Drug interactions
Fingolimod + Smallpox vaccine live
Severity: Major
Fingolimod and Smallpox vaccine live: 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
Fingolimod reduces circulating lymphocytes and may blunt vaccine response. Live vaccinia in an immunosuppressed patient risks progressive vaccinia and other serious vaccine-related complications.
What this interaction means in plain words
Fingolimod and Smallpox vaccine live 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.
Why it happens
S1P receptor modulation impairs immune control of live attenuated vaccinia virus.
What to do
Avoid live vaccinia vaccine during fingolimod therapy and for about two months after stopping. Consider non-replicating vaccine alternatives where available.
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
Frequently asked questions
Can I take Fingolimod with Smallpox vaccine live?
MediHelp rates the interaction as major. Fingolimod and Smallpox vaccine live 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 reduces circulating lymphocytes and may blunt vaccine response. Live vaccinia in an immunosuppressed patient risks progressive vaccinia and other serious vaccine-related complications.
How serious is the interaction between Fingolimod and Smallpox vaccine live?
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 live vaccinia vaccine during fingolimod therapy and for about two months after stopping. Consider non-replicating vaccine alternatives where available.
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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