Drug interactions
Lonafarnib + Siponimod
Severity: Major
Lonafarnib 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
Lonafarnib is a strong CYP3A inhibitor and may raise siponimod concentrations. The effect is greater in patients with impaired CYP2C9 metabolism.
What this interaction means in plain words
Lonafarnib 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.
Lonafarnib belongs to Miscellaneous; Siponimod belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition decreases siponimod clearance.
What to do
Avoid the combination in patients with CYP2C9*1/*3 or *2/*3 genotypes. Otherwise monitor heart rate and for adverse effects, and consider a siponimod dose reduction.
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 Lonafarnib
- Alfuzosin + Lonafarnib Contraindicated
- Amobarbital + Lonafarnib Contraindicated
- Apalutamide + Lonafarnib Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Carbamazepine + Lonafarnib Contraindicated
- Clarithromycin + Lonafarnib Contraindicated
Frequently asked questions
Can I take Lonafarnib with Siponimod?
MediHelp rates the interaction as major. Lonafarnib 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. Lonafarnib is a strong CYP3A inhibitor and may raise siponimod concentrations. The effect is greater in patients with impaired CYP2C9 metabolism.
How serious is the interaction between Lonafarnib 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 the combination in patients with CYP2C9*1/*3 or *2/*3 genotypes. Otherwise monitor heart rate and for adverse effects, and consider a siponimod dose reduction.
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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