Golimumab and Abatacept: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 16, 2026 · Source data updated Jul 16, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abatacept
Golimumab
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.
Both of these medicines calm down your immune system, just in different ways. Abatacept (Orencia) and golimumab (a TNF blocker) both dial back inflammation to help with arthritis. The problem is that using them together turns your immune defenses down too far, so your body has a harder time fighting off infections.
In studies, taking these two together led to more serious infections without giving people any extra benefit. That is why doctors generally do not combine them. The good news: your care team knows how to handle this. If you are switching from one to the other, they will keep a close eye on you for any signs of infection. Talk with your pharmacist or doctor before making any changes.
Effect: Additive immunosuppression increasing risk of serious infection when abatacept is combined with a TNF antagonist (golimumab), with no added therapeutic benefit.
- Mechanism: Unknown/unspecified; presumed additive suppression of immune function. Neither agent is a prodrug and this is not a CYP-mediated interaction.
- Direction/magnitude: Increased infection risk demonstrated in controlled trials; onset unspecified.
- Evidence: Theoretical per database, though supported by controlled clinical trial data showing harm.
- Management: Concurrent use is not recommended. When transitioning off TNF antagonist therapy to abatacept, monitor for signs and symptoms of infection.
What happens
An increased risk of infection
Interaction Deep Dive
In controlled clinical trials, giving abatacept together with tumor necrosis factor (TNF) antagonists was shown to raise the likelihood of serious infection while offering no extra therapeutic benefit. The available data are inadequate to assess how safe and effective abatacept is when combined with anakinra or with biologics indicated for rheumatoid arthritis or psoriatic arthritis. For this reason, using these drugs at the same time is not advised. Patients being switched from TNF antagonist therapy to abatacept should be watched for indications of infection1.
Why it happens (mechanism)
Unknown
How to manage this interaction
The main guidance here is that these two are generally not used at the same time. Combining abatacept with a TNF blocker like golimumab raised the risk of serious infection in studies without adding benefit, so care teams typically avoid using them together.
- Keep taking your medicines exactly as prescribed. Do not start, stop, or switch anything on your own.
- If your team is transitioning you from golimumab to abatacept, they will watch you closely for signs of infection (fever, chills, cough, sore throat, or feeling unusually unwell).
- Report any of those symptoms to your prescriber promptly.
- Ask your pharmacist or doctor if you are ever unsure which of your biologics you should be on.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) Combining abatacept with etanercept provided no extra efficacy but raised the risk of serious infection relative to etanercept given alone. In a 1-year randomized study (N=121) followed by an open-label long-term extension (LTE; n=80), patients with rheumatoid arthritis who were already receiving etanercept 25 mg twice/week continued that etanercept and were randomized to receive either abatacept 2 mg/kg IV on days 1, 15, and 30, and then every 4 weeks (n=85) or placebo (n=36). After the double-blind phase concluded, patients qualified for the LTE phase, at which point the abatacept dose was raised to approximately 10 mg/kg. At 6 months, the 2 mg/kg abatacept group demonstrated no significant improvement versus the placebo group in modified American College of Rheumatology 20% (ACR20; 48.2% vs 30.6%) or ACR50 (25.9% vs 19.4%) response rates, although there was a significant difference in modified ACR70 rates (10.6% vs 0%). At 1 year, no significant differences in ACR20, 50, or 70 response rates were seen between the two groups. Serious adverse events occurred more often in the 2 mg/kg abatacept group (16.5%) at one year and in the 10 mg/kg abatacept group after 2 years of LTE (32.5%) than in the placebo group (2.8%). Serious infections at 1 year were reported in 3.5% of the 2 mg/kg abatacept group and 0% of the placebo group 2.
b) In controlled clinical trials involving adults with active rheumatoid arthritis who received abatacept together with a tumor necrosis factor (TNF) antagonist (n=204) versus TNF antagonist therapy alone (n=134), the rate of infection (63% vs 43%, respectively) and serious infection (4.4% vs 0.8%, respectively) was higher with the combined therapy; furthermore, the combined therapy offered no additional benefit 1.
Common questions
Can I take Golimumab and Abatacept together?
Abatacept and golimumab are generally not used together because the combination raises the risk of serious infection without extra benefit; if you are switching between them, your care team will monitor you closely for signs of infection. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Golimumab and Abatacept 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 is the Golimumab and Abatacept interaction managed?
The main guidance here is that these two are generally not used at the same time. Combining abatacept with a TNF blocker like golimumab raised the risk of serious infection in studies without adding benefit, so care teams typically avoid using them together. Keep taking your medicines exactly as prescribed. Do not start, stop, or switch anything on your own. If your team is transitioning you from… Management is individual — always follow your own care team's guidance.
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 Golimumab or Abatacept 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 (2)
- Product Information: ORENCIA(R) intravenous, subcutaneous injection, abatacept intravenous, subcutaneous injection. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2020. DailyMed
- Weinblatt M, Schiff M, Goldman A, et al: Selective costimulation modulation using abatacept in patients with active rheumatoid arthritis while receiving etanercept: a randomised clinical trial. Ann Rheum Dis 2007; 66(2):228-234. PubMed
Keep reading about Abatacept
Keep reading about Golimumab
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