Anakinra and Adalimumab: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Anakinra
Adalimumab
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of serious infections
Interaction Deep Dive
Concomitant use of anakinra and tumor necrosis factor (TNF) antagonists, such as adalimumab or an adalimumab biosimilar product is not recommended due to in an increased risk of serious infection2314 and neutropenia. Coadministration of anakinra and the TNF blocking agent etanercept resulted in a greater incidence of serious infections and neutropenia and provided no additional benefit in a rheumatoid arthritis clinical study (N=242) 314.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In a 24-week study (N=242), patients on background methotrexate received both anakinra and etanercept (another tumor necrosis factor (TNF) blocking agent) or etanercept alone for active rheumatoid arthritis. The incidence of serious infection was 7% with combination therapy compared with 0% with etanercept alone. The most common infections were bacterial pneumonia and cellulitis (4 cases each). Neutropenia (absolute neutrophil count less than 1 x 10(9)/L) was observed in 2% of patients receiving combination therapy. In addition, the combination of anakinra and etanercept did not offer any additional clinical benefit when compared with etanercept alone (American College of Rheumatology 50% response rate (ACR50) was 31% vs 41%, ) 1.
Common questions
Can I take Anakinra and Adalimumab together?
An increased risk of serious infections Always confirm with your pharmacist or prescriber before making any change.
How serious is the Anakinra and Adalimumab interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Anakinra or Adalimumab need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (4)
- Product Information: KINERET(R) subcutaneous injection, anakinra subcutaneous injection. Amgen,Inc, Thousand Oaks, CA, 2006. DailyMed
- Product Information: AMJEVITA® subcutaneous injection, adalimumab-atto subcutaneous injection. Amgen Inc (per FDA), Thousand Oaks, CA, 2025. DailyMed
- Product Information: HUMIRA(R) solution for subcutaneous injection, adalimumab solution for subcutaneous injection. Abbott Laboratories, North Chicago, IL, 2011. DailyMed
- Product Information: YUFLYMA(R) subcutaneous injection, adalimumab-aaty subcutaneous injection. CELLTRION USA Inc (per FDA), Jersey City, NJ, 2023. DailyMed
Keep reading about Anakinra
Keep reading about Adalimumab
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