Drug interactions
Fingolimod + Olanzapine
Severity: Major
Fingolimod and Olanzapine: major interaction.
Last updated Sources: UK SmPC
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 bradycardia and has been associated with QT prolongation, and olanzapine has a small potential to prolong the QT interval. Together they may increase the risk of torsades de pointes, especially after the first fingolimod dose.
What this interaction means in plain words
Fingolimod and Olanzapine 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; Olanzapine belongs to Central Nervous System.
Why it happens
Additive QTc prolongation, with fingolimod-induced bradycardia increasing susceptibility to arrhythmia.
What to do
Obtain an ECG before starting fingolimod and observe first-dose monitoring as per labeling; consider extended observation in this setting. Correct electrolytes and seek cardiology advice when QTc is prolonged.
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
- Olanzapine 10 mg orodispersible tablets - SmPC sections 4.3/4.5 (class statement: medicinal products known to increase QTc interval; "Caution should be used if olanzapine is being administered concomitantly with medicinal products known to increase QTc interval (see section 4.4).") — electronic medicines compendium (UK SmPC)
Other interactions of Olanzapine
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 Olanzapine?
MediHelp rates the interaction as major. Fingolimod and Olanzapine 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 bradycardia and has been associated with QT prolongation, and olanzapine has a small potential to prolong the QT interval. Together they may increase the risk of torsades de pointes, especially after the first fingolimod dose.
How serious is the interaction between Fingolimod and Olanzapine?
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 observe first-dose monitoring as per labeling; consider extended observation in this setting. Correct electrolytes and seek cardiology advice when QTc is prolonged.
What other medicines interact with Olanzapine?
MediHelp also lists interactions of Olanzapine with, for example, Amisulpride, Amoxapine, Apomorphine. The full list is on the Olanzapine page.
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