Drug interactions
Fingolimod + Imipramine
Severity: Major
Fingolimod and Imipramine: 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 after the first dose and has been linked to QT prolongation, while imipramine can prolong QT and slow conduction. Together they may increase the risk of serious arrhythmia.
What this interaction means in plain words
Fingolimod and Imipramine 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; Imipramine belongs to Central Nervous System.
Why it happens
Additive effects on cardiac conduction and repolarization, with fingolimod-induced bradycardia increasing proarrhythmic risk.
What to do
Obtain a baseline ECG and observe the patient after the first fingolimod dose per labeling. Consider an alternative to the tricyclic or arrange cardiology input 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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide 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 Imipramine?
MediHelp rates the interaction as major. Fingolimod and Imipramine 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 after the first dose and has been linked to QT prolongation, while imipramine can prolong QT and slow conduction. Together they may increase the risk of serious arrhythmia.
How serious is the interaction between Fingolimod and Imipramine?
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 patient after the first fingolimod dose per labeling. Consider an alternative to the tricyclic or arrange cardiology input if the QTc is prolonged.
What other medicines interact with Imipramine?
MediHelp also lists interactions of Imipramine with, for example, Dronedarone, Isocarboxazid, Phenelzine. The full list is on the Imipramine page.
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