7 known interactions • 1 major • 3 moderate • 3 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Live attenuated vaccines (e.g., live influenza, MMR, varicella)
Concurrent use of tezepelumab with live attenuated vaccines is not recommended. The immunomodulatory effects of tezepelumab may theoretically alter the immune response to live vaccines, potentially reducing efficacy or increasing risk of vaccine-strain infection. Ensure patients are up to date with all recommended vaccinations, including inactivated vaccines, prior to initiating therapy.
Systemic corticosteroids (prednisone, methylprednisolone)
Patients on long-term oral corticosteroids for asthma control may require gradual dose tapering when tezepelumab achieves disease control. Abrupt discontinuation of corticosteroids can precipitate adrenal insufficiency. The combination is clinically intended to reduce corticosteroid burden, but the taper must be medically supervised to avoid adrenal crisis or loss of asthma control.
Other biologic immunomodulators (dupilumab, mepolizumab, benralizumab, omalizumab)
Co-administration of tezepelumab with other biologic agents for asthma or atopic disease has not been adequately studied. The potential for additive immunosuppression, unforeseen immune dysregulation, or interference with efficacy endpoints is unknown. Switching between biologics should be done under the supervision of a specialist, generally with an appropriate washout period.
Immunosuppressants (methotrexate, azathioprine, cyclosporine)
Combining tezepelumab with other systemic immunosuppressants may increase the cumulative risk of serious infections including opportunistic infections. Close clinical monitoring for signs of infection is warranted. The combination is not standard for asthma management and should only be used if the clinical benefit clearly outweighs the risks.
Anti-helminthic agents (albendazole, mebendazole, ivermectin)
TSLP plays a role in host immune defense against helminthic (parasitic worm) infections. Tezepelumab may blunt the innate immune response to parasitic infection. In patients living in or traveling to endemic regions, screening for helminth infection prior to initiating therapy is recommended. If a helminth infection develops during treatment, anti-parasitic therapy should be initiated promptly.
Inhaled corticosteroids (fluticasone, budesonide, beclomethasone)
Tezepelumab is indicated as an add-on to, not a replacement for, inhaled corticosteroids. The combination is the backbone of severe asthma management. No pharmacokinetic interaction exists, but dose adjustments of the inhaled corticosteroid may be considered after sustained asthma control is achieved with the biologic.
Beta-2 agonists (salmeterol, formoterol, albuterol)
No known pharmacokinetic or pharmacodynamic interaction between tezepelumab and beta-2 agonists. These agents are complementary: tezepelumab reduces underlying airway inflammation while beta-2 agonists provide bronchodilation. Patients should continue their rescue inhaler as prescribed and not use improved symptom control as a reason to discontinue bronchodilators without medical guidance.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Tezepelumab. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.