Drug interactions
Fingolimod + Leflunomide
Severity: Major
Fingolimod and Leflunomide: 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
Both drugs suppress immune function, and combining them may increase the risk of serious infection. Leflunomide's active metabolite persists for a long time, so the effect continues after stopping.
What this interaction means in plain words
Fingolimod and Leflunomide 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; Leflunomide belongs to Musculoskeletal.
Why it happens
Additive immunosuppression; leflunomide inhibits pyrimidine synthesis in lymphocytes while fingolimod sequesters lymphocytes in lymphoid tissue.
What to do
Avoid combining where possible and monitor for infection and blood counts if used together. Consider an accelerated elimination procedure for leflunomide when switching therapies.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live 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 Leflunomide?
MediHelp rates the interaction as major. Fingolimod and Leflunomide 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. Both drugs suppress immune function, and combining them may increase the risk of serious infection. Leflunomide's active metabolite persists for a long time, so the effect continues after stopping.
How serious is the interaction between Fingolimod and Leflunomide?
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 combining where possible and monitor for infection and blood counts if used together. Consider an accelerated elimination procedure for leflunomide when switching therapies.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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