Drug Interactions With Fingolimod
Ketoconazole increases the level of fingolimod in the body, increasing the risk for fingolimod side effects. Check with your healthcare provider before taking these medications together.
Fingolimod can cause QT prolongation (a certain change in the heart rhythm), which may increase the risk for a life-threatening arrhythmia. Combining this medication with other QT-prolonging medications may further increase your risk for this problem. If you take a medication that can cause QT prolongation, you will need to be monitored overnight in a healthcare facility after taking your first fingolimod dose to make sure you do not develop any heart rhythm problems.
Non-Dihydropyridine Calcium Channel Blockers
Fingolimod can cause a dangerously slow heart rate (bradycardia). Because non-dihydropyridine calcium channel blockers can also lower the heart rate, your healthcare provider will need to monitor you closely if you take fingolimod with such medications. You may need to stay overnight in a healthcare facility after your first dose to make sure your heart rate does not drop too low.
Fingolimod can make vaccines less effective, as it suppresses the immune response. More importantly, however, fingolimod may increase the risk of actually developing the disease you are trying to prevent (for live vaccines only).
For instance, you may be at a higher risk for developing chickenpox from the chickenpox vaccine if you are taking fingolimod. These effects persist for two months after you stop taking fingolimod. You should not receive any live vaccines while taking fingolimod or for two months after stopping this medication. You may receive non-live vaccines, although they may be less effective.