Drug interactions
Fingolimod + Promethazine
Severity: Moderate
Fingolimod and Promethazine: moderate 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 bradycardia and can affect cardiac conduction, while promethazine has a modest potential to prolong the QT interval. Bradycardia increases the risk of torsades de pointes with QT-prolonging drugs, so the combination may raise arrhythmia risk, especially at treatment initiation.
What this interaction means in plain words
Fingolimod and Promethazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fingolimod belongs to Central Nervous System; Promethazine belongs to Respiratory.
Why it happens
Additive pharmacodynamic cardiac effects: fingolimod-induced bradycardia combined with promethazine-related QT prolongation.
What to do
Obtain a baseline ECG and monitor heart rate and QTc, particularly during fingolimod initiation. Consider a non-QT-prolonging antiemetic or antihistamine if the patient has other risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Promethazine
- Ibutilide + Promethazine Contraindicated
- Pimozide + Promethazine Contraindicated
- Promethazine + Thioridazine Contraindicated
- Alfentanil + Promethazine Major
- Amiodarone + Promethazine Major
- Amisulpride + Promethazine 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 Promethazine?
MediHelp rates the interaction as moderate. Fingolimod and Promethazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fingolimod causes bradycardia and can affect cardiac conduction, while promethazine has a modest potential to prolong the QT interval. Bradycardia increases the risk of torsades de pointes with QT-prolonging drugs, so the combination may raise arrhythmia risk, especially at treatment initiation.
How serious is the interaction between Fingolimod and Promethazine?
MediHelp rates it moderate, 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 monitor heart rate and QTc, particularly during fingolimod initiation. Consider a non-QT-prolonging antiemetic or antihistamine if the patient has other risk factors.
What other medicines interact with Promethazine?
MediHelp also lists interactions of Promethazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Promethazine page.
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