Drug interactions
Diltiazem + Ponesimod
Severity: Major
Diltiazem and Ponesimod: 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
Ponesimod slows heart rate on initiation, and diltiazem also lowers heart rate and slows AV conduction. Combining them raises the risk of significant bradycardia and conduction block.
What this interaction means in plain words
Diltiazem and Ponesimod 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.
Diltiazem belongs to Cardiovascular; Ponesimod belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic slowing of heart rate and AV conduction.
What to do
Avoid starting ponesimod in patients on diltiazem unless benefit outweighs risk, and obtain cardiology advice. If used, monitor heart rate and ECG during initiation.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem 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 Diltiazem with Ponesimod?
MediHelp rates the interaction as major. Diltiazem and Ponesimod 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. Ponesimod slows heart rate on initiation, and diltiazem also lowers heart rate and slows AV conduction. Combining them raises the risk of significant bradycardia and conduction block.
How serious is the interaction between Diltiazem and Ponesimod?
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 starting ponesimod in patients on diltiazem unless benefit outweighs risk, and obtain cardiology advice. If used, monitor heart rate and ECG during initiation.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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