Drug General Information (ID: DDIEL9QJRW)
Drug Name			Arsenic trioxide		Drug Info		Siponimod		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Selective Immunosuppressants
Structure

Mechanism of Arsenic trioxide-Siponimod Interaction (Severity Level: Major)
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Arsenic trioxide				Siponimod
Mechanism		Prolong QT interval				Bradycardia
Key Mechanism Factor 1
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Siponimod

Recommended Action
Management		Siponimod has not been studied in patients receiving drugs that can prolong the QT interval. Because bradycardia and AV block are recognized risk factors for QT prolongation and torsade de pointes arrhythmia, treatment with siponimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

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