Drug interactions
Amiodarone + Siponimod
Severity: Major
Amiodarone and Siponimod: major interaction.
Last updated
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
Siponimod slows heart rate and can cause AV conduction delay, and amiodarone adds bradycardia and QT prolongation. Together this can cause serious bradyarrhythmia and torsades de pointes.
What this interaction means in plain words
Amiodarone and Siponimod 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.
Amiodarone belongs to Cardiovascular; Siponimod belongs to Central Nervous System.
Why it happens
Additive heart rate lowering and QTc prolongation, with possible CYP2C9/3A4 inhibition by amiodarone raising siponimod exposure.
What to do
Avoid starting siponimod in patients on amiodarone unless cardiology agrees. If used, do a baseline ECG and monitor heart rate at initiation.
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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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
Frequently asked questions
Can I take Amiodarone with Siponimod?
MediHelp rates the interaction as major. Amiodarone and Siponimod 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. Siponimod slows heart rate and can cause AV conduction delay, and amiodarone adds bradycardia and QT prolongation. Together this can cause serious bradyarrhythmia and torsades de pointes.
How serious is the interaction between Amiodarone and Siponimod?
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 starting siponimod in patients on amiodarone unless cardiology agrees. If used, do a baseline ECG and monitor heart rate at initiation.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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