What are the possible interactions between militizumab and other drugs? What medications should be avoided?

Mirikizumab is a targeted therapy drug mainly used to treat inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. It reduces the inflammatory response by inhibiting IL-23 (interleukin-23) receptor signaling, thereby alleviating the condition. Milizumab may cause some drug interactions when used with other medications, which may affect treatment effectiveness or increase the risk of side effects. Therefore, patients need to pay special attention to drug interactions when using militizumab.

Militizumab is an immunosuppressant, and its combined use with immunosuppressive drugs may enhance the immunosuppressive effect. For example, when used in combination with other anti-TNF-alpha (tumor necrosis factor-alpha) drugs or immunosuppressants (such as azathioprine, cyclosporine, etc.), the risk of infection, especially opportunistic infections, may be increased. Therefore, when using these drugs in combination, doctors usually closely monitor the patient's immune function and adjust the treatment plan based on the patient's clinical manifestations.

The interaction of militizumab with vaccination is also a matter of concern. Because militizumab suppresses the immune system, it may reduce the effectiveness of vaccines, especially live vaccines. While receiving militizumab, patients should avoid receiving live vaccines, such as measles, rubella, and mumps vaccines. In addition, it is best for patients to complete all necessary vaccinations before starting treatment with militizumab to reduce the risk of infection.
The use of antibiotics and antifungals may also affect the effectiveness of militizumab treatment. Certain antibiotics, especially broad-spectrum antibiotics, may interfere with the balance of the gut microbiota and thus affect the effectiveness of militizumab. During militizumab treatment, you need to be cautious when using antibiotics or antifungal drugs, and adjust the medication under the guidance of a doctor to ensure that the therapeutic effect is not affected.
Patients should also avoid concurrent use with other immunomodulatory drugs, which may further suppress immune system function and increase the risk of infection. For example, immunomodulatory drugs such as methotrexate or thalidomide may have undesirable immunosuppressive effects when used in combination with militizumab, causing adverse reactions or exacerbating existing health problems. Therefore, before using militizumab, patients should inform their doctors about all the drugs they are taking so that doctors can make reasonable drug adjustments and reduce the occurrence of drug interactions.
Reference: https://omvoh.lilly.com/