Drug interactions
Fingolimod + Hydroxychloroquine
Severity: Major
Fingolimod and Hydroxychloroquine: major interaction.
Last updated Sources: US FDA label
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 on initiation and has been associated with QT prolongation, and hydroxychloroquine adds to the QT risk. Bradycardia combined with QT prolongation increases the risk of torsades de pointes.
What this interaction means in plain words
Fingolimod and Hydroxychloroquine 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; Hydroxychloroquine belongs to Musculoskeletal.
Why it happens
Additive QT prolongation, with fingolimod-induced bradycardia increasing susceptibility to arrhythmia.
What to do
Obtain a baseline ECG and extend first-dose monitoring as clinically appropriate. Avoid the combination in patients with a prolonged QTc, and correct electrolytes.
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 Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib 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 Hydroxychloroquine?
MediHelp rates the interaction as major. Fingolimod and Hydroxychloroquine 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 on initiation and has been associated with QT prolongation, and hydroxychloroquine adds to the QT risk. Bradycardia combined with QT prolongation increases the risk of torsades de pointes.
How serious is the interaction between Fingolimod and Hydroxychloroquine?
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 extend first-dose monitoring as clinically appropriate. Avoid the combination in patients with a prolonged QTc, and correct electrolytes.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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