Drug interactions
Fingolimod + Tacrolimus
Severity: Major
Fingolimod and Tacrolimus: 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
Tacrolimus is a potent immunosuppressant and also prolongs the QT interval, while fingolimod reduces lymphocyte counts and slows heart rate. The combination can increase infection risk and arrhythmia risk.
What this interaction means in plain words
Fingolimod and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression and additive QT prolongation, with fingolimod-related bradycardia.
What to do
Avoid unless specifically indicated; if used, monitor ECG, electrolytes, tacrolimus levels, lymphocyte counts and for infection.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Fingolimod with Tacrolimus?
MediHelp rates the interaction as major. Fingolimod and Tacrolimus 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. Tacrolimus is a potent immunosuppressant and also prolongs the QT interval, while fingolimod reduces lymphocyte counts and slows heart rate. The combination can increase infection risk and arrhythmia risk.
How serious is the interaction between Fingolimod and Tacrolimus?
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 unless specifically indicated; if used, monitor ECG, electrolytes, tacrolimus levels, lymphocyte counts and for infection.
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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