Tremfya (guselkumab) is a brand-name subcutaneous injection prescribed for psoriasis and psoriatic arthritis in adults. Tremfya has interactions with some other drugs. Examples include abatacept (Orencia) and amitriptyline.
An interaction occurs when one substance causes another substance to have a different effect than expected.
To learn more about Tremfya’s interactions, keep reading. For additional information about Tremfya, including details about its uses, see this article.
Before you start treatment with Tremfya, 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 Tremfya interacts with supplements, herbs, or vitamins, see the “Tremfya 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 Tremfya. Keep in mind that this table doesn’t include all drugs that may interact with Tremfya. Some of these interactions are described in more detail in the “Drug interactions in depth” section.
| Drug class | Drug examples | Interaction result with Tremfya |
|---|---|---|
| biologic immunomodulators | • abatacept (Orencia) • canakinumab (Ilaris) • upadacitinib (Rinvoq) | can increase the risk of infections |
| tricyclic antidepressants (TCAs) | • amitriptyline • imipramine • nortriptyline (Pamelor) | may make TCAs less effective |
| certain opioids | • codeine • methadone (Methadose) • oliceridine (Olinvyk) | may make certain opioids less effective |
| certain antipsychotics | • pimozide • thioridazine | may make certain antipsychotics less effective |
In some cases, factors or conditions could prevent your doctor from prescribing Tremfya due to the risk of harm. These are known as contraindications. The contraindications of Tremfya include:
Having had an allergic reaction to Tremfya or any of its ingredients
If you have had an allergic reaction to Tremfya or any of its ingredients, your doctor will likely not prescribe Tremfya. 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 Tremfya, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Tremfya.
There aren’t any known interactions between Tremfya and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Tremfya treatment.
This is because drinking alcohol may worsen some of Tremfya side effects. For example, you may experience headaches and diarrhea.
Alcohol can also worsen the condition Tremfya is used to treat. For example, if you have psoriasis or psoriatic arthritis, drinking alcohol may worsen your symptoms.
If you have questions about drinking alcohol during Tremfya treatment, talk with your doctor.
Here’s a closer look at certain drug interactions of Tremfya.
Biologic immunomodulators
Biologic immunomodulators are prescribed to treat certain autoimmune conditions, such as psoriasis and psoriatic arthritis. (A biologic is a drug made using living cells. And an immunomodulator is a drug that reduces activity in part of your immune system. Tremfya is a biologic immunomodulator.)
Interaction result: Tremfya use with other biologic immunomodulators can raise your risk of infection.
Interaction explained: Tremfya and other biologic immunomodulators both weaken your immune system. This can make it harder for your body to fight infections. So these drugs together can raise your risk of infections.
Examples of biologic immunomodulator drugs: Here are some biologic immunomodulators that may interact with Tremfya:
Steps you or your doctor may take: Doctors will usually avoid prescribing Tremfya with other biologic immunomodulators. If you already use one of these drugs for your condition, talk with your doctor about your treatment options.
If you have questions about Tremfya use with other biologic immunomodulators, talk with your doctor or pharmacist.
Tricyclic antidepressants (TCAs)
TCAs are prescribed to treat depression. Some may also be prescribed for certain other conditions, such as nerve pain or migraine.
Interaction result: Tremfya use with a TCA could make the antidepressant less effective.
Interaction explained: With psoriasis and psoriatic arthritis (which Tremfya treats), you have increased levels of inflammatory proteins called cytokines in your body. These cytokines can slow the activity of certain enzymes that help your body breakdown TCAs. (An enzyme is a type of protein.)
Tremfya lowers the levels of certain cytokines in your body. Because of this, the enzymes that breakdown TCAs may work more quickly. So using Tremfya with a TCA may lower the level of the TCA in your body. This could make the antidepressant less effective.
Examples of TCAs: Here are some TCAs that may interact with Tremfya:
- amitriptyline
- imipramine
- nortriptyline (Pamelor)
Steps you or your doctor may take: If you take a TCA, talk with your doctor before starting Tremfya. If you take these drugs together, your doctor will likely monitor you more closely to make sure the antidepressant is still working for you.
If you have questions about Tremfya use with a TCA, talk with your doctor or pharmacist.
Tremfya may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Tremfya.
Tremfya and supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Tremfya and herbs
There are no specific reports of herbs interacting with Tremfya. 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 Tremfya treatment.
Tremfya and vitamins
There are no specific reports of vitamins interacting with Tremfya. 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 Tremfya.
Tremfya and food
There were no reports of food interactions with Tremfya. If you’d like to learn more about eating certain foods during treatment with Tremfya, talk with your doctor.
Tremfya interactions with vaccines
Tremfya 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 Tremfya works by weakening your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.
Examples of live vaccines to avoid during Tremfya treatment include:
- measles, mumps, rubella (MMR)
- chickenpox
- flu vaccine (nasal spray form)
Before starting Tremfya, talk with your doctor or pharmacist about any vaccines you may need.
Tremfya and lab tests
Tremfya isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
TREMFYA INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Tremfya. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Tremfya. The impact of cannabis may affect how well you stick to your Tremfya 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 Tremfya. Before you start this drug, be sure to talk with your doctor about your health history. Tremfya 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 Tremfya include:
- Infections: Tremfya weakens part of your immune system, so you may have a higher risk of infections while receiving it. Before starting treatment, tell your doctor if you have any ongoing infections or infections that keep coming back. Also, tell your doctor if you’ve had serious infections such as tuberculosis (TB) in the past. Your doctor may test you for TB before prescribing Tremfya. They also may recommend getting certain vaccinations and prescribe medications to treat any infections you have.
- Allergic reaction: If you’ve had an allergic reaction to Tremfya or any of its ingredients, your doctor will likely not prescribe Tremfya. Taking 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 Tremfya while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Tremfya may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before starting Tremfya. They can talk with you about treatment options and ways to feed your child.
- Pregnancy: There haven’t been enough clinical trials to determine whether Tremfya is safe to use while pregnant. In animal studies, the drug did not cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Tremfya. They can advise you on the right treatment plan for you.
You can take certain steps to help prevent interactions with Tremfya. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should 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 Tremfya label and other
If Tremfya 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 Tremfya by using it 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.