Drug interactions
Fingolimod + Fluoxetine
Severity: Major
Fingolimod and Fluoxetine: 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 can prolong the QT interval, and fluoxetine may add to the repolarization effect. Bradycardia together with QT prolongation raises the risk of torsades de pointes.
What this interaction means in plain words
Fingolimod and Fluoxetine 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; Fluoxetine belongs to Central Nervous System.
Why it happens
Additive QT prolongation combined with fingolimod-induced bradycardia.
What to do
Obtain a baseline ECG and observe the first fingolimod dose with heart rate monitoring, and seek cardiology advice before starting in patients taking QT-prolonging drugs. Consider an alternative antidepressant if the QTc is prolonged.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline 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 Fluoxetine?
MediHelp rates the interaction as major. Fingolimod and Fluoxetine 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 can prolong the QT interval, and fluoxetine may add to the repolarization effect. Bradycardia together with QT prolongation raises the risk of torsades de pointes.
How serious is the interaction between Fingolimod and Fluoxetine?
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 a baseline ECG and observe the first fingolimod dose with heart rate monitoring, and seek cardiology advice before starting in patients taking QT-prolonging drugs. Consider an alternative antidepressant if the QTc is prolonged.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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