Drug & supplement interaction

Fish Therapy + Tofacitinib

Tofacitinib brand names: Xeljanz, Xeljanz XR.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Fish Therapy and Tofacitinib in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

Know someone interested in this? Share
Facebook Post Reddit Email
On this page
Interaction report

Fish Therapy and Tofacitinib

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Tofacitinib and Fish Therapy in our sources. This does not guarantee that the combination is completely free of risk — research on Fish Therapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Fish Therapy at all — not against Tofacitinib, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Fish Therapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Fish Therapy safety at a glance

Fish Therapy overall Use caution Hygiene and infection risks make this a cautious choice, especially with shared water.
Pregnancy Use caution Not studied in pregnancy; avoid due to infection risk unless cleared by your doctor.
Breastfeeding Use caution No safety data; infection risk makes caution reasonable while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Tofacitinib and Fish Therapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Fish Therapy and Tofacitinib May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Fish Therapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Liver problems / A higher chance of infection Worth acting on Additional detail

    Fish Therapy

    “Multiple case reports suggest that fish therapy can increase the risk for bacterial infection. Studies of fish therapy water have identified multiple bacteria capable of causing disease. It is currently not possible to adequately sterilize the water without killing the fish. Additionally, when performed in a spa or salon setting, pedicure tubs cannot be adequately cleaned when fish are present.”

    Fish Therapy · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 103109. Vanhooteghem O, Anseeuw D, Michel C, et al. Fish Pedicure-induced Aeromonas sobria Superficial Necrotic Bullous Dermatitis in a Previously Undiagnosed Diabetes Patient. What are the Risks of Fish Pedicure for Public Health? BJMMR. 2015;10(12):1-10. DOI
    2. 103110. Veraldi S, Nazzaro G, Çuka E. Staphylococcus aureus infection of the feet following fish pedicure. Infection. 2014 Oct;42(5):925-6. PubMed
    3. 103111. Sugimoto K, Frei R, Graber P. Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure. Infection. 2013 Oct;41(5):1013-5. PubMed
    4. 103112. Vanhooteghem O, Theate I. Fish pedicure-induced foot mycobacteriosis infection due to Mycobacterium marinum: a first case report. Eur J Dermatol. 2017 Jun 1;27(3):299-300. PubMed
    5. 103108. Lipner SR. Onychomadesis Following a Fish Pedicure. JAMA Dermatol. 2018 Sep 1;154(9):1091-1092. PubMed
    6. 103113. US Centers for Disease Control (CDC). Fish Pedicures and Fish Spas. August 2, 2016. Available at: https://www.cdc.gov/healthywater/hygiene/body/fish_pedicures.html. Accessed on June 15, 2020.

    Tofacitinib

    Listed in the ADVERSE REACTIONS section of the FDA label for Tofacitinib. Read the label on DailyMed ›

  • A skin rash Additional detail

    Fish Therapy

    Recorded for Fish Therapy in the same Natural Medicines adverse-effect record shown under Liver problems / A higher chance of infection above.

    Tofacitinib

    Listed in the ADVERSE REACTIONS section of the FDA label for Tofacitinib. Read the label on DailyMed ›

Reported for Fish Therapy but not commonly for Tofacitinib: swelling.

Effects for Tofacitinib come from the ADVERSE REACTIONS section of its FDA label; effects for Fish Therapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 185,980 voluntary FDA FAERS reports for Tofacitinib that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Tofacitinib

This page covers Fish Therapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tofacitinib page lists 184 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 143 moderate · 38 minor.

From our pharmacist’s overview on the Tofacitinib page

“Supplements deserve genuine care alongside tofacitinib (Xeljanz, Xeljanz XR), a medicine that deliberately dials down the immune system to control conditions like rheumatoid arthritis and ulcerative colitis. Most of the interactions on this page run through the liver enzymes that clear the drug, meaning an herb can push its blood level…”

Reviewed by 2 · Jul 18, 2026

Open the Tofacitinib interaction page

How much people look this up

Where Fish Therapy and Tofacitinib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Fish Therapy
Steady interest

#1,005 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tofacitinib
Steady interest

#1,579 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Fish Therapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Fish Therapy and Tofacitinib records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Fish Therapy

What is Fish Therapy?

