Drug interactions
Darunavir + Siponimod
Severity: Major
Darunavir and Siponimod: major 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
Darunavir, usually boosted with ritonavir or cobicistat, inhibits CYP3A4 and can raise siponimod exposure. This increases the risk of bradycardia, infection and hepatic effects, especially with reduced CYP2C9 function.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Siponimod belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition reduces siponimod metabolism.
What to do
Avoid in CYP2C9*1/*3 and *2/*3 patients. In others, monitor heart rate, ECG and liver tests.
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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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 Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Siponimod?
MediHelp rates the interaction as major. Darunavir 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. Darunavir, usually boosted with ritonavir or cobicistat, inhibits CYP3A4 and can raise siponimod exposure. This increases the risk of bradycardia, infection and hepatic effects, especially with reduced CYP2C9 function.
How serious is the interaction between Darunavir 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 in CYP2C9*1/*3 and *2/*3 patients. In others, monitor heart rate, ECG and liver tests.
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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