What Medications Can Cause Shingles?

Shingles

Shingles, also known as herpes zoster, is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. While medications themselves do not directly cause shingles, certain medications may weaken the immune system, increasing the risk of shingles reactivation in individuals who have previously been infected with the varicella-zoster virus. Medications that suppress the immune system or affect its functioning may include:

  • Immunosuppressants: Medications used to suppress the immune system in conditions such as autoimmune diseases, organ transplantation, or certain cancers can increase the risk of shingles reactivation. Examples of immunosuppressants include corticosteroids (e.g., prednisone), methotrexate, cyclosporine, and biologic agents like tumor necrosis factor (TNF) inhibitors (e.g., infliximab, adalimumab).
  • Chemotherapy Drugs: Chemotherapy medications used to treat cancer can suppress the immune system, making individuals more susceptible to infections, including shingles.
  • Biologic Therapies: Biologic therapies used to treat conditions such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease can suppress the immune system and increase the risk of shingles reactivation. Examples include TNF inhibitors, interleukin inhibitors (e.g., ustekinumab), and Janus kinase (JAK) inhibitors (e.g., tofacitinib).
  • HIV Medications: Antiretroviral medications used to treat HIV/AIDS can suppress the immune system and increase the risk of shingles reactivation in individuals living with HIV.

It’s important to note that while these medications can increase the risk of shingles reactivation, not everyone who takes them will develop shingles. Additionally, shingles can occur in individuals with intact immune systems, particularly as they age, due to natural declines in immune function. If you are taking medications that suppress the immune system and are concerned about your risk of shingles, it’s important to discuss this with your healthcare provider. Vaccination against shingles with the herpes zoster vaccine can help reduce the risk of shingles in certain populations, including older adults and individuals with certain medical conditions or medications that may increase their risk.

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