Drug interactions
Schisandra + Siponimod
Severity: Moderate
Schisandra 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
Schisandra may inhibit CYP3A4 and raise siponimod exposure. Labeling advises against combining siponimod with agents that inhibit both CYP2C9 and CYP3A4, and the clinical effect of schisandra is uncertain.
What this interaction means in plain words
Schisandra 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.
Why it happens
Schisandra constituents may inhibit CYP3A4, reducing siponimod metabolism, which is mainly via CYP2C9 and CYP3A4.
What to do
Avoid the herbal product in patients with reduced CYP2C9 function (e.g. CYP2C9*1/*3 or *2/*3).
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
Frequently asked questions
Can I take Schisandra with Siponimod?
MediHelp rates the interaction as moderate. Schisandra 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. Schisandra may inhibit CYP3A4 and raise siponimod exposure. Labeling advises against combining siponimod with agents that inhibit both CYP2C9 and CYP3A4, and the clinical effect of schisandra is uncertain.
How serious is the interaction between Schisandra 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: Avoid the herbal product in patients with reduced CYP2C9 function (e.g. CYP2C9*1/*3 or *2/*3).
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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