Drug interactions
Ponesimod + Tacrolimus
Severity: Major
Ponesimod and Tacrolimus: 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
Tacrolimus can prolong the QT interval, while ponesimod can slow heart rate and cause atrioventricular conduction effects. Together, they may raise the risk of arrhythmia. Ponesimod also adds immunosuppression.
What this interaction means in plain words
Ponesimod and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive cardiac effects (QT prolongation with bradycardia) plus additive immunosuppression.
What to do
Obtain an ECG before starting ponesimod and monitor heart rate and QTc, especially during initiation. Consider alternatives in patients with other QT risk factors, and monitor for infection.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus 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 Tacrolimus?
MediHelp rates the interaction as major. Ponesimod and Tacrolimus 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. Tacrolimus can prolong the QT interval, while ponesimod can slow heart rate and cause atrioventricular conduction effects. Together, they may raise the risk of arrhythmia. Ponesimod also adds immunosuppression.
How serious is the interaction between Ponesimod and Tacrolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG before starting ponesimod and monitor heart rate and QTc, especially during initiation. Consider alternatives in patients with other QT risk factors, and monitor for infection.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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