Drug interactions
Ponesimod + Propranolol
Severity: Major
Ponesimod and Propranolol: major interaction.
Last updated Sources: UK SmPC
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
Ponesimod causes a transient heart rate reduction on initiation, and beta-blockers can add to bradycardia and atrioventricular conduction slowing. The risk is greatest during the first doses of ponesimod.
What this interaction means in plain words
Ponesimod and Propranolol 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.
Ponesimod belongs to Central Nervous System; Propranolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic effects from S1P receptor modulation and beta-adrenergic blockade.
What to do
Check resting heart rate before starting ponesimod and follow the labeled titration, considering cardiology advice if heart rate is low. Avoid starting ponesimod in patients with significant bradycardia or conduction block on a beta-blocker.
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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References
- Ponvory 2, 3, 4, 5, 6, 7, 8, 9, 10 mg film-coated tablets - SmPC sections 4.3/4.5 (names the partner; "ients taking QT prolonging medicinal products (see section 4.4). Beta-blockers The negative chronotropic effect of co‑administration of ponesimod and propranolo") — electronic medicines compendium (UK SmPC)
Other interactions of Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Albuterol + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
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 Ponesimod with Propranolol?
MediHelp rates the interaction as major. Ponesimod and Propranolol 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. Ponesimod causes a transient heart rate reduction on initiation, and beta-blockers can add to bradycardia and atrioventricular conduction slowing. The risk is greatest during the first doses of ponesimod.
How serious is the interaction between Ponesimod and Propranolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check resting heart rate before starting ponesimod and follow the labeled titration, considering cardiology advice if heart rate is low. Avoid starting ponesimod in patients with significant bradycardia or conduction block on a beta-blocker.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.
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