Drug interactions
Chlorpromazine + Ponesimod
Severity: Major
Chlorpromazine and Ponesimod: 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
Ponesimod slows heart rate and conduction, and chlorpromazine prolongs the QT interval. Combining them raises the risk of bradycardia-related torsades de pointes, particularly when starting ponesimod.
What this interaction means in plain words
Chlorpromazine and Ponesimod 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.
Chlorpromazine belongs to Central Nervous System; Ponesimod belongs to Central Nervous System.
Why it happens
Sphingosine-1-phosphate receptor-mediated bradycardia combined with chlorpromazine-induced QT prolongation.
What to do
Avoid starting ponesimod in patients on chlorpromazine unless the benefit is clear; obtain cardiology input and an ECG before initiation and monitor heart rate during up-titration.
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 Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Other interactions of Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Chlorpromazine with Ponesimod?
MediHelp rates the interaction as major. Chlorpromazine and Ponesimod 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. Ponesimod slows heart rate and conduction, and chlorpromazine prolongs the QT interval. Combining them raises the risk of bradycardia-related torsades de pointes, particularly when starting ponesimod.
How serious is the interaction between Chlorpromazine and Ponesimod?
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 ponesimod in patients on chlorpromazine unless the benefit is clear; obtain cardiology input and an ECG before initiation and monitor heart rate during up-titration.
What other medicines interact with Chlorpromazine?
MediHelp also lists interactions of Chlorpromazine with, for example, Dofetilide, Dronedarone, Droperidol. The full list is on the Chlorpromazine page.
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