Drug interactions
Brigatinib + Siponimod
Severity: Moderate
Brigatinib 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
Brigatinib is a CYP3A4 inducer and may lower siponimod concentrations. The effect is greater in patients with reduced CYP2C9 activity, as CYP3A4 then plays a larger role in siponimod clearance, and it may reduce efficacy.
What this interaction means in plain words
Brigatinib 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.
Brigatinib belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
CYP3A4 induction increases siponimod metabolism and lowers its exposure.
What to do
Check CYP2C9 genotype, and avoid the combination in patients with CYP2C9*1/*3 or *2/*3 genotypes. Otherwise monitor for reduced siponimod efficacy and consider an alternative treatment.
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 Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
Other interactions of Brigatinib
Frequently asked questions
Can I take Brigatinib with Siponimod?
MediHelp rates the interaction as moderate. Brigatinib 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. Brigatinib is a CYP3A4 inducer and may lower siponimod concentrations. The effect is greater in patients with reduced CYP2C9 activity, as CYP3A4 then plays a larger role in siponimod clearance, and it may reduce efficacy.
How serious is the interaction between Brigatinib 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 CYP2C9 genotype, and avoid the combination in patients with CYP2C9*1/*3 or *2/*3 genotypes. Otherwise monitor for reduced siponimod efficacy and consider an alternative treatment.
What other medicines interact with Siponimod?
MediHelp also lists interactions of Siponimod with, for example, Cladribine, Fingolimod, Fluconazole. The full list is on the Siponimod page.
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