Drug interactions
Cladribine + Siponimod
Severity: Contraindicated
Cladribine and Siponimod: contraindicated 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
Cladribine causes prolonged lymphocyte depletion, and siponimod further reduces lymphocyte counts. Combined use may produce profound, long-lasting immunosuppression with serious infection risk.
What this interaction means in plain words
Cladribine and Siponimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Cladribine belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Additive lymphocyte depletion: cladribine is cytotoxic to lymphocytes and siponimod sequesters them in lymphoid tissue.
What to do
Do not use together; cladribine labeling advises against concomitant immunosuppressive or myelosuppressive therapy. When switching, check lymphocyte counts and allow adequate recovery before starting the second drug.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Siponimod
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
- Adenovirus types 4 and 7 live + Siponimod Major
Other interactions of Cladribine
- Adenovirus types 4 and 7 live + Cladribine Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Axicabtagene ciloleucel + Cladribine Major
- Belatacept + Cladribine Major
- Brexucabtagene autoleucel + Cladribine Major
- Cholera vaccine + Cladribine Major
Frequently asked questions
Can I take Cladribine with Siponimod?
MediHelp rates the interaction as contraindicated. Cladribine and Siponimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cladribine causes prolonged lymphocyte depletion, and siponimod further reduces lymphocyte counts. Combined use may produce profound, long-lasting immunosuppression with serious infection risk.
How serious is the interaction between Cladribine and Siponimod?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; cladribine labeling advises against concomitant immunosuppressive or myelosuppressive therapy. When switching, check lymphocyte counts and allow adequate recovery before starting the second drug.
What other medicines interact with Siponimod?
MediHelp also lists interactions of Siponimod with, for example, Fingolimod, Fluconazole, Influenza virus vaccine quadrivalent intranasal. The full list is on the Siponimod page.
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