Drug interactions
Siponimod + Sirolimus
Severity: Moderate
Siponimod and Sirolimus: 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
Both agents suppress immune function, so using them together can raise the risk of serious or opportunistic infections. The effect of siponimod on lymphocyte counts can persist for some time after it is stopped.
What this interaction means in plain words
Siponimod and Sirolimus 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.
Siponimod belongs to Central Nervous System; Sirolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression: siponimod sequesters lymphocytes in lymphoid tissue via S1P receptor modulation while sirolimus inhibits mTOR-dependent T-cell proliferation.
What to do
Monitor for signs of infection and check lymphocyte and total blood counts during combined therapy and for several weeks after either drug is stopped. Weigh the benefit of the combination against infection risk before starting.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Siponimod with Sirolimus?
MediHelp rates the interaction as moderate. Siponimod and Sirolimus 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. Both agents suppress immune function, so using them together can raise the risk of serious or opportunistic infections. The effect of siponimod on lymphocyte counts can persist for some time after it is stopped.
How serious is the interaction between Siponimod and Sirolimus?
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 for signs of infection and check lymphocyte and total blood counts during combined therapy and for several weeks after either drug is stopped. Weigh the benefit of the combination against infection risk before starting.
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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