Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Mayzent
Synonyms :
siponimod
Class :
Neurologics, Sphingosine 1-Phosphate Receptor Modulators
Brand Name :
Mayzent
Synonyms :
siponimod
Class :
Neurologics, Sphingosine 1-Phosphate Receptor Modulators
Dosage Forms & StrengthsÂ
tabletÂ
2mgÂ
0.25mgÂ
CYP2C9 genotypes Patients *1/*1, *1/*2, and *2/*2
Begin with a five-day titration
On day 6 Maintenance dose: 2 mg orally daily
Use a starter pack in patients titrated with a 2mg maintenance dose
Do not use the starting pack for patients titrated with a 1mg maintenance dose
Titration for the daily maintenance dosage of 2mg
Day 1: (1 x 0.25 mg) 0.25 mg orally
Day 2: (1 x 0.25 mg) 0.25 mg orally
Day 3: (2 x 0.25 mg) 0.50 mg orally
Day 4: (3 x 0.25 mg) 0.75 mg orally
Day 5: (5 x 0.25 mg) 1.25 mg orally
Day 6 and following days: (1 x 2 mg) 2 mg orally daily
CYP2C9 genotypes Patients *1/*3 and *2/*3
Begin with a four-day titration
On day 5 Maintenance dose: 1 mg orally daily
Do not use the starting pack for patients titrated with a 1mg maintenance dose
Titration for the daily maintenance dosage of 1mg
Day 1: (1 x 0.25 mg) 0.25 mg orally
Day 2: (1 x 0.25 mg) 0.25 mg orally
Day 3: (2 x 0.25 mg) 0.50 mg orally
Day 4: (3 x 0.25 mg) 0.75 mg orally
Day 5 and following days: (4 x 0.25 mg) 1 mg orally daily
Restarting therapy after an interruption
If maintenance therapy is discontinued for four or more consecutive daily doses following completing the initial titration, restart treatment on Day 1 of the titration regimen
Dose Adjustments
Dosage Modifications
Hepatic impairment
Dose adjustment is not required
Renal impairment
Dose adjustment is not required
ESRD or hemodialysis patients: Not studied
Safety and efficacy not establishedÂ
Refer to the adult dosing regimenÂ
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may reduce the therapeutic effect of vaccines
poliovirus vaccine, live, trivalent
may reduce the therapeutic effect of vaccines
poliovirus vaccine inactivated
may reduce the therapeutic effect of vaccines
measles, mumps, rubella, and varicella vaccine, live (Rx)
may reduce the therapeutic effect of vaccines
measles mumps and rubella vaccine, live
may reduce the therapeutic effect of vaccines
may reduce the therapeutic effect of vaccines
smallpox (vaccinia) vaccine, live
may reduce the therapeutic effect of vaccines
may reduce the therapeutic effect of vaccines
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may have an increased bradycardic effect when combined with siponimod
may decrease the therapeutic effect when combined with COVID-19 vaccine
respiratory syncytial virus vaccine, adjuvanted
may have a decreased therapeutic effect of influenza virus vaccines
respiratory syncytial virus (RSV) vaccine
may have a decreased therapeutic effect of influenza virus vaccines
siponimod: they may increase the bradycardic effect of Bradycardia-Causing Agents
siponimod: they may increase the bradycardic effect of Bradykinin receptor antagonists
siponimod: they may decrease the therapeutic effect of vaccines
measles, mumps, rubella, and varicella vaccine, live 
siponimod: they may decrease the therapeutic effect of vaccines
measles mumps and rubella vaccine, live
siponimod: they may decrease the therapeutic effect of vaccines
siponimod: they may decrease the therapeutic effect of vaccines
smallpox (vaccinia) vaccine, live
siponimod: they may decrease the therapeutic effect of vaccines
may diminish the therapeutic effect of drug
immunosuppressants may diminish the therapeutic effect of vaccines
vaccinia immune globulin intravenous (Rx)
immunosuppressants may diminish the therapeutic effect of vaccines
immunosuppressants may diminish the therapeutic effect of vaccines
immunosuppressants may diminish the therapeutic effect of vaccines
immunosuppressants may diminish the therapeutic effect of vaccines
may increase the bradycardia effect
may increase the bradycardic effect of bradycardiac agents
may increase the bradycardic effect of bradycardia causing agents
may enhance the serum concentrations of calcimimetic agents
may decrease the diagnostic effect when combined with coccidioides immitis skin test
may have an increased immunosuppressive effect when combined with denosumab
measles, mumps, rubella, and varicella vaccine, live (Rx)
may decrease the therapeutic effect of immunosuppressants
measles mumps and rubella vaccine, live
may decrease the therapeutic effect of immunosuppressants
may decrease the therapeutic effect of immunosuppressants
smallpox (vaccinia) vaccine, live
may decrease the therapeutic effect of immunosuppressants
may decrease the therapeutic effect of immunosuppressants
may enhance the bradycardic effect of bradycardia causing agents
may increase the bradycardic effect of bradycardia causing agents
may have an increased immunosuppressive effect when combined with leflunomide
may decrease the therapeutic effect when combined with sipuleucel-t
may decrease the therapeutic effect when combined with covid-19 vaccine
may decrease the therapeutic effect when combined with influenza virus vaccines
influenza virus vaccine, h5n1, liveÂ
may decrease the therapeutic effect when combined with influenza virus vaccines
influenza virus vaccine (h5n1), adjuvantedÂ
may decrease the therapeutic effect when combined with influenza virus vaccines
siponimod has immunosuppressive properties that lessen the effects of the influenza A (H5N1) vaccination
poliovirus vaccine inactivatedÂ
siponimod reduces the immunosuppressive effects of the poliovirus vaccine inactivated
may have an increasingly adverse effect when combined with poliovirus vaccine (live/trivalent/oral)
measles, mumps, rubella, and varicella vaccine, live 
may have an increasingly adverse effect when combined with poliovirus vaccine (live/trivalent/oral)
