Drug interactions
Fingolimod + Itraconazole
Severity: Major
Fingolimod and Itraconazole: 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 can cause bradycardia and QT prolongation, and itraconazole also prolongs QT. Itraconazole may also raise fingolimod levels, so the combination increases the risk of arrhythmia.
What this interaction means in plain words
Fingolimod and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation, with possible CYP4F2/CYP3A4 inhibition increasing fingolimod exposure.
What to do
Avoid the combination where possible; if needed, obtain a baseline ECG and monitor heart rate and QTc, particularly after the first fingolimod dose.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole?
MediHelp rates the interaction as major. Fingolimod and Itraconazole 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 can cause bradycardia and QT prolongation, and itraconazole also prolongs QT. Itraconazole may also raise fingolimod levels, so the combination increases the risk of arrhythmia.
How serious is the interaction between Fingolimod and Itraconazole?
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 the combination where possible; if needed, obtain a baseline ECG and monitor heart rate and QTc, particularly after the first fingolimod dose.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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