Drug interactions
Clozapine + Fingolimod
Severity: Major
Clozapine 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 can slow heart rate and prolong the QT interval, and clozapine also carries QT and cardiac risks. The combination may increase the chance of bradycardia and arrhythmia, especially after the first fingolimod dose.
What this interaction means in plain words
Clozapine 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.
Clozapine belongs to Central Nervous System; Fingolimod belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with fingolimod-induced bradycardia increasing torsades risk.
What to do
Perform ECG monitoring before and after the first fingolimod dose, and monitor continuously for bradycardia. Seek cardiology advice if baseline QT is prolonged.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
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 Clozapine with Fingolimod?
MediHelp rates the interaction as major. Clozapine 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 slow heart rate and prolong the QT interval, and clozapine also carries QT and cardiac risks. The combination may increase the chance of bradycardia and arrhythmia, especially after the first fingolimod dose.
How serious is the interaction between Clozapine 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: Perform ECG monitoring before and after the first fingolimod dose, and monitor continuously for bradycardia. Seek cardiology advice if baseline QT is prolonged.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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