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

Yusimry (adalimumab-aqvh) interacts with a number of other medications, vaccines, and medical products. Some interactions are dangerous and must be avoided; others simply require closer monitoring. Because Yusimry suppresses part of your immune system, many interactions relate to increased infection risk. Here's what you and your doctor need to know.

Major Interactions: Avoid These Combinations

Other Biologic DMARDs (Anakinra, Abatacept, Other TNF Blockers)

Combining Yusimry with other biologic medications that also suppress the immune system is not recommended. Specifically:

Anakinra (Kineret): Combining anakinra (an IL-1 receptor antagonist) with a TNF blocker was associated with a greater proportion of serious infections and neutropenia, with no added benefit. This combination is not recommended.

Abatacept (Orencia): Concurrent use with TNF blockers including Yusimry was associated with more serious infections in RA trials, with no improvement in clinical benefit. Not recommended.

Other TNF blockers (etanercept, certolizumab, golimumab, infliximab): Combining multiple TNF blockers provides no additional benefit and significantly increases infection risk. Never use two TNF inhibitors simultaneously.

Live and Live-Attenuated Vaccines

You must NOT receive live or live-attenuated vaccines while on Yusimry. Because Yusimry suppresses the immune system, a live vaccine could cause infection instead of immunity. Live vaccines to avoid include:

MMR (measles, mumps, rubella)

Varicella (chickenpox)

Yellow fever

Live attenuated influenza vaccine (nasal spray flu vaccine — FluMist)

Non-live vaccines are generally safe on Yusimry: standard flu shot, COVID-19 vaccines, Shingrix (shingles), pneumococcal vaccines, and Tdap. Talk to your doctor about timing vaccines before starting Yusimry if possible.

Moderate Interactions: Monitor Carefully

Rituximab (Rituxan) — Higher Infection Risk After Use

A higher rate of serious infections has been observed in RA patients treated with rituximab who then receive a TNF blocker like Yusimry. If you have been on rituximab recently, your doctor should carefully consider the timing before starting Yusimry.

CYP450 Substrates (Warfarin, Cyclosporine, Theophylline)

TNF-alpha and other cytokines regulate liver enzymes called CYP450, which metabolize many medications. When TNF-alpha is blocked by Yusimry, CYP450 enzyme activity may change — altering how other drugs are processed. Drugs that are metabolized by CYP450 and have narrow therapeutic windows may need dose adjustment:

Warfarin (Coumadin): Monitor INR levels closely when starting or stopping Yusimry

Cyclosporine: Monitor blood levels and adjust dose as needed

Theophylline: Monitor drug concentrations — levels may change when starting or stopping Yusimry

Azathioprine and 6-Mercaptopurine (6-MP)

Azathioprine and 6-mercaptopurine are used in some IBD patients on Yusimry. While they can be continued if clinically necessary, this combination has been associated with hepatosplenic T-cell lymphoma (HSTCL) — a rare, aggressive, and often fatal T-cell cancer. HSTCL has primarily been reported in young adult males with Crohn's disease or ulcerative colitis. Discuss this risk carefully with your gastroenterologist.

Compatible Medications (Generally Safe to Continue)

Methotrexate — commonly used with Yusimry in RA; can improve efficacy and reduce antibody formation

Non-biologic DMARDs (hydroxychloroquine, sulfasalazine, leflunomide)

NSAIDs (ibuprofen, naproxen) — for pain management

Glucocorticoids (prednisone) — can be continued during Yusimry therapy (note: increases infection risk)

Aminosalicylates (mesalamine) — commonly continued in IBD patients on Yusimry

What to Tell Your Doctor

Before starting Yusimry, tell your doctor about all medications you take — including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Also share:

Any recent or planned vaccines (ask about timing before starting)

Any history of tuberculosis, hepatitis B, or opportunistic infections

If you are pregnant, plan to become pregnant, or are breastfeeding

Any blood thinners, immunosuppressants, or other biologic medications

For a complete overview of Yusimry side effects, see our guide: Yusimry Side Effects: What to Expect. And if you need help finding your prescription, medfinder can locate pharmacies near you with Yusimry in stock.