Drug interactions
Diltiazem + Fingolimod
Severity: Major
Diltiazem 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
Both drugs slow heart rate and AV conduction, so combining them raises the risk of symptomatic bradycardia and AV block, especially after fingolimod initiation or re-initiation after an interruption.
What this interaction means in plain words
Diltiazem 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.
Diltiazem belongs to Cardiovascular; Fingolimod belongs to Central Nervous System.
Why it happens
Additive negative chronotropic and dromotropic effects at the sinoatrial and AV nodes.
What to do
Obtain a baseline ECG and monitor heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Consider an alternative to diltiazem if conduction abnormalities are present.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem 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 Diltiazem with Fingolimod?
MediHelp rates the interaction as major. Diltiazem 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. Both drugs slow heart rate and AV conduction, so combining them raises the risk of symptomatic bradycardia and AV block, especially after fingolimod initiation or re-initiation after an interruption.
How serious is the interaction between Diltiazem 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 monitor heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Consider an alternative to diltiazem if conduction abnormalities are present.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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