Drug class Mechanism of action Drug name Risk Comments/considerations∗
Classic immunosuppressants
Inhibits NF-κB Corticosteroids Likely concerning risk Consider stopping when viral symptoms present especially with known or potential exposure
Calcineurin inhibitor Tacrolimus
Cyclosporine
 Antimetabolites Inhibits DNA replication Mycophenolate mofetil
Azathioprine
Methotrexate
Immunomodulators
 Monoclonal antibodies TNF-α inhibition Infliximab Likely moderate risk Continue if viral symptoms are mild, consider stopping if viral symptoms worsen or high fever develops
 Receptor fusion protein Etanercept
 Monoclonal antibodies Certolizumab
 Monoclonal antibodies Adalimumab
 IL receptor modulators IL inhibition Anakinra (IL-1)
 Monoclonal antibodies Dupilumab (IL-4) Likely low risk Continue unless severe symptoms present
 Monoclonal antibodies Brodalumab (IL-17) Likely moderate risk Continue if viral symptoms are mild, consider stopping if viral symptoms worsen or high fever develops
 Monoclonal antibodies Secukinumab (IL-17a)
 Monoclonal antibodies Ixekizumab (IL-17a)
 Monoclonal antibodies Ustekinumab (IL-12/23)
 Monoclonal antibodies Guselkumab (IL-23)
 Monoclonal antibodies Anti-CD20 antibody Rituximab Likely concerning risk Consider stopping when viral symptoms present especially with known or potential exposure.
PDE4 inhibition Apremilast Likely low risk Continue unless severe symptoms present