Drug interactions
Ivacaftor + Siponimod
Severity: Moderate
Ivacaftor 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
Ivacaftor is a weak CYP3A inhibitor and may modestly raise siponimod exposure. The label concern applies mainly when combined with moderate or strong dual CYP2C9/CYP3A4 inhibition, so the effect is usually limited.
What this interaction means in plain words
Ivacaftor 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.
Ivacaftor belongs to Miscellaneous; Siponimod belongs to Central Nervous System.
Why it happens
Weak inhibition of CYP3A4 reduces siponimod clearance.
What to do
Monitor heart rate and for adverse effects of siponimod. Avoid adding a further CYP2C9 inhibitor, and consider CYP2C9 genotype.
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 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 Ivacaftor
- Ensitrelvir + Ivacaftor Contraindicated
- Apalutamide + Ivacaftor Major
- Carbamazepine + Ivacaftor Major
- Clarithromycin + Ivacaftor Major
- Efavirenz + Ivacaftor Major
- Enzalutamide + Ivacaftor Major
Frequently asked questions
Can I take Ivacaftor with Siponimod?
MediHelp rates the interaction as moderate. Ivacaftor 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. Ivacaftor is a weak CYP3A inhibitor and may modestly raise siponimod exposure. The label concern applies mainly when combined with moderate or strong dual CYP2C9/CYP3A4 inhibition, so the effect is usually limited.
How serious is the interaction between Ivacaftor 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: Monitor heart rate and for adverse effects of siponimod. Avoid adding a further CYP2C9 inhibitor, and consider CYP2C9 genotype.
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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