Drug interactions
Fluvastatin + Siponimod
Severity: Moderate
Fluvastatin and Siponimod: moderate 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
Siponimod is cleared mainly by CYP2C9, with a lesser contribution from CYP3A4. Fluvastatin is a CYP2C9 inhibitor, and while it is not a strong one, it may raise siponimod exposure, potentially increasing adverse effects such as bradycardia and lymphopenia.
What this interaction means in plain words
Fluvastatin and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fluvastatin belongs to Cardiovascular; Siponimod belongs to Central Nervous System.
Why it happens
Fluvastatin inhibits CYP2C9, which reduces siponimod metabolism.
What to do
Check the patient's CYP2C9 genotype, since siponimod is contraindicated in CYP2C9*3/*3 patients. Monitor heart rate and lymphocyte counts, and avoid adding any CYP3A4 inhibitor.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluvastatin
- Cyclosporin + Fluvastatin Major
- Fluvastatin + Gemfibrozil Major
- Fluvastatin + Letermovir Major
- Fluvastatin + Red yeast rice Major
- Apalutamide + Fluvastatin Moderate
- Cholestyramine + Fluvastatin Moderate
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 Fluvastatin with Siponimod?
MediHelp rates the interaction as moderate. Fluvastatin and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Siponimod is cleared mainly by CYP2C9, with a lesser contribution from CYP3A4. Fluvastatin is a CYP2C9 inhibitor, and while it is not a strong one, it may raise siponimod exposure, potentially increasing adverse effects such as bradycardia and lymphopenia.
How serious is the interaction between Fluvastatin and Siponimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check the patient's CYP2C9 genotype, since siponimod is contraindicated in CYP2C9*3/*3 patients. Monitor heart rate and lymphocyte counts, and avoid adding any CYP3A4 inhibitor.
What other medicines interact with Fluvastatin?
MediHelp also lists interactions of Fluvastatin with, for example, Cyclosporin, Gemfibrozil, Letermovir. The full list is on the Fluvastatin page.
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