Drug interactions
Methotrexate + Siponimod
Severity: Moderate
Methotrexate 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
Siponimod reduces circulating lymphocytes and methotrexate is immunosuppressive, so combined use may raise infection risk. The effect may persist for some weeks after stopping siponimod.
What this interaction means in plain words
Methotrexate 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.
Methotrexate belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression from lymphocyte sequestration and antimetabolite activity.
What to do
Monitor for infection and check blood counts. Consider the prolonged immune effects of each drug when switching therapies.
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 Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate 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 Methotrexate with Siponimod?
MediHelp rates the interaction as moderate. Methotrexate 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. Siponimod reduces circulating lymphocytes and methotrexate is immunosuppressive, so combined use may raise infection risk. The effect may persist for some weeks after stopping siponimod.
How serious is the interaction between Methotrexate 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 for infection and check blood counts. Consider the prolonged immune effects of each drug when switching therapies.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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