Drug interactions
Amitriptyline + Fingolimod
Severity: Major
Amitriptyline and Fingolimod: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fingolimod causes bradycardia on treatment initiation and has been linked to QT effects, while amitriptyline prolongs QT and can cause conduction disturbances. Together they may increase the risk of serious arrhythmia, especially in the first hours after the first fingolimod dose.
What this interaction means in plain words
Amitriptyline and Fingolimod can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amitriptyline belongs to Central Nervous System; Fingolimod belongs to Central Nervous System.
Why it happens
Additive effects on cardiac conduction: fingolimod-induced bradycardia combined with tricyclic-related QT prolongation.
What to do
Obtain a baseline ECG and extend first-dose cardiac observation as recommended in fingolimod labeling. Consider an alternative antidepressant in patients with other QT or bradycardia risk factors.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Fingolimod
- Adenovirus types 4 and 7 live + Fingolimod Contraindicated
- Bcg vaccine live + Fingolimod Contraindicated
- Fingolimod + Pimozide Contraindicated
- Fingolimod + Ponesimod Contraindicated
- Fingolimod + Quinidine Contraindicated
- Fingolimod + Siponimod Contraindicated
Frequently asked questions
Can I take Amitriptyline with Fingolimod?
MediHelp rates the interaction as major. Amitriptyline and Fingolimod can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fingolimod causes bradycardia on treatment initiation and has been linked to QT effects, while amitriptyline prolongs QT and can cause conduction disturbances. Together they may increase the risk of serious arrhythmia, especially in the first hours after the first fingolimod dose.
How serious is the interaction between Amitriptyline and Fingolimod?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and extend first-dose cardiac observation as recommended in fingolimod labeling. Consider an alternative antidepressant in patients with other QT or bradycardia risk factors.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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