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Drug interactions

Fingolimod + Propranolol

Severity: Major

Fingolimod and Propranolol: 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, and beta-blockers add to these effects. The combination increases the risk of symptomatic bradycardia and heart block.

What this interaction means in plain words

Fingolimod and Propranolol 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; Propranolol belongs to Cardiovascular.

Evidence level: High

Why it happens

Additive negative chronotropic and dromotropic effects of S1P receptor modulation and beta-adrenergic blockade.

What to do

Obtain a baseline ECG and observe heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Consider an alternative to the beta-blocker, or seek cardiology advice before initiating.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Fingolimod with Propranolol?

MediHelp rates the interaction as major. Fingolimod and Propranolol 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, and beta-blockers add to these effects. The combination increases the risk of symptomatic bradycardia and heart block.

How serious is the interaction between Fingolimod and Propranolol?

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 observe heart rate and blood pressure for at least 6 hours after the first fingolimod dose. Consider an alternative to the beta-blocker, or seek cardiology advice before initiating.

What other medicines interact with Propranolol?

MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.

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