  • Psoriasis
  • Skin exfoliation and smoothing
  • Eczema and dry skin
  • Cosmetic foot care (pedicure)
  • General relaxation

Fish therapy (also called ichthyotherapy or a 'fish pedicure') uses small Garra rufa fish to nibble away dead skin, and it is mostly used cosmetically or for skin conditions like psoriasis. Evidence that it treats any medical condition is very limited, and there are real infection and hygiene concerns. If you have a skin condition, talk with a dermatologist before trying it.

Live fish (commonly Garra rufa); the whole animal used in skin-immersion baths · Spa fish baths (foot or full-body immersion with Garra rufa fish)

An interaction check asks whether these two react with each other — it does not ask whether Fish Therapy is a good idea for someone in your situation. Here is what our Fish Therapy record says about it on its own.

Fish Therapy: dosing

There is no standard 'dose' for fish therapy, since it is a spa procedure rather than a supplement you take. Sessions are usually a set number of minutes in a spa setting.If you choose to try it, only use a reputable, licensed facility that follows strict hygiene rules, and never share water with someone who has a skin infection.

From our Fish Therapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Fish Therapy monograph & all interactions
Medication

About Tofacitinib

What Is Tofacitinib Used For?

Brand names: Xeljanz, Xeljanz XR

  • Tofacitinib is used alone or with other medications to treat rheumatoid arthritis (condition in which the body attacks its own joints causing pain, swelling, and loss of function) in adults who are unable to take or did not respond to one or more tumor necrosis factor (TNF) inhibitor medication(s). It is also used to treat psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin) in adults who are unable to take or did not respond to or tolerate one or more TNF inhibitor medication(s). Tofacitinib is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) in adults who are unable to take or who did not respond to one or more TNF inhibitor medication(s). It is also used to treat polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years and older who are unable to take or who did not respond to one or more TNF inhibitor medication(s). Tofacitinib is in a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of the immune system.

See full Tofacitinib drug information
Keep checking

Other Drugs & Fish Therapy

Browse every other medication we’ve checked against Fish Therapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Fish Therapy against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Fish Therapy list.

See the full Fish Therapy interactions page
See every supplement checked against Tofacitinib, ranked by severity
Evidence & sources

Fish Therapy References

The 8 references that drive our Fish Therapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Grassberger M, Hoch W. Ichthyotherapy as alternative treatment for patients with psoriasis: a pilot study. Evid Based Complement Alternat Med. 2006 Dec;3(4):483-8. PubMed
  2. Lipner SR. Onychomadesis Following a Fish Pedicure. JAMA Dermatol. 2018 Sep 1;154(9):1091-1092. PubMed
  3. Vanhooteghem O, Anseeuw D, Michel C, et al. Fish Pedicure-induced Aeromonas sobria Superficial Necrotic Bullous Dermatitis in a Previously Undiagnosed Diabetes Patient. What are the Risks of Fish Pedicure for Public Health? BJMMR. 2015;10(12):1-10. DOI
  4. Veraldi S, Nazzaro G, Çuka E. Staphylococcus aureus infection of the feet following fish pedicure. Infection. 2014 Oct;42(5):925-6. PubMed
  5. Sugimoto K, Frei R, Graber P. Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure. Infection. 2013 Oct;41(5):1013-5. PubMed
  6. Vanhooteghem O, Theate I. Fish pedicure-induced foot mycobacteriosis infection due to Mycobacterium marinum: a first case report. Eur J Dermatol. 2017 Jun 1;27(3):299-300. PubMed
  7. US Centers for Disease Control (CDC). Fish Pedicures and Fish Spas. August 2, 2016. Available at: https://www.cdc.gov/healthywater/hygiene/body/fish_pedicures.html. Accessed on June 15, 2020.
  8. Vanhooteghem O, Theate I, De Schaetzen V. Periungual Mycobacterium marinum Infection following a Fish Manicure. Skin Appendage Disord. 2021 Aug;7(5):393-396.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Fish Therapy While Taking Tofacitinib: Common Questions

Is it safe to have Fish Therapy while taking Tofacitinib?
We do not list a known interaction between Fish Therapy and Tofacitinib. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Fish Therapy and Tofacitinib have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Tofacitinib interact with any supplements?
Yes. Tofacitinib has documented interactions with 184 supplements in our database — Fish Therapy is not one of them. The Tofacitinib interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Fish Therapy monograph Uses, safety profile, and every drug interaction in one place Tofacitinib drug information The full plain-English guide to this medication Tofacitinib supplement interactions Every supplement checked against Tofacitinib, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Tofacitinib and Fish Therapy?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.