Avonex Interactions: Alcohol, Medications, and Others

Does Avonex interact with other drugs?

Before you start using Avonex, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.

To learn whether Avonex interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Avonex?” section.

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

The following table lists drugs that may interact with Avonex. Keep in mind this table does not include all drugs that may interact with Avonex. For more information about some of these interactions, see the “Drug interactions explained” section.

When should I avoid Avonex?

Certain health conditions or other factors could raise your risk of harm if you take Avonex. In such cases, your doctor may not prescribe Avonex for you. These are known as contraindications. Avonex has one contraindication, which is a previous allergic reaction.

If you’ve had an allergic reaction to Avonex or any of its ingredients, your doctor likely won’t prescribe this medication for you. Ask them about other treatments that may be better options.

Does Avonex interact with alcohol?

It may not be safe to consume alcohol during your Avonex treatment. Avonex and alcohol can cause some similar side effects, such as dizziness, nausea, fatigue, and headache. So you may be more likely to experience these side effects if you combine alcohol and Avonex.

Avonex and alcohol can also both cause liver damage. So combining the two may further increase your risk of liver problems.

If you have questions about consuming alcohol while using Avonex, talk with your doctor or pharmacist.

Drug interactions explained

Learn more about certain drug interactions that can occur with Avonex.

Interaction with monoclonal antibodies

Avonex can interact with certain monoclonal antibodies, which work by targeting parts of the immune system. Although this is helpful for treating certain conditions, it can also make it harder for your body to fight off infections and cancers. Avonex also works by suppressing the immune system, so combining it with a monoclonal antibody can further raise your risk of a weakened immune system.

Examples of monoclonal antibodies that may interact with Avonex include:

• ofatumumab (Arzerra, Kesimpta)
• ocrelizumab (Ocrevus)
• natalizumab (Tysabri)
• alemtuzumab (Lemtrada, Campath)

What you can do

If you take any monoclonal antibodies, talk with your doctor before starting Avonex treatment. Doctors typically try to avoid prescribing these drugs together.

If you use Avonex with a monoclonal antibody, tell your doctor right away if you have symptoms of an infection. These may include fever, shortness of breath, or cough. It’s also important to keep up with your recommended cancer screenings.

If you have questions about using Avonex with monoclonal antibodies, talk with your doctor or pharmacist.

Interaction with NRTIs

Using an NRTI drug with Avonex can increase your risk of liver problems and of having low blood cell levels. Both NRTIs and Avonex can cause liver problems and lower your blood cell counts. So taking these drugs together can further raise this risk.

Examples of NRTIs that may interact with Avonex include:

• efavirenz (Sustiva)
• rilpivirine (Edurant)
• nevirapine (Viramune)
• emtricitabine (Emtriva)
• entecavir (Baraclude)

What you can do

If you take Avonex and an NRTI together, tell your doctor right away if you have symptoms of liver problems. These may include nausea, dark-colored urine, jaundice (yellowing of the skin or whites of your eyes), unusual bleeding, and confusion. Also, let your doctor know if you have any symptoms of low blood cell counts. These include unusual bleeding, shortness of breath, and fatigue.

If you have questions about taking Avonex with an NRTI, talk with your doctor or pharmacist.

Interaction with protease inhibitors

Using Avonex with a protease inhibitor can increase the risk of liver problems. Similar to NRTIs, protease inhibitors can cause liver damage. Because Avonex can also cause liver damage, combining a protease inhibitor with Avonex can further increase your risk.

Protease inhibitors that may interact with Avonex include:

• ritonavir (Norvir)
• tipranavir (Aptivus)
• atazanavir (Reyataz)
• darunavir (Prezista)

What you can do

If you use Avonex with a protease inhibitor, tell your doctor right away if you have symptoms of liver problems. These may include nausea, loss of appetite, confusion, dark-colored urine, and jaundice.

If you have questions about taking Avonex with a protease inhibitor, talk with your doctor or pharmacist.

Are there other interactions with Avonex?

Avonex may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.

Here are additional interactions that may occur with Avonex. Note that this is not a full list of all other possible interactions with Avonex.

Does Avonex interact with supplements?

Before you start using Avonex, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Avonex interactions with herbs

There are currently no reports of Avonex interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while using Avonex.

Avonex interactions with vitamins

There are currently no reports of Avonex interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while using Avonex.

Does Avonex interact with food?

There are currently no reports of Avonex interacting with food. If you have questions about eating certain foods during your treatment with Avonex, talk with your doctor.

Does Avonex interact with vaccines or lab tests?

There are currently no reports of Avonex interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Avonex treatment, talk with your doctor.

Does Avonex interact with cannabis or CBD?

There are currently no reports of Avonex interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Avonex.

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

Does my health history affect whether I should take Avonex?

Certain medical conditions or other health factors may raise the risk of interactions with Avonex. Before using Avonex, talk with your doctor about your health history. They’ll determine whether Avonex is right for you.

Health conditions or other factors that might interact with Avonex include:

Liver problems: Avonex can cause or worsen liver problems. Due to this risk, your doctor will likely monitor your liver health closely during your treatment.

Bleeding problems: Avonex can lower the levels of certain blood cells. This can increase your risk of irregular bleeding or blood clots. Tell your doctor if you’ve ever had blood clots or any bleeding problems. They’ll likely monitor your blood counts closely during treatment.

Low blood cell counts: Avonex can lower your blood cell counts, such as your red blood cell, white blood cell, and platelet counts. Let your doctor know if you’ve had low blood cell counts in the past. They may check your blood cell counts more frequently while you’re using Avonex.

Thyroid problems: Avonex may increase the risk of thyroid problems, including underactive or overactive thyroid. If you have existing thyroid problems, Avonex may worsen your condition. Due to this risk, your doctor may recommend monitoring your thyroid function closely during Avonex treatment. They might also adjust the dosages of your thyroid medications.

Heart problems: In rare cases, Avonex may cause or worsen heart failure. If you have heart failure or other heart problems, Avonex can make your condition worse. Tell your doctor about any heart problems you have before starting Avonex treatment. They may recommend heart monitoring.

Seizures: Tell your doctor if you have a history of seizures. Avonex can cause seizures even if you’ve never had a seizure before. Your doctor can help determine whether Avonex is safe for you.

Autoimmune diseases: Let your doctor know if you have any other autoimmune disorders. Avonex may cause or worsen certain autoimmune disorders. Your doctor can discuss whether Avonex is the right treatment for you.

Mental health conditions: Avonex may increase your risk of mood disorders. These include depression, suicidal thoughts, hallucinations, and other problems. If you have a history of mental health conditions, using Avonex may cause your condition to come back or worsen. Before starting Avonex treatment, tell your doctor if you’ve had any mental health conditions before. They can help determine whether this drug is safe for you.

Pregnancy: It’s not known whether Avonex is safe to use during pregnancy. If you’re pregnant or may become pregnant, talk with your doctor before using Avonex.

Breastfeeding: It’s not known whether it’s safe to use Avonex while breastfeeding. The drug may pass into breast milk, but it isn’t known whether the drug may cause side effects in a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Avonex or any of its ingredients, your doctor will likely not prescribe Avonex. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Avonex. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• whether you drink alcohol or use cannabis
• the list of medications you take, as well as any vitamins, supplements, and herbs
• what to do if you start taking a new drug during your Avonex treatment

It’s also important to understand Avonex’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. The paperwork, sometimes called the patient package insert or medication guide, may have other details about interactions.

If you did not get paperwork with Avonex, ask your pharmacist to print a copy for you. If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Using Avonex exactly as prescribed can also help prevent interactions.

Disclaimer: Healthline 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.