Drug interactions
Fingolimod + Levobunolol
Severity: Moderate
Fingolimod and Levobunolol: moderate 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 lower heart rate, so combined use may cause symptomatic bradycardia or atrioventricular block, particularly after the first fingolimod dose. Levobunolol is an ophthalmic beta-blocker, but systemic absorption can be enough to matter in susceptible patients.
What this interaction means in plain words
Fingolimod and Levobunolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fingolimod belongs to Central Nervous System; Levobunolol belongs to Miscellaneous.
Why it happens
Additive negative chronotropic and dromotropic effects of beta-blockade and fingolimod's S1P-mediated heart rate slowing.
What to do
Obtain an ECG before starting fingolimod and monitor heart rate and blood pressure for at least 6 hours after the first dose; consult a cardiologist or change the beta-blocker if bradycardia risk is high.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Levobunolol
- Clonidine + Levobunolol Moderate
- Digoxin + Levobunolol Moderate
- Diltiazem + Levobunolol Moderate
- Levobunolol + Rivastigmine Moderate
- Levobunolol + Verapamil Moderate
Frequently asked questions
Can I take Fingolimod with Levobunolol?
MediHelp rates the interaction as moderate. Fingolimod and Levobunolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both lower heart rate, so combined use may cause symptomatic bradycardia or atrioventricular block, particularly after the first fingolimod dose. Levobunolol is an ophthalmic beta-blocker, but systemic absorption can be enough to matter in susceptible patients.
How serious is the interaction between Fingolimod and Levobunolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG before starting fingolimod and monitor heart rate and blood pressure for at least 6 hours after the first dose; consult a cardiologist or change the beta-blocker if bradycardia risk is high.
What other medicines interact with Fingolimod?
MediHelp also lists interactions of Fingolimod with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Pimozide. The full list is on the Fingolimod page.
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