Drug interactions
Fingolimod + Rituximab
Severity: Major
Fingolimod and Rituximab: 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
Rituximab depletes B cells for months and fingolimod sequesters lymphocytes, so the combination can profoundly impair immune defense and raise infection risk, including opportunistic infections. The combined effect persists after either agent is stopped.
What this interaction means in plain words
Fingolimod and Rituximab 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; Rituximab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression through B-cell depletion and lymphocyte sequestration in lymph nodes.
What to do
Avoid concurrent use where possible; when switching, check lymphocyte and immunoglobulin levels and monitor closely for infection. Take the long duration of rituximab effect into account.
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 Rituximab
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 Rituximab?
MediHelp rates the interaction as major. Fingolimod and Rituximab 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. Rituximab depletes B cells for months and fingolimod sequesters lymphocytes, so the combination can profoundly impair immune defense and raise infection risk, including opportunistic infections. The combined effect persists after either agent is stopped.
How serious is the interaction between Fingolimod and Rituximab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible; when switching, check lymphocyte and immunoglobulin levels and monitor closely for infection. Take the long duration of rituximab effect into account.
What other medicines interact with Rituximab?
MediHelp also lists interactions of Rituximab with, for example, Adenovirus types 4 and 7 live, Baricitinib, Certolizumab pegol. The full list is on the Rituximab page.
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