Drug interactions
Leflunomide + Ponesimod
Severity: Major
Leflunomide and Ponesimod: 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
Both agents impair immune function, and teriflunomide persists for a long time after leflunomide is stopped. Together they may increase the risk of serious infection.
What this interaction means in plain words
Leflunomide and Ponesimod 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.
Leflunomide belongs to Musculoskeletal; Ponesimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression: ponesimod sequesters lymphocytes in lymphoid tissue while leflunomide inhibits lymphocyte proliferation.
What to do
Avoid coadministration where possible. If switching, consider leflunomide's long half-life or an accelerated elimination procedure, and monitor for infection and lymphocyte counts.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Other interactions of Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Leflunomide with Ponesimod?
MediHelp rates the interaction as major. Leflunomide and Ponesimod 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. Both agents impair immune function, and teriflunomide persists for a long time after leflunomide is stopped. Together they may increase the risk of serious infection.
How serious is the interaction between Leflunomide and Ponesimod?
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 coadministration where possible. If switching, consider leflunomide's long half-life or an accelerated elimination procedure, and monitor for infection and lymphocyte counts.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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