Drug interactions
Hydroxychloroquine + Siponimod
Severity: Major
Hydroxychloroquine 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
Siponimod can slow the heart rate and affect cardiac conduction at initiation, and hydroxychloroquine prolongs the QT interval. Together, bradycardia and QT prolongation could increase the risk of torsades de pointes.
What this interaction means in plain words
Hydroxychloroquine 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.
Hydroxychloroquine belongs to Musculoskeletal; Siponimod belongs to Central Nervous System.
Why it happens
Siponimod-related bradycardia combined with hydroxychloroquine QT prolongation.
What to do
Obtain a cardiology review and ECG before starting siponimod in patients on hydroxychloroquine, and use first-dose monitoring. Consider alternatives where the QTc is prolonged.
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 Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib Contraindicated
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 Hydroxychloroquine with Siponimod?
MediHelp rates the interaction as major. Hydroxychloroquine 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. Siponimod can slow the heart rate and affect cardiac conduction at initiation, and hydroxychloroquine prolongs the QT interval. Together, bradycardia and QT prolongation could increase the risk of torsades de pointes.
How serious is the interaction between Hydroxychloroquine 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: Obtain a cardiology review and ECG before starting siponimod in patients on hydroxychloroquine, and use first-dose monitoring. Consider alternatives where the QTc is prolonged.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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