. 2008 May;4(5):337–347.

Table 9.

Biologic Drug Interactions

Drug	Drug-Drug Interaction	Cytochrome Association	Renal Impairment	Hepatic Impairment
Infliximab	Abciximab: increases potential for hypersensitivity reaction; may increase risk of thrombocytopenia and/or reduced therapeutic efficacy Anakinra: may increase risk of serious infection when used in combination Etanercept: may increase risk of serious infection when used in combination Vaccine (dead organism): infliximab may decrease the efiect of vaccines Vaccine (live organism): immunosuppressants may enhance the adverse/toxic efiects of vaccines	No	No	No
Adalimumab	Anakinra: increases risk of serious infection and neutropenia Methotrexate: reduces adalimumab clearance Vaccine (live organism): immunosuppressants may enhance the adverse/toxic efiects of vaccines	No	No	No
Natalizumab	Caution with concurrent immunomodulator therapy/immunosuppression/antineoplastic therapy, as they may be risk factors for the development of PML, opportunistic infections, and neoplasms Interferon beta-1a: may increase the levels of natalizumab; no dosage adjustment necessary Caution advised in patients with history of depression Caution advised with hepatotoxic drugs, as they can increase bilirubin and transaminases	No	Not studied	Postmarketing reports of hepatotoxicity