Avonex interactions: Alcohol, medications, and other factors

Avonex interactions with other drugs

Before you start treatment with Avonex, 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 Avonex interacts with supplements, herbs, or vitamins, see the “Avonex and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

The manufacturer of Avonex did not look at drug interactions in clinical trials. However, other studies have identified some possible interactions. Here’s a table of drugs that may interact with Avonex. Keep in mind this table doesn’t include all drugs that may interact with Avonex. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Avonex 

In some cases, factors or conditions could prevent your doctor from prescribing Avonex due to the risk of harm. These are known as contraindications.

The contraindications of Avonex include:

Having had an allergic reaction to Avonex or any of its ingredients

If you’ve had an allergic reaction to Avonex or any of its ingredients, your doctor will likely not prescribe Avonex. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Avonex, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Avonex.

Avonex and alcohol

If you drink alcohol, your doctor will likely recommend that you not drink it while using Avonex.

Consuming alcohol and using Avonex can increase the risk of liver damage. It may also worsen some of the side effects of Avonex, including:

• confusion
• dizziness
• drowsiness
• fatigue

If you have concerns about avoiding alcohol while you’re using Avonex, talk with your doctor before starting treatment.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Avonex.

NNRTIs

NNRTIs are a type of antiretroviral drug for HIV. Both Avonex and NNRTIs can cause liver damage. Taking NNRTIs with Avonex can increase the risk of liver damage. Having chronic hepatitis C infection further increases this risk.

Here are some NNRTI drugs that may interact with Avonex:

• doravirine (Pifeltro)
• efavirenz
• nevirapine
• rilpivirine (Edurant)

These and other NNRTI drugs may also be found in combination antiretroviral treatments.

Steps you or your doctor may take

Doctors usually try to avoid prescribing Avonex with an NNRTI. In some cases, it isn’t possible to avoid prescribing this combination. If your doctor prescribes an NNRTI with Avonex, they’ll check the health of your liver during treatment. For instance, they may order certain liver function tests.

Some NNRTI drugs are more likely to cause liver damage than others. If your doctor needs to prescribe one of these drugs, they may choose one with a lower risk of problems.

NRTIs

As with NNRTI drugs, NRTIs can cause liver damage. Taking NRTIs with Avonex can increase this risk. NRTI drugs can also cause problems with low blood cell counts, including red blood cells and white blood cells. Avonex can increase the risk of this potentially serious side effect of NRTIs.

Here are some NRTI drugs that may interact with Avonex:

• abacavir (Ziagen)
• emtricitabine (Emtriva)
• lamivudine (Epivir)
• zidovudine (Retrovir)

These and other NRTI drugs may also be found in combination antiretroviral treatments.

Steps you or your doctor may take

Doctors will use caution if they have to prescribe Avonex with an NRTI drug. Some NRTI drugs cause more problems with the liver and blood cell counts than others. They’ll pick the best drug for your situation and closely monitor your liver function and blood cell levels.

Monoclonal antibody drugs

Monoclonal antibodies work by targeting parts of the immune system. This is helpful for treating certain diseases, but it can also weaken the immune system. Having a weak immune system can raise your risk of certain infections and cancers. Using Avonex with a monoclonal antibody medication can increase your risk further.

Here are some monoclonal antibody drugs that may interact with Avonex:

• alemtuzumab (Campath, Lemtrada)
• natalizumab (Tysabri)
• ocrelizumab (Ocrevus)
• ofatumumab (Arzerra, Kesimpta)

Steps you or your doctor may take

Usually, doctors try to avoid prescribing Avonex with a monoclonal antibody. However, the interaction is stronger with certain drugs, such as natalizumab, compared to others. If you need a monoclonal antibody drug while using Avonex, your doctor will likely choose one that doesn’t have such a strong interaction.

Avonex and other interactions 

Avonex may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with Avonex. Keep in mind that the following information does not include all possible Avonex interactions.

Avonex and supplements

The prescribing information for Avonex doesn’t list any interactions with supplements such as vitamins and herbs.

Avonex and herbs

There are no specific reports of herbs interacting with Avonex. 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 Avonex treatment.

Avonex and vitamins

There are no specific reports of vitamins interacting with Avonex. But vitamin interactions are still possible. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Avonex.

