Drug interactions
Fluconazole + Siponimod
Severity: Contraindicated
Fluconazole and Siponimod: contraindicated 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
Fluconazole inhibits both CYP2C9 and CYP3A4, the main pathways clearing siponimod, and can substantially raise siponimod exposure. This increases the risk of bradyarrhythmia, infections, liver injury and other dose-related effects.
What this interaction means in plain words
Fluconazole and Siponimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Fluconazole belongs to Anti Fungals; Siponimod belongs to Central Nervous System.
Why it happens
Combined moderate inhibition of CYP2C9 and CYP3A4 by fluconazole reduces siponimod clearance.
What to do
Do not coadminister; siponimod labeling advises against use with drugs that moderately inhibit both CYP2C9 and CYP3A4. Choose a different antifungal.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Other interactions of Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
- Adenovirus types 4 and 7 live + Siponimod Major
Frequently asked questions
Can I take Fluconazole with Siponimod?
MediHelp rates the interaction as contraindicated. Fluconazole and Siponimod are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Fluconazole inhibits both CYP2C9 and CYP3A4, the main pathways clearing siponimod, and can substantially raise siponimod exposure. This increases the risk of bradyarrhythmia, infections, liver injury and other dose-related effects.
How serious is the interaction between Fluconazole and Siponimod?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; siponimod labeling advises against use with drugs that moderately inhibit both CYP2C9 and CYP3A4. Choose a different antifungal.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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