Drug interactions
Efavirenz + Fingolimod
Severity: Major
Efavirenz 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 causes bradycardia and can prolong the QT interval, and efavirenz also has QT-prolonging potential. Together they may raise the risk of arrhythmia, especially at first fingolimod dosing.
What this interaction means in plain words
Efavirenz 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.
Efavirenz belongs to Anti Virals; Fingolimod belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with fingolimod-induced bradycardia adding to proarrhythmic risk.
What to do
Use an alternative antiretroviral if possible. If used together, perform ECG and first-dose monitoring and correct electrolytes.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir 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 Efavirenz with Fingolimod?
MediHelp rates the interaction as major. Efavirenz 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 causes bradycardia and can prolong the QT interval, and efavirenz also has QT-prolonging potential. Together they may raise the risk of arrhythmia, especially at first fingolimod dosing.
How serious is the interaction between Efavirenz 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: Use an alternative antiretroviral if possible. If used together, perform ECG and first-dose monitoring and correct electrolytes.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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