Rebif interactions: Alcohol, medications, and other factors

Rebif interactions with other drugs

Before you start treatment with Rebif, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether Rebif interacts with supplements, herbs, or vitamins, see the “Rebif and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Rebif. Keep in mind this table doesn’t include all drugs that may interact with Rebif. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Rebif 

In some cases, factors or conditions could prevent your doctor from prescribing Rebif due to the risk of harm. These are known as contraindications. Below is a contraindication of Rebif.

Note: Before you start treatment with Rebif, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Rebif.

Having had an allergic reaction to Rebif or any of its ingredients

If you’ve had an allergic reaction to Rebif or any of its ingredients, your doctor will likely not prescribe Rebif. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Rebif and alcohol

There are no known interactions between Rebif and alcohol. However, if you drink alcohol, your doctor may advise you to avoid or limit it during Rebif treatment. This is because consuming large amounts of alcohol can cause liver damage, which is also a side effect of Rebif. So drinking alcohol during Rebif treatment may increase the risk of liver problems.

In addition, drinking alcohol while using Rebif may worsen some of the drug’s side effects, such as drowsiness or dizziness. If you consume alcohol during Rebif treatment, these side effects may be more likely to occur.

Talk with your doctor if you have questions about drinking alcohol during Rebif treatment.

Drug interactions in depth  

Here’s a closer look at certain drug interactions of Rebif.

Certain monoclonal antibodies

Rebif may interact with certain monoclonal antibodies, which are used to treat different conditions, including MS.

Both Rebif and monoclonal antibodies can weaken your immune system. When taken together, they can weaken your immune system further and may increase the risk of serious infection.

Here are some monoclonal antibodies that may interact with Rebif:

• alemtuzumab (Lemtrada)
• natalizumab (Tysabri, Tyruko)
• ofatumumab (Kesimpta)

Steps you or your doctor may take

Be sure to tell your doctor if you are currently taking a monoclonal antibody. They can determine whether Rebif is a good treatment option for you. If your doctor prescribes Rebif and a monoclonal antibody together, you’ll want to watch for symptoms of an infection. Tell your doctor right away if you have a fever, chills, a sore throat, or body aches.

Certain NRTIs

Rebif may interact with certain NRTIs, which are a class of drugs used to treat HIV.

Both Rebif and NRTIs can cause liver damage. When Rebif is used together with an NRTI, there may be an increased risk of serious liver damage, including liver failure.

Here are some NRTIs that may interact with Rebif:

• zidovudine
• emtricitabine
• abacavir

Steps you or your doctor may take

If you are taking an NRTI, tell your doctor before starting treatment with Rebif. They can determine whether it’s safe to take these drugs together. If your doctor prescribes Rebif and an NRTI, they’ll monitor you closely for signs of liver damage. If you notice symptoms of liver damage, such as loss of appetite, nausea, abdominal pain, or jaundice (yellowing of the skin and whites of the eyes), tell your doctor right away.

Vigabatrin

Rebif may interact with vigabatrin (Sabril), which is prescribed to treat certain seizure disorders.

Because both Rebif and Vigabatrin can cause vision problems, using them together can increase the risk of serious vision problems, including vision loss.

Steps you or your doctor may take

Tell your doctor if you are taking vigabatrin before starting treatment with Rebif. They can decide whether taking these drugs together is a safe treatment option. If your doctor prescribes Rebif and vigabatrin together, be sure to tell them right away if you have any vision changes or eye pain.

Rebif and other interactions 

Rebif may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with Rebif. Keep in mind that the following information does not include all possible Rebif interactions.

Rebif interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Rebif interactions with herbs

There are no specific reports of herbs interacting with Rebif. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Rebif treatment.

Rebif interactions with vitamins

There are no specific reports of vitamins interacting with Rebif. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Rebif.

Rebif interactions with food

There were no reports of food interactions with Rebif. If you’d like to learn more about eating certain foods during treatment with Rebif, talk with your doctor.

Rebif interactions with vaccines

There aren’t any known interactions between Rebif and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines and if they’re safe for you to receive during Rebif treatment.

Rebif interactions with lab tests

Rebif isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

REBIF INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Rebif. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Rebif. The impact of cannabis may affect how well you stick to your Rebif treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Rebif and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Rebif. Before you use this drug, be sure to talk with your doctor about your health history. Rebif may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Rebif include:

• Seizure disorder: Using Rebif may increase your risk of seizures. If you have a seizure disorder, tell your doctor before starting treatment with Rebif.
• Thyroid problems: Rebif can cause new or worsening thyroid problems. Before starting Rebif tell your doctor if you have any thyroid problems. They may recommend checking your thyroid hormone levels more often during treatment.
• Liver problems: Tell your doctor if you have any liver problems before starting treatment with Rebif. Severe liver injury, including liver failure, is a possible side effect of Rebif. If you already have liver disease, Rebif could worsen your condition. Your doctor can determine if Rebif is a good treatment option for you.
• Low blood cell counts: Rebif can affect the levels of your red blood cells, white blood cells, and platelets. Your doctor will likely order blood tests before and during treatment with Rebif. If you already have low blood cell levels, Rebif may lower them further. Your doctor can recommend whether Rebif is a good option for you.
• History of blood clots or bleeding problems: You may have an increased risk of bleeding or blood clots during treatment with Rebif if you’ve had them in the past. If you have a history of blood clots or bleeding problems, tell your doctor before using Rebif.
• Allergic reaction: If you’ve had an allergic reaction to Rebif or any of its ingredients, your doctor will likely not prescribe Rebif. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Pregnancy: There haven’t been enough clinical trials to determine whether Rebif is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Rebif. They can recommend the right treatment plan for you.
• Breastfeeding: It’s not known whether it’s safe to use Rebif while breastfeeding. If you’re breastfeeding or planning to, talk with your doctor before using Rebif. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
• Depression or suicidal thoughts: Before starting therapy with Rebif, tell your doctor if you have symptoms of depression or suicidal thoughts. Using Rebif can worsen these. Your doctor can determine if Rebif is a safe treatment option for you.

Preventing interactions  

You can take certain steps to help prevent interactions with Rebif. Your doctor and pharmacist are key resources, so reaching out to them before starting treatment is a helpful first step. For example, it’s important that you plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Rebif label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Rebif doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Rebif by using it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.