Siponimod

What is Siponimod

Siponimod is an oral sphingosine 1-phosphate receptor modulator indicated for the treatment of relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

Brand Name

MAYZENT

Indications & Dosage

  • multiple sclerosis

Side Effects

  • asthenia
  • AV block
  • bradycardia
  • diarrhea
  • dizziness
  • dyspnea
  • elevated hepatic enzymes
  • encephalopathy
  • fluid retention
  • headache
  • hypertension
  • infection
  • lymphopenia
  • macular edema
  • multiple sclerosis exacerbation
  • myocardial infarction
  • nausea
  • new primary malignancy
  • peripheral edema
  • progressive multifocal leukoencephalopathy
  • pulmonary embolism
  • seizures
  • sinusitis
  • stroke
  • tremor

Monitoring Parameters

  • blood pressure
  • CBC
  • ECG
  • LFTs
  • ophthalmologic exam
  • serum bilirubin
  • skin cancer screening exam

Contraindications

  • acquired immunodeficiency syndrome (AIDS)
  • alcoholism
  • angina
  • asthma
  • AV block
  • bradycardia
  • breast-feeding
  • cardiac arrest
  • cardiac arrhythmias
  • cardiac disease
  • cerebrovascular disease
  • chemotherapy
  • chronic obstructive pulmonary disease (COPD)
  • contraception requirements
  • coronary artery disease
  • corticosteroid therapy
  • diabetes mellitus
  • encephalopathy
  • females
  • fungal infection
  • geriatric
  • heart failure
  • hepatic disease
  • herpes infection
  • human immunodeficiency virus (HIV) infection
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • immunosuppression
  • infection
  • leukemia
  • long QT syndrome
  • lymphoma
  • malnutrition
  • multiple sclerosis exacerbation
  • myocardial infarction
  • pregnancy
  • progressive multifocal leukoencephalopathy
  • pulmonary disease
  • QT prolongation
  • reproductive risk
  • respiratory insufficiency
  • sick sinus syndrome
  • sleep apnea
  • stroke
  • syncope
  • thyroid disease
  • uveitis
  • vaccination
  • viral infection
  • visual disturbance

Interactions

  • Acebutolol
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Aclidinium; Formoterol
  • Albuterol
  • Albuterol; Ipratropium
  • Alemtuzumab
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Anthrax Vaccine
  • Apalutamide
  • Apomorphine
  • Aprepitant, Fosaprepitant
  • Arformoterol
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atomoxetine
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azithromycin
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bendroflumethiazide; Nadolol
  • Beta-adrenergic blockers
  • Betamethasone
  • Betaxolol
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bosentan
  • Brimonidine; Timolol
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Carbamazepine
  • Carteolol
  • Carvedilol
  • Cenobamate
  • Ceritinib
  • Chloramphenicol
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clomipramine
  • Clozapine
  • Cobicistat
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
  • Cortisone
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasatinib
  • Deflazacort
  • Degarelix
  • Delavirdine
  • Desflurane
  • Desipramine
  • Deutetrabenazine
  • Dexamethasone
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Digoxin
  • Diltiazem
  • Diphtheria Toxoid, Tetanus Toxoid, Acellular Pertussis Vaccine, DTaP; Haemophilus influenzae type b Conjugate Vaccine; Inactivated Poliovirus Vaccine, IPV
  • Diphtheria Toxoid, Tetanus Toxoid, Acellular Pertussis Vaccine, DTaP; Hepatitis B Vaccine, Recombinant; Inactivated Poliovirus Vaccine, IPV
  • Diphtheria Toxoid, Tetanus Toxoid, Acellular Pertussis Vaccine, DTaP; Inactivated Poliovirus Vaccine, IPV
  • Diphtheria Toxoid; Tetanus Toxoid Adsorbed, DT, Td
  • Diphtheria/Tetanus Toxoids; Pertussis Vaccine
  • Diphtheria/Tetanus Toxoids; Pertussis Vaccine; Haemophilus influenzae type b Conjugate Vaccine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxepin
  • Dronedarone
  • Droperidol
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Enzalutamide
  • Eribulin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Eslicarbazepine
  • Esmolol
  • Etravirine
  • Ezogabine
  • Fedratinib
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluorouracil, 5-FU
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Foscarnet
  • Fosphenytoin
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glycopyrrolate; Formoterol
  • Goserelin
  • Granisetron
  • grapefruit juice
  • Haemophilus influenzae type b Conjugate Vaccine
  • Haemophilus influenzae type b Conjugate Vaccine; Hepatitis B Vaccine, Recombinant
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Hepatitis A Vaccine, Inactivated
  • Hepatitis A Vaccine, Inactivated; Hepatitis B Vaccine, Recombinant
  • Hepatitis B Vaccine, Recombinant
  • Histrelin
  • Human Papillomavirus 9-Valent Vaccine
  • Human Papillomavirus Bivalent Vaccine
  • Human Papillomavirus Quadrivalent Vaccine
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocortisone
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Imipramine
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Indinavir
  • Influenza Virus Vaccine
  • Inotuzumab Ozogamicin
  • Intranasal Influenza Vaccine
  • Isavuconazonium
  • Isoflurane
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ivabradine
  • Ivosidenib
  • Japanese Encephalitis Virus Vaccine
  • Ketoconazole
  • Labetalol
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Letermovir
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levalbuterol
  • Levobetaxolol
  • Levobunolol
  • Levofloxacin
  • Lithium
  • Live Vaccines
  • Lofexidine
  • Long-acting beta-agonists
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lyme Disease Vaccine
  • Macimorelin
  • Maprotiline
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Mefloquine
  • Meningococcal Conjugate Vaccine (MCV4)
  • Meningococcal Group B Vaccine (3 strain)
  • Meningococcal Group B Vaccine (4 strain)
  • Meningococcal Haemophilus influenzae type b Conjugate Vaccine
  • Meningococcal Polysaccharide Vaccine (MPSV4)
  • Meperidine; Promethazine
  • Metaproterenol
  • Methadone
  • Methylprednisolone
  • Metoprolol
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Moxifloxacin
  • Nadolol
  • Nafcillin
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nilotinib
  • Non-Live Vaccines
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Olodaterol
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Penbutolol
  • Pentamidine
  • Pentobarbital
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pindolol
  • Pirbuterol
  • Pitolisant
  • Pneumococcal Vaccine, Polyvalent
  • Poliovirus Vaccine, Inactivated, IPV
  • Posaconazole
  • Prednisolone
  • Prednisone
  • Primaquine
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propranolol
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Rabies Vaccine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Romidepsin
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Salmeterol
  • Saquinavir
  • Secobarbital
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Solifenacin
  • Sorafenib
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Terbutaline
  • Tetanus Toxoid
  • Tetrabenazine
  • Thioridazine
  • Timolol
  • Tiotropium; Olodaterol
  • Tipranavir
  • Tolterodine
  • Toremifene
  • Trandolapril; Verapamil
  • Trazodone
  • Triamcinolone
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Tucatinib
  • Typhoid Vaccine
  • Umeclidinium; Vilanterol
  • Vandetanib
  • Vardenafil
  • Varicella-Zoster Virus Vaccine, Live
  • Vemurafenib
  • Venlafaxine
  • Verapamil
  • Voriconazole
  • Vorinostat
  • Yellow Fever Vaccine, Live
  • Ziprasidone
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