Tremfya (guselkumab) is a prescription drug used to treat psoriatic arthritis and plaque psoriasis. It can interact with other medications and some vaccines. For example, Tremfya can interact with abatacept (Orencia) and paroxetine (Brisdelle, Paxil).
Tremfya is used in certain adults to treat:
Tremfya comes as a liquid solution that’s injected under your skin. It’s a biologic drug and contains the active ingredient guselkumab.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Tremfya’s possible interactions. And for more information about Tremfya, including details about its uses, see this article.
Before you start Tremfya treatment, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Tremfya interacts with herbs or vitamins and supplements, see the “Are there other interactions with Tremfya?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Tremfya. Keep in mind that this table does not include all drugs that may interact with Tremfya. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| tricyclic antidepressants (TCAs) | • amitriptyline • clomipramine (Anafranil) • doxepin (Silenor, Zonalon) • imipramine • nortriptyline (Pamelor) | can increase the risk of side effects from the TCA |
| certain opioids | • codeine • methadone (Methadose) • oliceridine (Olinvyk) | can increase the risk of side effects from the opioid |
| certain antipsychotics | • pimozide • thioridazine | can increase the risk of side effects from the antipsychotic |
| abatacept (Orencia) | — | can increase the risk of infection |
| canakinumab (Ilaris) | — | can increase the risk of infection |
| paroxetine (Brisdelle, Paxil) | — | can increase the risk of side effects from paroxetine |
| upadacitinib (Rinvoq) | — | can increase the risk of infection |
Certain health conditions or other factors could raise your risk of harm if you take Tremfya. In such cases, your doctor may not prescribe Tremfya for you. These are known as contraindications. Tremfya has one contraindication, which is described below.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Tremfya or any of its ingredients, your doctor likely won’t prescribe Tremfya for you. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start using Tremfya, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Tremfya is safe for you to take.
Tremfya is not known to interact with alcohol. But Tremfya and alcohol can cause some similar side effects, such as headache and diarrhea. So you may be more likely to experience these side effects if you drink alcohol during your Tremfya treatment.
Alcohol may also trigger symptoms of psoriatic arthritis or plaque psoriasis. (Tremfya is used to treat these conditions.)
If you have questions about consuming alcohol during Tremfya treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Tremfya.
Interaction with tricyclic antidepressants (TCAs)
Tremfya can interact with TCAs, which are used to treat depression and other conditions.
Examples of TCAs include:
- amitriptyline
- clomipramine (Anafranil)
- doxepin (Silenor, Zonalon)
- imipramine
- nortriptyline (Pamelor)
What could happen
Taking a TCA during Tremfya treatment could increase your risk of side effects from the TCA. Tremfya may cause your body to break down the TCA more slowly than usual, which can lead to a high level of the drug in your system. This can raise your risk of side effects from the TCA.
What you can do
Before starting Tremfya treatment, tell your doctor if you take a TCA. They can tell you whether it’s safe to take these medications together.
If you use Tremfya with a TCA, your doctor may prescribe a lower dosage of the TCA for you. You should not take a higher dose of either medication than your doctor prescribes.
If you have questions about taking Tremfya and a TCA together, talk with your doctor or pharmacist.
Interaction with abatacept
Tremfya can interact with abatacept (Orencia), which is used to treat psoriatic arthritis and other conditions.
What could happen
Treatment with Tremfya and abatacept could increase your risk of infection. Both drugs may suppress your immune system, which can affect your ability to fight infection.
What you can do
Before starting Tremfya treatment, tell your doctor if you already use abatacept. They’ll likely prescribe a drug other than Tremfya for your condition.
If you have questions about Tremfya and abatacept, talk with your doctor or pharmacist.
Interaction with paroxetine
Tremfya can interact with paroxetine (Brisdelle, Paxil), which is used to treat depression and other conditions.
What could happen
Combining Tremfya and paroxetine can increase your risk of side effects from paroxetine. This is because Tremfya may cause your body to break down paroxetine more slowly than it should. This can raise the level of paroxetine in your body, which increases your risk of side effects from the drug.
What you can do
Before starting Tremfya treatment, tell your doctor if you take paroxetine. They can help determine whether it’s safe to take these drugs together.
If you have questions about Tremfya and paroxetine, talk with your doctor or pharmacist.
Tremfya may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Tremfya.
Does Tremfya interact with supplements?
Before you start Tremfya treatment, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Tremfya and herbs
There are currently no reports of Tremfya interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Tremfya.
Tremfya and vitamins
There are currently no reports of Tremfya interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Tremfya.
Does Tremfya interact with food?
There are currently no reports of Tremfya interacting with food. If you have questions about eating certain foods during your treatment with Tremfya, talk with your doctor.
Does Tremfya interact with vaccines?
You should not receive live vaccines during your Tremfya treatment. (Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.)
Getting a live vaccine while you’re using Tremfya may increase your risk of infection. Examples of live vaccines include chickenpox, measles, mumps, rubella (MMR), and rotavirus.
If you need to receive a vaccine during your Tremfya treatment, talk with your doctor first to make sure it’s safe.
Does Tremfya interact with lab tests?
There are currently no reports of Tremfya interacting with lab tests. If you have questions about having certain lab tests during your treatment with Tremfya, talk with the healthcare professional ordering the test.
Does Tremfya interact with cannabis or CBD?There are currently no reports of Tremfya interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Tremfya.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Tremfya. Before using Tremfya, talk with your doctor about your health history. They’ll determine whether Tremfya is right for you.
Health conditions or other factors that might interact with Tremfya include:
Infection, including tuberculosis (TB): Treatment with Tremfya may lead to new or worsened infections, including TB. Before using Tremfya, tell your doctor if you think you may have an infection. Some common symptoms of infection include cough, headache, sore throat, and fever.
If you do have an infection, your doctor will likely treat it before you begin Tremfya treatment.
Your doctor may test you for TB before prescribing Tremfya for you. If the test shows you have TB, your doctor will treat it before you start Tremfya treatment.
Pregnancy: It’s not known whether Tremfya treatment is safe during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting this medication.
If you do use Tremfya while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Tremfya. To learn more, call 877-311-8972 or visit the registry website. You can also talk with your doctor.
Breastfeeding: It’s not known whether Tremfya treatment is safe while breastfeeding. It isn’t known whether the drug passes into breast milk and, if so, what effects this could have on a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Tremfya or any of its ingredients, your doctor will likely not prescribe Tremfya. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Tremfya. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Tremfya treatment
It’s also important to understand Tremfya’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Using Tremfya exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.