Drug interactions
Dofetilide + Fingolimod
Severity: Major
Dofetilide 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
Fingolimod slows heart rate and conduction, and dofetilide markedly prolongs QT with a risk of torsades de pointes. Bradycardia increases the proarrhythmic risk of dofetilide.
What this interaction means in plain words
Dofetilide 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.
Dofetilide belongs to Cardiovascular; Fingolimod belongs to Central Nervous System.
Why it happens
Fingolimod-induced bradycardia adds to dofetilide's potassium channel blockade and QT prolongation.
What to do
Avoid if possible; if fingolimod is necessary, obtain cardiology advice and provide extended ECG monitoring at initiation. Consider an alternative MS therapy.
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 Dofetilide
- Amiodarone + Dofetilide Contraindicated
- Amisulpride + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
Frequently asked questions
Can I take Dofetilide with Fingolimod?
MediHelp rates the interaction as major. Dofetilide 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 slows heart rate and conduction, and dofetilide markedly prolongs QT with a risk of torsades de pointes. Bradycardia increases the proarrhythmic risk of dofetilide.
How serious is the interaction between Dofetilide 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 if possible; if fingolimod is necessary, obtain cardiology advice and provide extended ECG monitoring at initiation. Consider an alternative MS therapy.
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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