Drug interactions
Aprepitant + Siponimod
Severity: Moderate
Aprepitant and Siponimod: moderate 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
Aprepitant inhibits CYP3A4 and may raise siponimod exposure, which is metabolized mainly by CYP2C9 and partly by CYP3A4. The effect is greater in patients who have reduced CYP2C9 activity, increasing bradyarrhythmia and other adverse effects.
What this interaction means in plain words
Aprepitant and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aprepitant belongs to Gastrointestinal Tract; Siponimod belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated siponimod metabolism, with a larger effect when CYP2C9 is also impaired.
What to do
Check the patient's CYP2C9 status and avoid the combination in patients with CYP2C9*3/*3 or on a CYP2C9 inhibitor. Otherwise monitor heart rate and ECG.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
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 Aprepitant with Siponimod?
MediHelp rates the interaction as moderate. Aprepitant and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Aprepitant inhibits CYP3A4 and may raise siponimod exposure, which is metabolized mainly by CYP2C9 and partly by CYP3A4. The effect is greater in patients who have reduced CYP2C9 activity, increasing bradyarrhythmia and other adverse effects.
How serious is the interaction between Aprepitant and Siponimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check the patient's CYP2C9 status and avoid the combination in patients with CYP2C9*3/*3 or on a CYP2C9 inhibitor. Otherwise monitor heart rate and ECG.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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