Drug interactions
Fingolimod + Metoprolol
Severity: Major
Fingolimod and Metoprolol: major interaction.
Last updated Sources: Health Canada product monograph
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 transient heart rate slowing and AV conduction delay after the first dose, and beta-blockers add to these effects. The combination increases the risk of symptomatic bradycardia and heart block.
What this interaction means in plain words
Fingolimod and Metoprolol 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; Metoprolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic and dromotropic effects: fingolimod activates cardiac S1P receptors while metoprolol blocks beta-1 receptors.
What to do
Obtain a baseline ECG and observe heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Seek cardiology advice before starting, or consider an alternative to the beta-blocker.
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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References
Other interactions of Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol 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 Metoprolol?
MediHelp rates the interaction as major. Fingolimod and Metoprolol 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 transient heart rate slowing and AV conduction delay after the first dose, and beta-blockers add to these effects. The combination increases the risk of symptomatic bradycardia and heart block.
How serious is the interaction between Fingolimod and Metoprolol?
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 and observe heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Seek cardiology advice before starting, or consider an alternative to the beta-blocker.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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