Drug interactions
Fingolimod + Maprotiline
Severity: Major
Fingolimod and Maprotiline: 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 can prolong the QT interval, and maprotiline may also affect cardiac conduction and repolarization. Combined use may increase the risk of arrhythmia, especially at treatment initiation.
What this interaction means in plain words
Fingolimod and Maprotiline 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; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with fingolimod-induced bradycardia increasing susceptibility to torsades de pointes.
What to do
Obtain a baseline ECG before starting fingolimod and observe the patient for first-dose bradycardia. Seek cardiology advice before combining, and consider a different antidepressant if 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 Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue 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 Maprotiline?
MediHelp rates the interaction as major. Fingolimod and Maprotiline 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 can prolong the QT interval, and maprotiline may also affect cardiac conduction and repolarization. Combined use may increase the risk of arrhythmia, especially at treatment initiation.
How serious is the interaction between Fingolimod and Maprotiline?
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 before starting fingolimod and observe the patient for first-dose bradycardia. Seek cardiology advice before combining, and consider a different antidepressant if QTc is prolonged.
What other medicines interact with Maprotiline?
MediHelp also lists interactions of Maprotiline with, for example, Arsenic trioxide, Disopyramide, Dofetilide. The full list is on the Maprotiline page.
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