Drug interactions
Fingolimod + Fluconazole
Severity: Major
Fingolimod and Fluconazole: 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 may prolong the QT interval, and fluconazole adds QT-prolonging potential. Fluconazole may also modestly raise fingolimod levels via CYP inhibition. The combination raises arrhythmia risk.
What this interaction means in plain words
Fingolimod and Fluconazole 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; Fluconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation and bradycardia, with possible CYP inhibition raising fingolimod exposure.
What to do
Obtain baseline ECG and consider extended monitoring after the first fingolimod dose. Avoid or closely monitor in patients with other QT risk factors.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole 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 Fluconazole?
MediHelp rates the interaction as major. Fingolimod and Fluconazole 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 may prolong the QT interval, and fluconazole adds QT-prolonging potential. Fluconazole may also modestly raise fingolimod levels via CYP inhibition. The combination raises arrhythmia risk.
How serious is the interaction between Fingolimod and Fluconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain baseline ECG and consider extended monitoring after the first fingolimod dose. Avoid or closely monitor in patients with other QT risk factors.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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