inflammation.
Keep in mind that using Actemra and ibuprofen or other NSAIDs together can increase the risk of developing ulcers in your stomach or intestine. Talk with your doctor or pharmacist if you have any concerns about using ibuprofen.
You can take certain steps to help prevent interactions with Actemra. Your doctor and pharmacist are key resources, so reaching out to them before starting treatment is a helpful first step. For example, it’s important that you plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list , which your doctor and pharmacist can help you fill out.
It’s also important to read the Actemra label and other
If Actemra doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Actemra by staying on schedule with your infusion appointments or using the subcutaneous injection exactly as your doctor prescribes.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.