Drug interactions
Duvelisib + Siponimod
Severity: Major
Duvelisib 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
Duvelisib, a PI3K inhibitor, is associated with serious infections including opportunistic infections and with neutropenia. Combined with siponimod, the risk of infection may be higher.
What this interaction means in plain words
Duvelisib 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.
Duvelisib belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression from S1P-mediated lymphocyte sequestration and PI3K-delta/gamma inhibition. Duvelisib is also a CYP3A4 inhibitor, which may raise siponimod exposure.
What to do
Avoid the combination where possible, or hold siponimod during duvelisib therapy. If combined, monitor blood counts and infection signs, and give PJP prophylaxis as recommended for duvelisib.
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 Duvelisib
- Duvelisib + Ergotamine Contraindicated
- Alfuzosin + Duvelisib Major
- Apalutamide + Duvelisib Major
- Avanafil + Duvelisib Major
- Carbamazepine + Duvelisib Major
- Chloramphenicol + Duvelisib Major
Frequently asked questions
Can I take Duvelisib with Siponimod?
MediHelp rates the interaction as major. Duvelisib 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. Duvelisib, a PI3K inhibitor, is associated with serious infections including opportunistic infections and with neutropenia. Combined with siponimod, the risk of infection may be higher.
How serious is the interaction between Duvelisib 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, or hold siponimod during duvelisib therapy. If combined, monitor blood counts and infection signs, and give PJP prophylaxis as recommended for duvelisib.
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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