Drug General Information (ID: DDIVMOHDNI)
Drug Name			Betaxolol (ophthalmic)		Drug Info		Siponimod		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Selective Immunosuppressants
Structure

Mechanism of Betaxolol (ophthalmic)-Siponimod Interaction (Severity Level: Major)
Increased risk of atrioventricular block Click to Show/Hide Mechanism Graph
Drug Name		Betaxolol (ophthalmic)				Siponimod
Mechanism 1		Delay atrioventricular conduction				Delay atrioventricular conduction
Key Mechanism Factor 1
		Factor Name		Atrioventricular block
		Factor Description		Atrioventricular block is a type of cardiac conduction block that occurs when the electrical signal from the atria to the ventricles is impaired. In an Atrioventricular block, this electrical signal is either delayed or completely blocked. When the signal is completely blocked, the ventricles produce their own electrical signal to control the heart rate. The heart rate produced by the ventricles is much slower than that produced by the sinus node.
Mechanism Description		Increased risk of atrioventricular block by the combination of Betaxolol (ophthalmic) and Siponimod
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Betaxolol (ophthalmic)				Siponimod
Mechanism 2		Bradycardia				Bradycardia
Key Mechanism Factor 2
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Betaxolol (ophthalmic) and Siponimod

Recommended Action
Management		Siponimod has not been adequately studied in patients receiving concomitant therapy with drugs that decrease heart rate. Treatment with siponimod should generally not be initiated in patients who are concurrently treated with heart rate-lowering drugs. Advice from a cardiologist should be sought if coadministration of siponimod and drugs that slow heart rate or AV conduction is considered.

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