Tremfya interactions: Alcohol, medications, and vaccines

Tremfya interactions with other medications  

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 Tremfya drug interactions.

Here are some of the drugs that can interact with Tremfya. Keep in mind that this table doesn’t include all drugs that may interact with Tremfya.

This list does not include all of Tremfya’s potential interactions with other medications. For questions about a drug not shown here, talk with your doctor.

Here’s a closer look at two specific types of Tremfya drug interactions:

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 infections.

Interaction explained: Tremfya and other biologic immunomodulators reduce immune system activity. 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:

• abatacept (Orencia)
• canakinumab (Ilaris)
• upadacitinib (Rinvoq)

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

Tricyclic antidepressants (TCAs) are prescribed to treat depression. Some may also be prescribed for certain other conditions, such as nerve pain or migraine. A specific enzyme system may be altered in states of chronic inflammation and receiving Tremfya may change how the body metabolizes TCAs.

Interaction result: Tremfya use with a TCA could make the antidepressant less effective.

Interaction explained: With psoriasis and psoriatic arthritis (which Tremfya treats), your body has increased levels of inflammatory proteins called cytokines. These cytokines can slow the activity of certain enzymes that help your body break down TCAs. (An enzyme is a type of protein.)

Tremfya lowers the levels of certain cytokines in your body. Because of this, the enzymes that break down TCAs may work more quickly. So using Tremfya with a TCA may lower the TCA levels 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

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 and alcohol

There are no 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 Tremfya side effects. For example, you may experience headaches and diarrhea. Alcohol can also worsen the conditions Tremfya is used to treat.

If you have questions about drinking alcohol during Tremfya treatment, talk with your doctor.

Tremfya and health-related interactions

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 reduces immune system activity, 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.
• Liver problems: Tremfya may cause liver problems. It’s important to discuss any history of liver problems with your doctor before starting treatment. If you have ulcerative colitis or Crohn’s disease, your doctor may monitor your liver function with regular tests during Tremfya treatment. If you have a history of liver disease or cirrhosis, your doctor may consider different treatment options for you.
• 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 cause pregnancy loss at high doses. 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.

Tremfya and other interactions

Tremfya may have other interactions, such as with supplements, foods, vaccines, or even lab tests. Read on for more details. 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 a live but weakened form of the virus or bacterium it’s meant to defend against. When your immune system is working as it should, live vaccines usually won’t cause infection.

But Tremfya works by reducing immune system activity, also referred to as weakening the immune system. So if you get a live vaccine, your immune system may be unable 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 is not 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 CBD

Cannabis (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.

When to avoid Tremfya

Sometimes, factors or conditions could prevent your doctor from prescribing Tremfya due to the risk of harm. These are known as contraindications.

One contraindication for use of Tremfya is if you have had a previous allergic reaction to the medication or any of its ingredients. If you suspect this is the case, be sure to mention this to your doctor before you start treatment with Tremfya.

Preventing interactions

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 paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

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.

Summary

Tremfya (guselkumab) is a medicine used for skin and joint problems, but it can react with other things you take. It is usually safe to drink alcohol in moderation while using it, but you should avoid live vaccines because they could make you sick. Some drugs, like certain antidepressants or blood thinners, might also change how Tremfya works in your body. Before you start treatment, tell your doctor about all your vitamins and medicines to stay safe and avoid any dangerous drug interactions.