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Brand Name :
Ponvory
Synonyms :
ponesimod
Class :
Immunomodulatory agents
Brand Name :
Ponvory
Synonyms :
ponesimod
Class :
Immunomodulatory agents
Dosage forms and strengths Â
Oral tablet Â
20 mgÂ
Indicated for relapsing multiple sclerosis
Take 2 mg one time daily by oral route on the first day & second day
Take 3 mg one time daily by oral route on the third day & fourth day
Take 4 mg one time daily by oral route on the fifth day & sixth day
Take 5 mg one time daily by oral route on the seventh day
Take 6 mg one time daily by oral route on the eighth day
Take 7 mg one time daily by oral route on the ninth day
Take 8 mg one time daily by oral route on the tenth day
Take 9 mg one time daily by oral route on the eleventh day
Take 10 mg one time daily by oral route on the twelfth, thirteenth & fourteenth day
Maintenance Dose
Take 20 mg one time daily by oral route on the fifteenth day
Not indicatedÂ
Refer adult dosingÂ
bradycardia-Causing Agents may enhance the bradycardic effect of ponesimod
bradycardia-Causing Agents may enhance the bradycardic effect of ponesimod
bradycardia-Causing Agents may enhance the bradycardic effect of ponesimod
bradycardia-Causing Agents may enhance the bradycardic effect of ponesimod
bradycardia-Causing Agents may enhance the bradycardic effect of ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with ponesimod
may increase the bradycardia effect
may increase the bradycardic effect of bradycardia, causing agents
may enhance the bradycardic effect of bradycardia, causing agents
may increase the bradycardic effect of bradycardia, causing agents
It may enhance effects when combined with inamrinone by pharmacodynamic synergism
dengue vaccine efficacy will be reduced by ponesimod
when both drugs are combined, there may be a decreased metabolism of etoposide   
when both drugs are combined, there may be a reduced metabolism of vincristine  
when both drugs are combined, the metabolism of paclitaxel decreases when compared with ponesimod  
when both the drugs are combined, the risk or severity of adverse effects increases    
when both drugs are combined, there may be an increased risk of developing an infection from the vaccine   
QTc interval of one another increases on taking ponesimod and lenvatinib together. Avoid or take an alternate drug
When both drugs are combined, there may be an increased risk of severe and potentially life-threatening infections  
may enhance the effects of the other by pharmacodynamic synergism
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
It may enhance the effects when combined with triamcinolone by immunosuppressive effects
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
additive immunosuppressive effects may raise the risk of severe infections
when both drugs are combined, there may be an increased risk of infection 
may increase the immunosuppressive effects of each other
may enhance the immunosuppressive effects of each other
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
When ponesimod is used together with acebutolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with acrivastine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with adagrasib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with adenosine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with acebutolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with ajmaline, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with alfentanil, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with alfuzosin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with alimemazine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amifampridine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amiodarone, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amisulpride, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amitriptyline, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amlodipine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amodiaquine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with amoxapine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with anagrelide, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with apomorphine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with arformoterol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with aripiprazole, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with arsenic trioxide, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with artemether, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with asenapine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with astemizole, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with atazanavir, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with atenolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with atomoxetine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with azatadine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with azithromycin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bedaquiline, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with benzatropine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bepridil, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with beractant, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with betaxolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bilastine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bisoprolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bortezomib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with bretylium, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with brompheniramine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with buclizine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with buserelin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with butriptyline, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with carbinoxamine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with carvedilol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with celiprolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with ceritinib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cetirizine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with chlorcyclizine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with chloroquine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with chlorpheniramine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with