Learn about adalimumab (Humira) drug interactions — which medications, supplements, and vaccines to avoid, and what to tell your doctor before starting.
Adalimumab (Humira and biosimilars) is a biologic medication that works by suppressing part of your immune system to reduce autoimmune inflammation. Because of how it works, combining it with certain other medications can increase your risk of serious infections, cancer, or other complications.
This guide covers the major and moderate drug interactions you should know about — plus supplements, vaccines, and what to tell your doctor before starting treatment.
Adalimumab doesn't interact with other drugs the way a pill might — it's not processed by your liver in the traditional sense. Instead, most adalimumab interactions happen because of additive immunosuppression. When you combine adalimumab with other medications that also suppress the immune system, the combined effect can be dangerously strong.
There's also a less obvious interaction: TNF-alpha (the protein adalimumab blocks) can affect CYP450 enzymes in your liver. These enzymes are responsible for breaking down many common medications. When adalimumab reduces inflammation, CYP450 activity may normalize, potentially changing how fast your body processes other drugs like warfarin, cyclosporine, or theophylline.
These combinations should be avoided or used with extreme caution:
If you've recently been treated with rituximab, starting adalimumab (or any TNF blocker) too soon increases your risk of serious infections. Your doctor will typically wait until your B-cell counts recover before starting a TNF inhibitor.
You should not receive any live vaccines while taking adalimumab. Live vaccines contain weakened but active viruses or bacteria, and your suppressed immune system may not be able to handle them safely. Examples include:
Inactivated vaccines (like the flu shot, COVID vaccines, and shingles vaccine Shingrix) are generally safe and recommended. Talk to your doctor about updating your vaccines before starting adalimumab.
These combinations are commonly used together but require monitoring:
Methotrexate is actually the most common medication used alongside adalimumab, especially for rheumatoid arthritis. The combination can be more effective than either drug alone. However, both suppress the immune system, so your doctor will monitor you closely for signs of infection and liver toxicity.
These immunosuppressants are sometimes used with adalimumab for Crohn's disease or ulcerative colitis. However, the combination has been linked to an increased risk of hepatosplenic T-cell lymphoma — a rare but often fatal cancer — particularly in younger patients. Discuss this risk carefully with your gastroenterologist.
Many patients take corticosteroids alongside adalimumab, especially when starting treatment. While this is common, combining them adds to overall immunosuppression. Your doctor will typically taper steroids as adalimumab takes effect.
If you take medications processed by CYP450 enzymes, starting adalimumab may change how your body handles them. Drugs to watch include:
This isn't a traditional drug interaction — it happens because reducing inflammation can restore normal liver enzyme activity, changing drug metabolism.
There are no major supplement interactions with adalimumab, but keep the following in mind:
Adalimumab has no significant food interactions. There are no dietary restrictions while taking it. You don't need to take it with food (it's injected, not swallowed), and no foods interfere with how it works.
Alcohol: There's no direct interaction between adalimumab and alcohol. However, if you're also taking methotrexate (which is hard on the liver), your doctor may recommend limiting alcohol consumption. Additionally, heavy drinking can weaken your immune system further.
Before starting adalimumab, make sure your doctor knows about:
Adalimumab's drug interactions are primarily about avoiding double immunosuppression and staying up to date on safe vaccines. The most important thing you can do is give your doctor a complete picture of everything you take — including supplements and OTC medications — and follow their monitoring schedule.
For more about adalimumab, including how it works and common side effects, explore our other guides:
Need help finding adalimumab at an affordable price? Check Medfinder for availability near you.
You focus on staying healthy. We'll handle the rest.
Try Medfinder Concierge FreeMedfinder's mission is to ensure every patient gets access to the medications they need. We believe this begins with trustworthy information. Our core values guide everything we do, including the standards that shape the accuracy, transparency, and quality of our content. We’re committed to delivering information that’s evidence-based, regularly updated, and easy to understand. For more details on our editorial process, see here.
%2C%20Color%3DOriginal.png)
