Drug interactions
Fingolimod + Melphalan
Severity: Major
Fingolimod and Melphalan: 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
Melphalan is a strongly myelosuppressive alkylating agent, and fingolimod reduces circulating lymphocytes. Together they can substantially increase the risk of serious infection.
What this interaction means in plain words
Fingolimod and Melphalan 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; Melphalan belongs to Oncology.
Why it happens
Additive immunosuppression from alkylating-agent marrow suppression and fingolimod lymphocyte sequestration.
What to do
Avoid combination where possible; if used, monitor blood counts closely and treat fever or infection promptly. Consider holding fingolimod during melphalan treatment.
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 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 Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + Melphalan Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Melphalan Contraindicated
- Measles mumps and rubella vaccine live + Melphalan Contraindicated
- Measles mumps and rubella vaccine + Melphalan Contraindicated
- Measles mumps rubella and varicella vaccine live + Melphalan Contraindicated
Frequently asked questions
Can I take Fingolimod with Melphalan?
MediHelp rates the interaction as major. Fingolimod and Melphalan 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. Melphalan is a strongly myelosuppressive alkylating agent, and fingolimod reduces circulating lymphocytes. Together they can substantially increase the risk of serious infection.
How serious is the interaction between Fingolimod and Melphalan?
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 combination where possible; if used, monitor blood counts closely and treat fever or infection promptly. Consider holding fingolimod during melphalan treatment.
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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