Drug interactions
Ponesimod + Quinine
Severity: Major
Ponesimod and Quinine: 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
Ponesimod lowers heart rate and slows AV conduction, while quinine prolongs the QT interval. Together they may increase the risk of bradycardia-related torsades de pointes.
What this interaction means in plain words
Ponesimod and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation with ponesimod-induced bradycardia.
What to do
Avoid starting ponesimod in patients on quinine unless benefit outweighs risk, and consult a cardiologist. Obtain an ECG before starting and monitor heart rate.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Ponesimod and Quinine 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 lowers heart rate and slows AV conduction, while quinine prolongs the QT interval. Together they may increase the risk of bradycardia-related torsades de pointes.
How serious is the interaction between Ponesimod and Quinine?
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 quinine unless benefit outweighs risk, and consult a cardiologist. Obtain an ECG before starting and monitor heart rate.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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