Drug interactions
Siponimod + Tacrolimus
Severity: Major
Siponimod 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 and siponimod slows heart rate and suppresses lymphocytes. The combination may increase arrhythmia risk and add to immunosuppression and infection risk.
What this interaction means in plain words
Siponimod 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.
Siponimod belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation with siponimod bradycardia, plus additive immunosuppression.
What to do
Avoid if an alternative exists. If both are required, obtain a baseline ECG, correct electrolytes, monitor ECG and tacrolimus levels, and watch 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 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 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
Frequently asked questions
Can I take Siponimod with Tacrolimus?
MediHelp rates the interaction as major. Siponimod 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 and siponimod slows heart rate and suppresses lymphocytes. The combination may increase arrhythmia risk and add to immunosuppression and infection risk.
How serious is the interaction between Siponimod 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: Avoid if an alternative exists. If both are required, obtain a baseline ECG, correct electrolytes, monitor ECG and tacrolimus levels, 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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