Drug interactions
Ponesimod + Quinidine
Severity: Major
Ponesimod and Quinidine: major interaction.
Last updated Sources: US FDA label
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 slows heart rate and can affect cardiac conduction, and quinidine prolongs the QT interval. Combined, they raise the risk of bradycardia and torsades de pointes.
What this interaction means in plain words
Ponesimod and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Additive pharmacodynamic effects: sphingosine-1-phosphate-mediated heart rate reduction with quinidine QT prolongation.
What to do
Avoid starting ponesimod in patients on quinidine unless a cardiologist advises it. If used, perform ECG monitoring at initiation.
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
Other interactions of Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine 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 Ponesimod with Quinidine?
MediHelp rates the interaction as major. Ponesimod and Quinidine 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 slows heart rate and can affect cardiac conduction, and quinidine prolongs the QT interval. Combined, they raise the risk of bradycardia and torsades de pointes.
How serious is the interaction between Ponesimod and Quinidine?
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 starting ponesimod in patients on quinidine unless a cardiologist advises it. If used, perform ECG monitoring at initiation.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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