Drug interactions
Influenza virus vaccine quadrivalent intranasal + Siponimod
Severity: Contraindicated
Influenza virus vaccine quadrivalent intranasal 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
The intranasal influenza vaccine contains live attenuated virus, which could cause vaccine-strain infection in a patient with siponimod-induced lymphopenia. Immune suppression also makes the vaccine response unreliable. Live vaccines should not be given during siponimod therapy.
What this interaction means in plain words
Influenza virus vaccine quadrivalent intranasal 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.
Why it happens
Lymphocyte sequestration by S1P receptor modulation impairs control of live attenuated virus replication.
What to do
Avoid live attenuated vaccines during siponimod and for about 4 weeks after discontinuation; use an inactivated influenza vaccine instead. If a live vaccine is needed, give it at least 4 weeks before starting siponimod.
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 Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
- Adenovirus types 4 and 7 live + Siponimod Major
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent intranasal with Siponimod?
MediHelp rates the interaction as contraindicated. Influenza virus vaccine quadrivalent intranasal 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. The intranasal influenza vaccine contains live attenuated virus, which could cause vaccine-strain infection in a patient with siponimod-induced lymphopenia. Immune suppression also makes the vaccine response unreliable. Live vaccines should not be given during siponimod therapy.
How serious is the interaction between Influenza virus vaccine quadrivalent intranasal 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: Avoid live attenuated vaccines during siponimod and for about 4 weeks after discontinuation; use an inactivated influenza vaccine instead. If a live vaccine is needed, give it at least 4 weeks before starting siponimod.
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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