siponimod fumaric acid at a glance
Medicine class
Sphingosine-1-phosphate receptor modulator
Licensed use
Active secondary progressive multiple sclerosis in adults
Before treatment
A CYP2C9 genetic test is required because metabolism and suitability vary by genotype.
Administration
Swallow the film-coated tablets whole with water, with or without food.
What is siponimod fumaric acid used for?
The selected UK product is licensed for:
Treating adults with secondary progressive multiple sclerosis where disease activity is demonstrated by relapses or inflammatory imaging features.
How does siponimod fumaric acid work?
Siponimod binds selectively to S1P1 and S1P5 receptors. Its action at S1P1 keeps more lymphocytes within lymph nodes, reducing their movement into the brain and spinal cord and limiting inflammatory damage.
siponimod fumaric acid preparations and strengths
Tablet
Route: Oral
Strengths: 0.25 mg, 1 mg, 2 mg
How to take siponimod fumaric acid
Treatment must be initiated and supervised by an MS specialist. Follow the supplied starter pack and prescriber's instructions exactly; gradual introduction reduces early effects on heart rate.
Swallow tablets whole with water.
Tablets may be taken with or without food.
Do not alter or stop treatment without speaking to the specialist team.
Tell healthcare professionals that you take siponimod before receiving another medicine or vaccine.
siponimod fumaric acid side effects
Common or expected effects
- Headache
- Raised blood pressure
- Raised liver enzymes
- Dizziness or tremor
- Nausea or diarrhoea
- Swelling of the hands, ankles, legs or feet
- Weakness or pain in the limbs
- Shingles
- Low lymphocyte count
- Slow heartbeat or heart-conduction disturbance
- Macular oedema affecting central vision
- New moles or basal cell skin cancer
Get urgent medical advice
- Severe infection, including meningitis or encephalitis
- New or worsening neurological symptoms suggesting progressive multifocal leukoencephalopathy
- Seizure
- Central blurred vision, shadows or a blind spot suggesting macular oedema
- Fainting or symptomatic slow or irregular heartbeat
- Yellow skin or eyes, dark urine or other evidence of liver injury
- A new or changing skin lesion, or a sore that does not heal
siponimod fumaric acid in pregnancy
Siponimod is contraindicated during pregnancy because it may harm the developing baby. A negative pregnancy test is required before treatment where relevant, and effective contraception is required during treatment and for at least 10 days after stopping. Contact the specialist promptly when planning pregnancy or if pregnancy occurs; stopping also requires consideration of returning MS activity.
siponimod fumaric acid while breastfeeding
Siponimod should not be used while breastfeeding. It is unknown whether it enters human milk, and potentially serious effects on the infant cannot be excluded.
siponimod fumaric acid interactions
Check all prescribed, non-prescribed and herbal products with the specialist or pharmacist. Important interactions include:
Amiodarone, sotalol, quinidine or procainamide
Using these antiarrhythmics during treatment initiation may compound heart-rate or rhythm effects and should be avoided.
Verapamil, diltiazem, ivabradine or digoxin
These may add to siponimod's heart-rate-lowering effect, requiring specialist review or monitoring before initiation.
Beta blockers
Starting siponimod while taking a beta blocker may further slow the heart rate and requires assessment of resting pulse and treatment planning.
Common questions about siponimod fumaric acid
Answers are fully visible for fast scanning and source review.
What is siponimod fumaric acid used for?
It is licensed for adults with secondary progressive multiple sclerosis that remains active through relapses or inflammatory MRI findings.
Why is a genetic test needed before siponimod fumaric acid?
CYP2C9 genotype affects how quickly siponimod is cleared. The result determines suitability and informs prescribing; one genotype is contraindicated.
Can siponimod fumaric acid be taken with food?
Yes. The tablets can be taken with or without food and should be swallowed whole with water.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.