Drug interactions
Chlorpromazine + Siponimod
Severity: Major
Chlorpromazine and Siponimod: major interaction.
Last updated Sources: Health Canada product monograph
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 on initiation, and chlorpromazine prolongs the QT interval. Together they raise the risk of bradycardia-related ventricular arrhythmia.
What this interaction means in plain words
Chlorpromazine 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.
Chlorpromazine belongs to Central Nervous System; Siponimod belongs to Central Nervous System.
Why it happens
Sphingosine-1-phosphate receptor-mediated bradycardia combined with QT prolongation by chlorpromazine.
What to do
Avoid combining where possible; if needed, obtain cardiology advice and an ECG before starting siponimod, and monitor heart rate during 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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References
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 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 Chlorpromazine with Siponimod?
MediHelp rates the interaction as major. Chlorpromazine 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 on initiation, and chlorpromazine prolongs the QT interval. Together they raise the risk of bradycardia-related ventricular arrhythmia.
How serious is the interaction between Chlorpromazine 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 combining where possible; if needed, obtain cardiology advice and an ECG before starting siponimod, and monitor heart rate during 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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