Drug interactions
Fingolimod + Flecainide
Severity: Major
Fingolimod and Flecainide: major interaction.
Last updated Sources: Health Canada product monograph
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 AV conduction delay after the first dose and has been associated with QT prolongation. Flecainide slows conduction and may be proarrhythmic, so the combination may increase the risk of bradyarrhythmia and ventricular arrhythmias.
What this interaction means in plain words
Fingolimod and Flecainide 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 belongs to Central Nervous System; Flecainide belongs to Cardiovascular.
Why it happens
Additive effects on heart rate, AV conduction and repolarization.
What to do
Avoid if possible. If used together, monitor the patient with ECG during first-dose observation, and seek cardiology input.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Fingolimod with Flecainide?
MediHelp rates the interaction as major. Fingolimod and Flecainide 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 AV conduction delay after the first dose and has been associated with QT prolongation. Flecainide slows conduction and may be proarrhythmic, so the combination may increase the risk of bradyarrhythmia and ventricular arrhythmias.
How serious is the interaction between Fingolimod and Flecainide?
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 used together, monitor the patient with ECG during first-dose observation, and seek cardiology input.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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