Drug interactions
Siponimod + Tolbutamide
Severity: Minor
Siponimod and Tolbutamide: minor 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
Tolbutamide is a CYP2C9 substrate and not a meaningful CYP2C9 inhibitor, so no clinically important rise in siponimod exposure is expected. Competition for CYP2C9 is a theoretical concern only.
What this interaction means in plain words
Siponimod and Tolbutamide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Siponimod belongs to Central Nervous System; Tolbutamide belongs to Endocrine.
Why it happens
Possible competition for CYP2C9 metabolism, which is theoretical and not established as clinically relevant.
What to do
No routine change is needed. Monitor blood glucose as usual and consider CYP2C9 genotype for siponimod dosing.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Siponimod with Tolbutamide?
MediHelp rates the interaction as minor. Siponimod and Tolbutamide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Tolbutamide is a CYP2C9 substrate and not a meaningful CYP2C9 inhibitor, so no clinically important rise in siponimod exposure is expected. Competition for CYP2C9 is a theoretical concern only.
How serious is the interaction between Siponimod and Tolbutamide?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine change is needed. Monitor blood glucose as usual and consider CYP2C9 genotype for siponimod dosing.
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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