Drug interactions
Clarithromycin + Fingolimod
Severity: Major
Clarithromycin and Fingolimod: major interaction.
Last updated Sources: UK SmPC
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 can cause bradycardia and QT prolongation, and clarithromycin also prolongs the QT interval. Together they increase the risk of serious ventricular arrhythmias, particularly around fingolimod initiation.
What this interaction means in plain words
Clarithromycin 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.
Clarithromycin belongs to Anti Bacterial; Fingolimod belongs to Central Nervous System.
Why it happens
Additive QT prolongation and bradycardic effects; fingolimod is also partly metabolized by CYP4F2 and possibly CYP3A4.
What to do
Avoid the combination where possible and choose a non-QT-prolonging antibiotic. If it is necessary, monitor the ECG and heart rate and correct electrolyte abnormalities.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clarithromycin and Fingolimod, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine 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 Clarithromycin with Fingolimod?
MediHelp rates the interaction as major. Clarithromycin 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 can cause bradycardia and QT prolongation, and clarithromycin also prolongs the QT interval. Together they increase the risk of serious ventricular arrhythmias, particularly around fingolimod initiation.
How serious is the interaction between Clarithromycin 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 where possible and choose a non-QT-prolonging antibiotic. If it is necessary, monitor the ECG and heart rate and correct electrolyte abnormalities.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
