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Drug Interactions between landiolol and Xeljanz XR

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tofacitinib landiolol

Applies to: Xeljanz XR (tofacitinib) and landiolol

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Tofacitinib has been shown to decrease heart rate and prolong the PR interval of the electrocardiogram in some patients. Theoretically, coadministration with other agents that prolong the PR interval (e.g., beta-blockers, digoxin, alpha-2 adrenoceptor agonists) may result in elevated risk of conduction disturbances and atrioventricular block. In clinical trials, use of tofacitinib (10 to 20 mg daily; at steady-state) was associated with significant decreases in heart rate (4 to 7 bpm) and increases in PR interval (4 to 10 ms) compared with placebo.

MANAGEMENT: According to the manufacturer, concomitant use of tofacitinib with other agents that lower heart rate and/or prolong the PR interval should be avoided when possible. Caution is advised if concomitant use is necessary, particularly in patients with known conduction problems or severe cardiac disease. An ECG should be considered in these patients before initiating concomitant therapy and after titration to steady-state. Patients should be advised to notify their physician if they experience dizziness, lightheadedness, fainting, or irregular heartbeats.

Drug and food interactions

Moderate

tofacitinib food

Applies to: Xeljanz XR (tofacitinib)

Consumer information for this interaction is not currently available.

MONITOR: Grapefruit juice may increase the plasma concentrations of tofacitinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.

MANAGEMENT: Until more information is available, some authorities recommend avoiding consumption of grapefruit juice during tofacitinib therapy (Canada). Patients receiving tofacitinib therapy who ingest grapefruits or grapefruit juice should be monitored for adverse effects and undue fluctuations in plasma drug levels.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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