Avonex and food

There were no reports of food interactions with Avonex. If you’d like to learn more about eating certain foods during treatment with Avonex, talk with your doctor.

Avonex and vaccines

There aren’t any known interactions between Avonex and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Avonex and lab tests

Avonex isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

AVONEX INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Avonex. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Avonex. The impact of cannabis may affect how well you stick to your Avonex treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Avonex and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Avonex. Before you use this drug, be sure to talk with your doctor about your health history. Avonex 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 Avonex include:

• Autoimmune diseases: New autoimmune diseases have been reported in people using Avonex. (An autoimmune disorder is when the immune system attacks healthy tissues by mistake.) If you have an autoimmune disorder, tell your doctor before starting Avonex. They can advise you on the right treatment plan for you.
• Bleeding problems or blood clots: Using Avonex can cause problems with blood cells called platelets. (Platelets help your blood clot.) Some people using Avonex may develop low platelets, leading to bleeding. It’s also possible to have a side effect that damages platelets and leads to blood clots. Tell your doctor if you have a history of bleeding or clotting problems.
• Heart problems: Tell your doctor if you have heart problems before starting Avonex. Using Avonex may cause or worsen congestive heart failure in some people. Your doctor may recommend increased heart monitoring while starting Avonex and during treatment.
• Latex allergy: Avonex prefilled syringes and prefilled auto-injectors have a latex cap. If you have a latex allergy, using Avonex could cause an allergic reaction. Tell your doctor if you have a latex allergy and ask about latex-free treatment options.
• Liver problems: New or worsening liver problems have happened in people using Avonex. This includes liver failure. If you have current or past problems with your liver, tell your doctor before starting Avonex. They may recommend checking your liver function more often during Avonex treatment.
• Low blood cell counts: Using Avonex can cause problems with low blood cell counts, including red blood cells, white blood cells, and platelets. Tell your doctor if you’ve had problems with low blood cell counts in the past. They may recommend checking your blood cell counts during Avonex treatment.
• Seizures: Using Avonex can cause seizures in people with or without a history of seizures. Tell your doctor if you’ve ever had a seizure. They can advise you on the right treatment plan for you.
• Thyroid problems: Thyroid problems, including high thyroid and low thyroid, have been reported in people using Avonex. Tell your doctor if you have or have had thyroid problems. They may recommend checking your thyroid function during Avonex treatment.
• Allergic reaction: If you’ve had an allergic reaction to Avonex or any of its ingredients, your doctor will likely not prescribe Avonex. 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 Avonex while breastfeeding. Avonex may pass into breast milk in low levels, but its effects on a child who is breastfed are not known. If you’re breastfeeding or planning to, talk with your doctor before using Avonex. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
• Pregnancy: There haven’t been enough clinical trials to determine whether Avonex is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Avonex. They can advise you on the right treatment plan for you.
• Mental health problems: Some people using Avonex have developed mood disorders, including depression and suicidal thoughts. Tell your doctor if you have a history of these or other mental health problems. Call your doctor if you have mood changes or other mental health symptoms during Avonex treatment.

FAQ about Avonex and interactions 

Here are some frequently asked questions about Avonex and possible interactions.

Does Avonex make you immunocompromised?

Yes, it’s possible to become immunocompromised while using Avonex. This means your immune system isn’t working as well as usual to protect your body from infections. Having a weaker immune system increases the risk of developing infections, some of which may be serious. It happens when your white blood cell count is too low. (White blood cells fight infections.)

People using Avonex have also reported new autoimmune diseases.

If you have questions or concerns about immune system problems while using Avonex, talk with your doctor or pharmacist. You can also read this in-depth article on Avonex side effects.

Can you take ibuprofen with Avonex?

Yes, it’s generally safe to take ibuprofen (Advil, Motrin) with Avonex. There aren’t any reports of these two medications interacting with each other.

People with MS often take ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID) to manage muscle pain and headaches. Because NSAIDs target inflammation, they can be very helpful for pain from MS.

Talk with your doctor or pharmacist before taking ibuprofen or other NSAIDs. They can advise you whether NSAIDs are safe for you and recommend an effective dosage.

Preventing interactions

You can take certain steps to help prevent interactions with Avonex. 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 Avonex label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Avonex 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 Avonex by using it exactly as your doctor prescribes. To learn more, see this article about Avonex and dosage.

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.