Drug interactions
Crizotinib + Siponimod
Severity: Major
Crizotinib and Siponimod: major interaction.
Last updated Sources: US FDA label
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
Crizotinib is a moderate CYP3A4 inhibitor and may raise siponimod levels. Both drugs can also prolong the QT interval and slow the heart rate, so the risks of bradyarrhythmia and torsades de pointes may be additive.
What this interaction means in plain words
Crizotinib 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.
Crizotinib belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Crizotinib inhibits CYP3A4, reducing siponimod clearance, and both drugs have additive effects on cardiac conduction and repolarisation.
What to do
Avoid the combination if possible. If it is needed, obtain a baseline ECG, monitor heart rate, QTc and electrolytes, and seek cardiology advice.
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 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 Crizotinib
- Crizotinib + Flibanserin Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Crizotinib + Lonafarnib Contraindicated
- Crizotinib + Pimozide Contraindicated
- Crizotinib + Saquinavir Contraindicated
- Crizotinib + Thioridazine Contraindicated
Frequently asked questions
Can I take Crizotinib with Siponimod?
MediHelp rates the interaction as major. Crizotinib 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. Crizotinib is a moderate CYP3A4 inhibitor and may raise siponimod levels. Both drugs can also prolong the QT interval and slow the heart rate, so the risks of bradyarrhythmia and torsades de pointes may be additive.
How serious is the interaction between Crizotinib 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 the combination if possible. If it is needed, obtain a baseline ECG, monitor heart rate, QTc and electrolytes, and seek cardiology advice.
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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