Drug interactions
Fingolimod + Mechlorethamine
Severity: Major
Fingolimod and Mechlorethamine: 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
Mechlorethamine is a cytotoxic alkylating agent that causes myelosuppression and immunosuppression. Added to fingolimod's lymphocyte lowering, it increases the risk of serious infection. Mechlorethamine in topical gel form has minimal systemic exposure, but systemic use carries the full risk.
What this interaction means in plain words
Fingolimod and Mechlorethamine 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; Mechlorethamine belongs to Oncology.
Why it happens
Additive immunosuppression from cytotoxic myelosuppression and fingolimod-induced lymphocyte sequestration.
What to do
Avoid combining where possible and use a non-immunosuppressive alternative. If combined, monitor blood counts, particularly lymphocytes, and watch closely for infection.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fingolimod and Mechlorethamine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Mechlorethamine
Frequently asked questions
Can I take Fingolimod with Mechlorethamine?
MediHelp rates the interaction as major. Fingolimod and Mechlorethamine 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. Mechlorethamine is a cytotoxic alkylating agent that causes myelosuppression and immunosuppression. Added to fingolimod's lymphocyte lowering, it increases the risk of serious infection. Mechlorethamine in topical gel form has minimal systemic exposure, but systemic use carries the full risk.
How serious is the interaction between Fingolimod and Mechlorethamine?
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 use a non-immunosuppressive alternative. If combined, monitor blood counts, particularly lymphocytes, and watch closely for infection.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
