Drug interactions
Etrasimod + Fingolimod
Severity: Major
Etrasimod and Fingolimod: major interaction.
Last updated Sources: UK SmPC
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 are S1P receptor modulators that reduce circulating lymphocytes and slow heart rate. Combining them duplicates the mechanism, adding to immunosuppression, infection risk and bradyarrhythmia without any established benefit.
What this interaction means in plain words
Etrasimod 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.
Etrasimod belongs to Gastrointestinal Tract; Fingolimod belongs to Central Nervous System.
Why it happens
Duplicate S1P receptor modulation causing additive lymphocyte sequestration and negative chronotropic effects.
What to do
Do not use the two together. When switching, allow fingolimod's lymphocyte-lowering effect to resolve and follow labeling for washout before starting etrasimod.
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 Etrasimod
- Abatacept + Etrasimod Major
- Amiodarone + Etrasimod Major
- Anagrelide + Etrasimod Major
- Anakinra + Etrasimod Major
- Anti-thymocyte + Etrasimod Major
- Asenapine + Etrasimod Major
Frequently asked questions
Can I take Etrasimod with Fingolimod?
MediHelp rates the interaction as major. Etrasimod 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 are S1P receptor modulators that reduce circulating lymphocytes and slow heart rate. Combining them duplicates the mechanism, adding to immunosuppression, infection risk and bradyarrhythmia without any established benefit.
How serious is the interaction between Etrasimod 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: Do not use the two together. When switching, allow fingolimod's lymphocyte-lowering effect to resolve and follow labeling for washout before starting etrasimod.
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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