Skyrizi Drug Interactions: What to Avoid and What to Tell Your Doctor

One of Skyrizi's notable advantages is its relatively low risk of drug-drug interactions compared to some other biologics. Clinical pharmacology studies show that Skyrizi does not significantly affect the activity of CYP enzymes (the liver enzymes involved in metabolizing most medications), and it has no known interactions with commonly used medications like metformin, statins, blood pressure drugs, or NSAIDs. However, there are specific interactions you need to know about—particularly with vaccines and other immunosuppressants.

Most Important Interaction: Live Vaccines (AVOID)

The most critical interaction with Skyrizi involves live vaccines. Do not receive any live vaccine right before, during, or immediately after treatment with Skyrizi. Because Skyrizi suppresses part of your immune system, live vaccines could cause serious infection.

Live vaccines to avoid while on Skyrizi include:

Live flu vaccine (FluMist nasal spray) — standard injectable flu shots are fine

Zostavax (live shingles vaccine) — Shingrix (recombinant, non-live) is acceptable

MMR vaccine (measles, mumps, rubella)

Varicella (chickenpox) vaccine

BCG vaccine

Yellow fever vaccine

Typhoid vaccine (live oral form)

Rotavirus oral vaccine

Adenovirus types 4 and 7 oral vaccine

If you need any vaccine, tell your healthcare provider you are taking Skyrizi. Ideally, complete all age-appropriate vaccinations before starting Skyrizi therapy. Inactivated (non-live) vaccines like standard flu shots, Shingrix, pneumococcal vaccines, hepatitis B, and HPV vaccines are generally safe to receive during Skyrizi treatment.

Major Drug Interaction: Upadacitinib (Rinvoq) — Contraindicated

Combining Skyrizi with upadacitinib (Rinvoq)—a JAK inhibitor—is contraindicated. Both drugs suppress the immune system by different mechanisms, and using them together dramatically increases the risk of serious and potentially life-threatening infections. Do not take Rinvoq while on Skyrizi.

Caution With Other Immunosuppressants

Using Skyrizi with other immunosuppressive medications increases infection risk through additive immunosuppressive effects. This includes:

Other biologic DMARDs (e.g., other TNF inhibitors, IL-17 inhibitors, vedolizumab) — combination biologic therapy is generally avoided unless specifically studied and prescribed under specialist supervision

High-dose corticosteroids — increased infection risk; taper corticosteroids as directed by your doctor

Ublituximab (Briumvi) and other anti-CD20 agents — monitor closely for additive immunosuppressive effects if coadministered

CAR-T cell therapies (e.g., axicabtagene ciloleucel, brexucabtagene autoleucel) — avoid combination due to additive immunosuppression and infection risk

Note: Methotrexate is commonly used with Skyrizi for PsA (as a non-biologic DMARD) and has not shown significant pharmacokinetic or safety interactions in clinical studies.

Medications That Do NOT Significantly Interact With Skyrizi

Clinical studies have confirmed that Skyrizi does not significantly interact with many commonly used medications, including:

Metformin (diabetes medication)

Atorvastatin and other statins (cholesterol medications)

Lisinopril, amlodipine (blood pressure medications)

Ibuprofen, aspirin (NSAIDs/pain relievers)

Levothyroxine (thyroid medication)

Corticosteroids (commonly used in IBD induction)

Alcohol and Food Interactions

There are no known interactions between Skyrizi and food or alcohol. However, alcohol can worsen the symptoms of Crohn's disease or UC, so patients with IBD may be advised to limit alcohol regardless. If you have concerns about alcohol use while on Skyrizi, speak with your doctor.

Always Tell Your Doctor About All Medications

Before starting Skyrizi, give your doctor a complete list of all prescription drugs, over-the-counter medications, vitamins, herbal supplements, and vaccines you've recently received or plan to receive. For a full overview of Skyrizi's safety profile, see Skyrizi Side Effects: What to Expect and When to Call Your Doctor.