Drug Interactions between fingolimod and givinostat

Before starting fingolimod, let your doctor know if you are currently receiving treatment with givinostat. 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 givinostat. 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.

Combining these medications can also increase the risk of serious infections. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Because fingolimod can stay in your blood for up to two months after the last dose, interactions with other drugs may occur for some time even after you have stopped taking it. Contact your doctor immediately if you develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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.