Drug interactions
Gilteritinib + Siponimod
Severity: Major
Gilteritinib 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
Gilteritinib prolongs the QT interval, and siponimod slows heart rate at treatment start. The combination raises the risk of serious ventricular arrhythmias such as torsades de pointes. Patients with electrolyte abnormalities or existing cardiac disease are at higher risk.
What this interaction means in plain words
Gilteritinib 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.
Gilteritinib belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Additive QT prolongation together with siponimod-induced bradycardia.
What to do
Avoid starting siponimod during gilteritinib therapy where possible; if essential, obtain cardiology input, perform baseline and follow-up ECGs and keep potassium and magnesium normal.
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 Gilteritinib
- Gilteritinib + Pimozide Contraindicated
- Amiodarone + Gilteritinib Major
- Amisulpride + Gilteritinib Major
- Amitriptyline + Gilteritinib Major
- Anagrelide + Gilteritinib Major
- Apalutamide + Gilteritinib Major
Frequently asked questions
Can I take Gilteritinib with Siponimod?
MediHelp rates the interaction as major. Gilteritinib 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. Gilteritinib prolongs the QT interval, and siponimod slows heart rate at treatment start. The combination raises the risk of serious ventricular arrhythmias such as torsades de pointes. Patients with electrolyte abnormalities or existing cardiac disease are at higher risk.
How serious is the interaction between Gilteritinib 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 starting siponimod during gilteritinib therapy where possible; if essential, obtain cardiology input, perform baseline and follow-up ECGs and keep potassium and magnesium normal.
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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