From the Guidelines
There are no direct contraindications to taking Lexapro (escitalopram) and Humira (adalimumab) together, but caution is advised due to potential increased risk of infections and bleeding. These medications work in different ways and treat different conditions - Lexapro is an antidepressant that affects serotonin levels in the brain, while Humira is a biologic medication that blocks tumor necrosis factor (TNF) to reduce inflammation in autoimmune conditions.
Key Considerations
- Patients should be aware of potential concerns when using these medications concurrently, including increased risk of infections, as both medications can potentially increase this risk, though Humira carries a more significant risk due to its immunosuppressive effects 1.
- There may also be a theoretical risk of increased bleeding when combining these medications, as SSRIs like Lexapro can affect platelet function.
- Patients taking both medications should monitor for unusual infections, mood changes, or bleeding issues.
Monitoring and Precautions
- It's essential to inform all healthcare providers about all medications being taken, and any new symptoms should be reported promptly.
- Regular follow-up appointments are important to monitor for potential interactions or side effects.
- While the study on ozanimod provides insight into potential drug interactions with various classes of medications, including serotonergic/adrenergic drugs like Lexapro, it does not directly address the combination of Lexapro and Humira 1.
Decision Making
- The decision to use Lexapro and Humira together should be made on a case-by-case basis, considering the individual patient's condition, the potential benefits of the combination, and the potential risks.
- Healthcare providers should weigh the benefits of using these medications together against the potential risks and monitor patients closely for any adverse effects.
From the Research
Contraindications and Interactions
- There are potential contraindications and interactions to consider when taking Lexapro (escitalopram) and Humira (adalimumab) together, including:
- Increased risk of serious infections with Humira, as reported in the Premier trial 2
- Reactivation of tuberculosis with Humira, requiring tuberculosis screening according to country standards 2
- Potential for serotonin syndrome with Lexapro, a potentially life-threatening syndrome precipitated by the use of serotonergic drugs 3, 4
- The use of Lexapro may increase the risk of serotonin syndrome, particularly when combined with other serotonergic drugs 3, 4
- Humira has been associated with rare but serious side effects, including worsening or initiation of congestive heart failure, lupus-like syndrome, promotion of lymphoma, and medically significant cytopenias 2
Specific Considerations
- Patients with a history of active infection, tuberculosis, or other serious infections should be carefully considered before starting Humira 2
- Patients taking Lexapro should be monitored for signs of serotonin syndrome, particularly when combined with other serotonergic drugs 3, 4
- The combination of Lexapro and Humira may increase the risk of adverse effects, and patients should be closely monitored for any changes in their condition 2, 3, 5, 4, 6