chlorpromazine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with acebutolol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cilostazol, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cinnarizine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cinoxacin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with ciprofloxacin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cisapride, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with citalopram, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clarithromycin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clemastine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clevidipine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clofazimine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clomipramine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clonidine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with clozapine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cocaine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with crizotinib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cyclandelate, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cyclizine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with cyproheptadine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with dabrafenib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with dasatinib, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with degarelix, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with delafloxacin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with delamanid, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with desflurane, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with desipramine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with deutetrabenazine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with dexbrompheniramine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with dexmedetomidine, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with digitoxin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with digoxin, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with diltiazem, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with dimenhydrinate, this leads to enhanced risk or seriousness of bradycardia
When ponesimod is used together with diphenhydramine, this leads to enhanced risk or seriousness of bradycardia
human papillomavirus vaccine, nonavalentÂ
may diminish the effect of each other when combined
Actions and Spectrum:Â
Action:Â
Sphingosine-1-Phosphate Receptor Modulation: ponesimod primarily acts by selectively binding to and modulating the S1P1 receptor. This action results in the internalization of the receptor and the inhibition of lymphocyte egress from lymphoid tissues into the bloodstream.Â
Immunomodulation: ponesimod’s action on S1P1 receptors helps reduce the infiltration of activated immune cells into target tissues, limiting inflammation and tissue damage associated with autoimmune diseases.Â
Spectrum:Â
Multiple Sclerosis: For the treatment of relapsing types of multiple sclerosis, ponesimod is approved, including relapsing remitting MS. By regulating immune cell migration, it helps reduce the frequency and severity of relapses and slows the progression of the disease.Â
Frequency not defined  Â
Abdominal painÂ
loss of appetiteÂ
vomitingÂ
NauseaÂ
Slow heartbeatÂ
Pain in hands or feetÂ
DizzinessÂ
Black Box Warning:Â Â
None
Contraindication/Caution:Â Â
Hypersensitivity: ponesimod should not be used in individuals with a known hypersensitivity or allergy to ponesimod or any of its components.Â
Immunodeficiency: Individuals with known immunodeficiency conditions, such as HIV/AIDS or congenital immunodeficiency disorders, should not use ponesimod due to its immunosuppressive effects.Â
Active Hepatic Disease: ponesimod can affect liver function. It is contraindicated in individuals with active liver disease, significant liver enzyme elevations, or known liver impairment.Â
Severe Cardiovascular Disease: ponesimod may cause a decrease in heart rate, so it should be used with caution or avoided in individuals with a history of certain cardiovascular conditions, such as recent heart attack, unstable angina, or heart block.Â
Pregnancy and Breastfeeding: ponesimod may have adverse effects on the developing fetus, and its use during pregnancy should be avoided. It is also not recommended during breastfeeding.Â
Pregnancy warnings:    Â
Pregnancy category: N/AÂ
Lactation: Excreted into human milk is unknownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology: ponesimod belongs to a class of drugs known as selective sphingosine-1-phosphate receptor 1 (S1P1) modulators.Â
Pharmacodynamics:Â Â
Immune Cell Sequestration: ponesimod binds to the S1P1 receptors on the surface of lymphocytes, particularly T cells. This binding prevents these immune cells from egressing from lymph nodes into the bloodstream. As a result, fewer autoreactive T cells are available to enter the central nervous system (CNS) in the case of MS, where they can cause inflammation and tissue damage. Â
Pharmacokinetics:Â
AbsorptionÂ
ponesimod is administered orally as a tablet.Â
It is well absorbed after oral administration, with a high bioavailability.Â
DistributionÂ
ponesimod is extensively distributed throughout the body.Â
It binds to plasma proteins, primarily albumin.Â
MetabolismÂ
ponesimod is extensively metabolized in the liver.Â
The main enzyme responsible for its metabolism is CYP2C9.Â
Excretion and EliminationÂ
The metabolites of ponesimod are primarily eliminated through the feces (biliary excretion).Â
A smaller portion is excreted in the urine.Â
Administration: Â
ponesimod is available in the form of oral tablets, which should be swallowed whole with water. It is essential to take ponesimod as prescribed by your healthcare provider.Â
Patient information leafletÂ
Generic Name: ponesimodÂ
Why do we use ponesimod? Â
ponesimod is usually employed in managing relapsing forms of multiple sclerosis. Its mechanism of action involves the modulation of the immune system to decrease the occurrence and intensity of relapses while also retarding the advancement of the condition.Â
ponesimod can help manage the symptoms associated with relapsing multiple sclerosis, including fatigue, muscle weakness, coordination problems, and other neurological symptoms.Â
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