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Drug interactions

Arsenic trioxide + Fingolimod

Severity: Major

Arsenic trioxide and Fingolimod: major interaction.

Last updated Sources: US FDA label

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

Arsenic trioxide markedly prolongs the QT interval and can cause torsades de pointes. Fingolimod can cause bradycardia and has been associated with QT effects, so the risk of serious arrhythmia is increased.

What this interaction means in plain words

Arsenic trioxide 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.

Arsenic trioxide belongs to Oncology; Fingolimod belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive QT prolongation together with fingolimod-related bradycardia, which promotes torsades de pointes.

What to do

Avoid the combination if possible. If needed, correct potassium and magnesium, monitor ECG and heart rate, and observe closely at fingolimod initiation.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Arsenic trioxide with Fingolimod?

MediHelp rates the interaction as major. Arsenic trioxide 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. Arsenic trioxide markedly prolongs the QT interval and can cause torsades de pointes. Fingolimod can cause bradycardia and has been associated with QT effects, so the risk of serious arrhythmia is increased.

How serious is the interaction between Arsenic trioxide 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: Avoid the combination if possible. If needed, correct potassium and magnesium, monitor ECG and heart rate, and observe closely at fingolimod initiation.

What other medicines interact with Fingolimod?

MediHelp also lists interactions of Fingolimod with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Pimozide. The full list is on the Fingolimod page.

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