Drug General Information (ID: DDI3TZPYD2)
Drug Name			Siponimod		Drug Info		Vibrio cholerae CVD 103-HgR strain live antigen (live)		Drug Info
Drug Type		Small molecule				Vaccine
Therapeutic Class		Selective Immunosuppressants				Vaccines

Mechanism of Siponimod-Vibrio cholerae CVD 103-HgR strain live antigen (live) Interaction (Severity Level: Major)
Antagonize the effect of vaccine/toxoid Click to Show/Hide Mechanism Graph
Drug Name		Siponimod				Vibrio cholerae CVD 103-HgR strain live antigen (live)
Mechanism		Immunosuppressive effects				Vaccine or toxoid
Key Mechanism Factor 1
		Factor Name		Vaccine/toxoid
		Factor Description		The beneficial effects of the vaccine/toxinoid may be reduced, leading to a diminished or suboptimal immune response.
Mechanism Description		Antagonize the effect of Vibrio cholerae CVD 103-HgR strain live antigen (live) when combined with Siponimod

Recommended Action
Management		The use of live attenuated vaccines should be avoided during and for up to 4 weeks after siponimod treatment, and siponimod should be paused 1 week prior to and until 4 weeks after a planned vaccination. Patients without a healthcare professional confirmed history of varicella or without documentation of a full course of vaccination against varicella-zoster virus (VZV) should be tested for antibodies to VZV before initiating treatment with siponimod. For antibody-negative patients, a full course of vaccination with varicella vaccine is recommended prior to treatment with siponimod. In patients who have recently been vaccinated, siponimod therapy should be postponed for 4 weeks to allow the full effect of vaccination to occur.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Product Information. Mayzent (siponimod). Novartis Pharmaceuticals, East Hanover, NJ.