Drug interactions
Ponesimod + Remifentanil
Severity: Moderate
Ponesimod and Remifentanil: 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
Ponesimod lowers heart rate on treatment initiation, and remifentanil can cause bradycardia through vagal stimulation. Together they may produce additive bradycardia and conduction effects.
What this interaction means in plain words
Ponesimod and Remifentanil 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.
Ponesimod belongs to Central Nervous System; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive negative chronotropic effects from S1P receptor modulation and opioid-induced vagotonic bradycardia.
What to do
Monitor heart rate and ECG during remifentanil use in patients on ponesimod, especially when it has recently been started or the dose raised. Have anticholinergic treatment available for symptomatic bradycardia.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ponesimod and Remifentanil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil 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 Remifentanil?
MediHelp rates the interaction as moderate. Ponesimod and Remifentanil 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. Ponesimod lowers heart rate on treatment initiation, and remifentanil can cause bradycardia through vagal stimulation. Together they may produce additive bradycardia and conduction effects.
How serious is the interaction between Ponesimod and Remifentanil?
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 heart rate and ECG during remifentanil use in patients on ponesimod, especially when it has recently been started or the dose raised. Have anticholinergic treatment available for symptomatic bradycardia.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
