Drug interactions
Fingolimod + Fludarabine
Severity: Major
Fingolimod and Fludarabine: 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
Fludarabine causes profound and prolonged lymphopenia and myelosuppression. Combined with fingolimod, the risk of serious infection is increased.
What this interaction means in plain words
Fingolimod and Fludarabine 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; Fludarabine belongs to Oncology.
Why it happens
Additive lymphocyte depletion from purine analog cytotoxicity and fingolimod sequestration.
What to do
Avoid concurrent use where possible. Monitor lymphocyte counts and infection signs, and consider stopping fingolimod before fludarabine.
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 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 Fludarabine
- Adenovirus types 4 and 7 live + Fludarabine Contraindicated
- Fludarabine + Pentostatin Contraindicated
- Belatacept + Fludarabine Major
- Dengue vaccine + Fludarabine Major
- Etrasimod + Fludarabine Major
- Fludarabine + Ofatumumab sc Major
Frequently asked questions
Can I take Fingolimod with Fludarabine?
MediHelp rates the interaction as major. Fingolimod and Fludarabine 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. Fludarabine causes profound and prolonged lymphopenia and myelosuppression. Combined with fingolimod, the risk of serious infection is increased.
How serious is the interaction between Fingolimod and Fludarabine?
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 concurrent use where possible. Monitor lymphocyte counts and infection signs, and consider stopping fingolimod before fludarabine.
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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