Drug interactions
Fingolimod + Nortriptyline
Severity: Major
Fingolimod and Nortriptyline: 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 can cause bradycardia and QT prolongation, and nortriptyline can prolong QT and affect conduction. Together they increase the risk of serious arrhythmia, particularly around the first dose.
What this interaction means in plain words
Fingolimod and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive effects on cardiac conduction and repolarization, with fingolimod-induced bradycardia increasing torsades risk.
What to do
Obtain a baseline ECG and extend first-dose observation as appropriate. Consider specialist advice before starting fingolimod in a patient on nortriptyline.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
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 Nortriptyline?
MediHelp rates the interaction as major. Fingolimod and Nortriptyline 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 can cause bradycardia and QT prolongation, and nortriptyline can prolong QT and affect conduction. Together they increase the risk of serious arrhythmia, particularly around the first dose.
How serious is the interaction between Fingolimod and Nortriptyline?
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 extend first-dose observation as appropriate. Consider specialist advice before starting fingolimod in a patient on nortriptyline.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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