Drug interactions
Fingolimod + Nadolol
Severity: Major
Fingolimod and Nadolol: 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
Both lower heart rate, so combined use can cause symptomatic bradycardia or atrioventricular block, particularly in the hours after the first fingolimod dose. Nadolol has long-lasting effects, so the interaction can persist.
What this interaction means in plain words
Fingolimod and Nadolol 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; Nadolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic and dromotropic effects of beta-blockade and fingolimod's S1P-mediated heart rate slowing.
What to do
Obtain an ECG before starting fingolimod and monitor heart rate and blood pressure for at least 6 hours after the first dose; seek cardiology advice or use an alternative if conduction disease is present.
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 Nadolol
- Acebutolol + Nadolol Major
- Adrenaline-articaine + Nadolol Major
- Albuterol + Nadolol Major
- Amifostine + Nadolol Major
- Amiodarone + Nadolol Major
- Arformoterol + Nadolol Major
Frequently asked questions
Can I take Fingolimod with Nadolol?
MediHelp rates the interaction as major. Fingolimod and Nadolol 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. Both lower heart rate, so combined use can cause symptomatic bradycardia or atrioventricular block, particularly in the hours after the first fingolimod dose. Nadolol has long-lasting effects, so the interaction can persist.
How serious is the interaction between Fingolimod and Nadolol?
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 an ECG before starting fingolimod and monitor heart rate and blood pressure for at least 6 hours after the first dose; seek cardiology advice or use an alternative if conduction disease is present.
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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