Drug interactions
Cladribine + Fingolimod
Severity: Major
Cladribine 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
Cladribine causes prolonged lymphocyte depletion, and fingolimod also reduces lymphocyte counts. Using both increases the risk of serious infection and of excessive immunosuppression.
What this interaction means in plain words
Cladribine 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.
Cladribine belongs to Oncology; Fingolimod belongs to Central Nervous System.
Why it happens
Additive lymphocyte depletion from cladribine and fingolimod-induced lymphocyte sequestration.
What to do
Avoid the combination. When switching between them, check lymphocyte counts and allow for the persistent immune effects of the first drug.
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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References
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
Other interactions of Cladribine
- Adenovirus types 4 and 7 live + Cladribine Contraindicated
- Cladribine + Siponimod Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Axicabtagene ciloleucel + Cladribine Major
- Belatacept + Cladribine Major
- Brexucabtagene autoleucel + Cladribine Major
Frequently asked questions
Can I take Cladribine with Fingolimod?
MediHelp rates the interaction as major. Cladribine 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. Cladribine causes prolonged lymphocyte depletion, and fingolimod also reduces lymphocyte counts. Using both increases the risk of serious infection and of excessive immunosuppression.
How serious is the interaction between Cladribine 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. When switching between them, check lymphocyte counts and allow for the persistent immune effects of the first drug.
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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