Drug interactions
Fingolimod + Ponesimod
Severity: Contraindicated
Fingolimod and Ponesimod: contraindicated 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 are sphingosine-1-phosphate receptor modulators that lower heart rate and reduce circulating lymphocytes. Using them together duplicates therapy and increases the risk of bradyarrhythmia, conduction delay and infection.
What this interaction means in plain words
Fingolimod and Ponesimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Fingolimod belongs to Central Nervous System; Ponesimod belongs to Central Nervous System.
Why it happens
Duplicate S1P receptor modulation producing additive negative chronotropic and immunosuppressive effects.
What to do
Do not combine; allow adequate washout of one agent, guided by labeling, before starting the other, with cardiac monitoring at initiation.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 + Quinidine Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fingolimod + Sotalol Contraindicated
Other interactions of Ponesimod
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
- Asenapine + Ponesimod Major
Frequently asked questions
Can I take Fingolimod with Ponesimod?
MediHelp rates the interaction as contraindicated. Fingolimod and Ponesimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Both are sphingosine-1-phosphate receptor modulators that lower heart rate and reduce circulating lymphocytes. Using them together duplicates therapy and increases the risk of bradyarrhythmia, conduction delay and infection.
How serious is the interaction between Fingolimod and Ponesimod?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; allow adequate washout of one agent, guided by labeling, before starting the other, with cardiac monitoring at initiation.
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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