Drug interactions
Cyclosporin + Siponimod
Severity: Major
Cyclosporin 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
Cyclosporine is an immunosuppressant that may additively increase infection risk when combined with siponimod. It may also raise siponimod exposure through CYP3A4 inhibition, with greater concern in patients with reduced CYP2C9 activity.
What this interaction means in plain words
Cyclosporin 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.
Cyclosporin belongs to Miscellaneous; Siponimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression plus CYP3A4 inhibition by cyclosporine decreasing siponimod clearance.
What to do
Avoid the combination where possible and check CYP2C9 genotype before siponimod. Monitor for infection and heart rate effects if it is used.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine 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 Cyclosporin with Siponimod?
MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporine is an immunosuppressant that may additively increase infection risk when combined with siponimod. It may also raise siponimod exposure through CYP3A4 inhibition, with greater concern in patients with reduced CYP2C9 activity.
How serious is the interaction between Cyclosporin 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 where possible and check CYP2C9 genotype before siponimod. Monitor for infection and heart rate effects if it is used.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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