Drug interactions
Clozapine + Ponesimod
Severity: Moderate
Clozapine and Ponesimod: 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
Ponesimod slows heart rate and atrioventricular conduction, and clozapine can prolong the QT interval and cause orthostatic hypotension. Together they may increase the risk of bradyarrhythmia and QT-related events.
What this interaction means in plain words
Clozapine and Ponesimod 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.
Clozapine belongs to Central Nervous System; Ponesimod belongs to Central Nervous System.
Why it happens
Additive effects on cardiac conduction and repolarization, with ponesimod-induced bradycardia increasing QT risk.
What to do
Review the ECG before starting ponesimod and monitor heart rate and QTc. Seek cardiology advice for patients with QT risk factors.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
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 Clozapine with Ponesimod?
MediHelp rates the interaction as moderate. Clozapine and Ponesimod 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. Ponesimod slows heart rate and atrioventricular conduction, and clozapine can prolong the QT interval and cause orthostatic hypotension. Together they may increase the risk of bradyarrhythmia and QT-related events.
How serious is the interaction between Clozapine and Ponesimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review the ECG before starting ponesimod and monitor heart rate and QTc. Seek cardiology advice for patients with QT risk factors.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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