Drug interactions
Fingolimod + Nebivolol
Severity: Major
Fingolimod and Nebivolol: 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 transient heart rate slowing and AV conduction delay after the first dose. Nebivolol adds to these effects, raising the risk of symptomatic bradycardia and heart block.
What this interaction means in plain words
Fingolimod and Nebivolol 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; Nebivolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic and dromotropic effects of S1P receptor modulation and beta-blockade.
What to do
Obtain a baseline ECG before starting fingolimod and monitor heart rate and blood pressure for at least 6 hours after the first dose. Consult a cardiologist about whether the beta-blocker can be changed or held beforehand.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol 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 Nebivolol?
MediHelp rates the interaction as major. Fingolimod and Nebivolol 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. Nebivolol adds to these effects, raising the risk of symptomatic bradycardia and heart block.
How serious is the interaction between Fingolimod and Nebivolol?
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 monitor heart rate and blood pressure for at least 6 hours after the first dose. Consult a cardiologist about whether the beta-blocker can be changed or held beforehand.
What other medicines interact with Nebivolol?
MediHelp also lists interactions of Nebivolol with, for example, Acebutolol, Aldesleukin, Amiodarone. The full list is on the Nebivolol page.
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