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Fingolimod and Quin-G

Determining the interaction of Fingolimod and Quin-G and the possibility of their joint administration.

Check result:

Fingolimod <> Quin-G

Relevance: 14.07.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Fingolimod is not recommended if you are currently receiving treatment with quiNIDine. Using fingolimod in this situation can increase the risk of an irregular heart rhythm that may be serious or life-threatening. This is most likely to occur early on after you start treatment with fingolimod, especially within the first 20 hours after the first dose. On the other hand, it may be alright for you to use these medications together if you have been stable on fingolimod therapy for over a month while you start treatment with quiNIDine. Talk to your doctor if you are uncertain whether you should be treated with these medications at the same time. Your first dose of fingolimod must be taken at your doctor's office or a hospital, and you will need to be observed for 6 hours or more afterwards. In the event that you restart the medication after an interruption in treatment, you may need to take the first dose again under medical observation depending on how long you were on the medication before you stopped, and how many days the interruption lasted. Contact your doctor if you develop dizziness, lightheadedness, fainting, shortness of breath, chest pain, or heart palpitations during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Theoretical concerns exist that initiating treatment with fingolimod may potentiate the risk of torsade de pointes arrhythmia associated with the use of class IA (e.g., disopyramide, quinidine, procainamide) and class III (e.g., amiodarone, dofetilide, ibutilide, sotalol) antiarrhythmic agents. Fingolimod can cause a decrease in heart rate during initiation of therapy that is apparent within an hour of the first dose and maximal at approximately 6 hours postdose in most cases, but occasionally up to 20 hours after the first dose. Further, but smaller decreases in heart rate may occur after the second dose, although heart rate eventually returns to baseline within one month of chronic treatment. The mean decrease in heart rate in patients receiving fingolimod 0.5 mg at 6 hours after the first dose was approximately 13 beats per minute (bpm). Heart rates below 40 bpm were rarely observed. In controlled clinical trials, adverse reactions of symptomatic bradycardia (hypotension, dizziness, fatigue, palpitations, chest pain) following the first dose were reported in 0.5% of patients receiving fingolimod 0.5 mg, compared to no patient on placebo. Initiation of fingolimod treatment has also resulted in transient AV conduction delays. First- and second-degree AV block (prolonged PR interval on ECG) following the first dose were each reported in 0.1% of patients receiving fingolimod 0.5 mg, compared to no patient on placebo. In a study of 698 patients with available 24-hour Holter monitoring data after their first dose, second degree AV blocks, usually Mobitz type I (Wenckebach), were reported in 3.7% of patients receiving fingolimod 0.5 mg and 2% of patients receiving placebo. Bradycardia and conduction abnormalities were usually transient and asymptomatic, and resolved within the first 24 hours on treatment, but they occasionally required treatment with atropine or isoproterenol.

MANAGEMENT: The use of fingolimod in patients with arrhythmias requiring treatment with class IA or class III antiarrhythmic agents has not been studied and is considered contraindicated.

References

"Product Information. Gilenya (fingolimod)." Novartis Pharmaceuticals, East Hanover, NJ.
FDA. U.S. Food and Drug Administration "FDA Drug Safety Communication: Revised recommendations for cardiovascular monitoring and use of multiple sclerosis drug Gilenya (fingolimod). Available from: URL: http://www.fda.gov/Drugs/DrugSafety/ucm303192.htm#data." ([2012 May 14]):

Fingolimod

Generic Name: fingolimod

Brand name: Gilenya

Synonyms: n.a.

What is Fingolimod?

Quin-G

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

Synonyms: n.a.

What is Quin-G?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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