Drug interactions
Fingolimod + Levofloxacin
Severity: Major
Fingolimod and Levofloxacin: 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 associated with QT prolongation. Levofloxacin adds QT liability, so the combination raises the risk of torsades de pointes, especially during treatment initiation.
What this interaction means in plain words
Fingolimod and Levofloxacin 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; Levofloxacin belongs to Anti Bacterial.
Why it happens
Additive QT prolongation combined with fingolimod-induced bradycardia, which promotes torsades.
What to do
Avoid starting fingolimod in a patient taking levofloxacin where possible, and use an alternative antibiotic. If both are needed, obtain an ECG and monitor heart rate and QTc.
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 Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin Major
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 Levofloxacin?
MediHelp rates the interaction as major. Fingolimod and Levofloxacin 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 associated with QT prolongation. Levofloxacin adds QT liability, so the combination raises the risk of torsades de pointes, especially during treatment initiation.
How serious is the interaction between Fingolimod and Levofloxacin?
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 starting fingolimod in a patient taking levofloxacin where possible, and use an alternative antibiotic. If both are needed, obtain an ECG and monitor heart rate and QTc.
What other medicines interact with Levofloxacin?
MediHelp also lists interactions of Levofloxacin with, for example, Dronedarone, Ibutilide, Thioridazine. The full list is on the Levofloxacin page.
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