Drug interactions
Erythromycin stearate + Fingolimod
Severity: Major
Erythromycin stearate 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
Erythromycin prolongs the QT interval and may cause torsades de pointes. Fingolimod causes bradycardia and may add to the effect, and erythromycin may also modestly raise fingolimod exposure through CYP inhibition.
What this interaction means in plain words
Erythromycin stearate 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.
Why it happens
Additive QTc prolongation with fingolimod-induced bradycardia, plus possible CYP3A4 inhibition raising fingolimod levels.
What to do
Prefer a non-macrolide antibiotic without QT effects. If erythromycin is needed, monitor ECG, heart rate and 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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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
Frequently asked questions
Can I take Erythromycin stearate with Fingolimod?
MediHelp rates the interaction as major. Erythromycin stearate 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. Erythromycin prolongs the QT interval and may cause torsades de pointes. Fingolimod causes bradycardia and may add to the effect, and erythromycin may also modestly raise fingolimod exposure through CYP inhibition.
How serious is the interaction between Erythromycin stearate 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: Prefer a non-macrolide antibiotic without QT effects. If erythromycin is needed, monitor ECG, heart rate and electrolytes.
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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