Drug interactions
Radium-223 dichloride + Siponimod
Severity: Moderate
Radium-223 dichloride and Siponimod: 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
Radium-223 can cause bone marrow suppression, and siponimod lowers lymphocyte counts. Combined use may increase the risk of infection, though radium-223 effects are mostly on neutrophils and platelets.
What this interaction means in plain words
Radium-223 dichloride and Siponimod 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.
Radium-223 dichloride belongs to Miscellaneous; Siponimod belongs to Central Nervous System.
Why it happens
Additive effects on blood cells from radiation-induced marrow suppression and S1P-mediated lymphocyte sequestration.
What to do
Monitor complete blood counts before each radium dose and watch for infection.
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?
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Other interactions of Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
Other interactions of Radium-223 dichloride
- Abiraterone + Radium-223 dichloride Contraindicated
- Prednisolone + Radium-223 dichloride Contraindicated
- Prednisone + Radium-223 dichloride Contraindicated
- Calcium + Radium-223 dichloride Minor
- Radium-223 dichloride + Vitamin d Minor
Frequently asked questions
Can I take Radium-223 dichloride with Siponimod?
MediHelp rates the interaction as moderate. Radium-223 dichloride and Siponimod 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. Radium-223 can cause bone marrow suppression, and siponimod lowers lymphocyte counts. Combined use may increase the risk of infection, though radium-223 effects are mostly on neutrophils and platelets.
How serious is the interaction between Radium-223 dichloride and Siponimod?
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 complete blood counts before each radium dose and watch for infection.
What other medicines interact with Siponimod?
MediHelp also lists interactions of Siponimod with, for example, Cladribine, Fingolimod, Fluconazole. The full list is on the Siponimod page.
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