Drug interactions
Fingolimod + Sirolimus
Severity: Major
Fingolimod and Sirolimus: major interaction.
Last updated Sources: US FDA label
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
Sirolimus is an immunosuppressant used in transplantation, and fingolimod lowers circulating lymphocytes. Combined use increases the risk of serious and opportunistic infection.
What this interaction means in plain words
Fingolimod and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression via mTOR inhibition and fingolimod lymphocyte sequestration.
What to do
Avoid combination where possible; if used, monitor lymphocyte counts and for infection closely. Review the need for each agent regularly.
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
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
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Fingolimod with Sirolimus?
MediHelp rates the interaction as major. Fingolimod and Sirolimus 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. Sirolimus is an immunosuppressant used in transplantation, and fingolimod lowers circulating lymphocytes. Combined use increases the risk of serious and opportunistic infection.
How serious is the interaction between Fingolimod and Sirolimus?
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 combination where possible; if used, monitor lymphocyte counts and for infection closely. Review the need for each agent regularly.
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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