when both drugs are combined, there may be an increased risk or severity of adverse effects   
when both drugs are combined, there may be an increased risk or severity of adverse effects  
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 or severity of adverse effects  
the effect of siponimod is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
the effect of erdafitinib is increased by fluorouracil by the action on CYP2C9/10 hepatic enzyme metabolism
when both drugs are combined, there may be a decreased effect of siponimod by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
enzalutamide may reduce the therapeutic efficacy of siponimod 
may increase the QTc interval when combined
may enhance the adverse/toxic effect
poliovirus vaccine, live, trivalent
may enhance the adverse/toxic effect
poliovirus vaccine inactivated
may enhance the adverse/toxic effect
may have an increasingly adverse effect when combined with talimogene laherparepvec
the immunosuppressive effect of immunosuppressants (cytotoxic chemotherapy) may be enhanced by abrocitinib
may have an increased immunosuppressive effect when combined with baricitinib
may have an increasingly adverse effect when combined with BCG products
cladribine: they may increase the immunosuppressive effect of selective immunosuppressants
filgrastim: they may increase the immunosuppressive effect of selective immunosuppressants
nadofaragene firadenovec: they may increase the immunosuppressive effect of selective immunosuppressants
natalizumab: they may increase the immunosuppressive effect of selective immunosuppressants
ritlecitinib: they may increase the immunosuppressive effect of selective immunosuppressants
tacrolimus: they may increase the immunosuppressive effect of selective immunosuppressants
upadacitinib: they may increase the immunosuppressive effect of selective immunosuppressants
respiratory syncytial virus vaccine, adjuvanted
may have an increased adverse/toxic effect when combined with immunosuppressants
respiratory syncytial virus (RSV) vaccine
may have an increased adverse/toxic effect when combined with immunosuppressants
respiratory syncytial virus vaccine, adjuvanted
may diminish the pharmacodynamic antagonistic effect of each other when combined
respiratory syncytial virus (RSV) vaccine
may diminish the pharmacodynamic antagonistic effect of each other when combined
respiratory syncytial virus vaccine, adjuvanted
may diminish the therapeutic effect of vaccines
respiratory syncytial virus (RSV) vaccine
may diminish the therapeutic effect of vaccines
Both siponimod and clofarabine enhance 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
By immunosuppressive effects, the toxicity of the other drug increases and results in risk of infection.
when siponimod and melphalan combine the immunosuppressive effects of both the drugs are enhanced and lead to increased risk of infection
when both the drugs are combined, the immunosuppressive effects of both the drugs increases and lead to an increased risk of infection    
additive immunosuppressive effects may raise the risk of severe infections
when both drugs are combined, there may be an increased immunosuppressive effect of both drugs and a risk of infection  
increases immunosuppressive effects and increases the risk of serious infection
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
may increase excessive immunosuppressive effects
when used in combination, both the drugs increase immunosuppression/risk of infection
may increase excessive immunosuppressive effects
may increase excessive immunosuppressive effects
siponimod increases the effect of immunosuppression when used simultaneously with ixazomib
may increase the risk of excessive bone marrow suppression
when both drugs are combined, there may be an increased risk or severity of infection  
when both drugs are combined, there may be an increased risk of infection 
neratinib and siponimod, when used simultaneously, increase the effect of immunosuppression
increases immunosuppressive effects and increases the risk of serious infection
May enhances the effects of the other by pharmacodynamic synergism
may enhance the immunosuppressive effects of each other
may increase the risk or severity of hypertension when combined
may decrease the therapeutic effect when combined with pneumococcal vaccines
may decrease the therapeutic effect when combined with pidotimod
may decrease the therapeutic effect when combined with brincidofovir
antithymocyte globulin equineÂ
may increase the immunosuppressive effect of 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
inebilizumab: they may increase the immunosuppressive effect of selective immunosuppressants
ocrelizumab: they may increase the immunosuppressive effect of selective immunosuppressants
ofatumumab: they may increase the immunosuppressive effect of selective immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
Actions and spectrum:Â
Â
Frequency definedÂ
1-10%Â
Nausea (7%)Â
Diarrhea (6%)Â
Pain in extremities (6%)Â
Seizures (1.7%)Â
Peripheral edema (8%)Â
Dizziness (7%)Â
Bradycardia (6%)Â
Vascular events (3%)Â Â
>10%Â
Hypertension (13%)Â
Falls (11%)
Headache (15%)Â
increased Transaminase (11%)Â Â
Frequency not definedÂ
Dose-dependent reductions of forced expiratory volume about 1 sec (FEV1)Â
Malignancies (squamous cell carcinoma, seminoma, basal cell carcinoma, malignant melanoma)Â
Black Box Warning:Â
siponimod carries a black box warning regarding its risk of fetal toxicity, including congenital malformations, if siponimod is used during pregnancy. Therefore, it is essential for women of childbearing potential to use effective contraception while taking siponimod and for a period of time after discontinuing the medication.Â
Contraindication/Caution:Â
Contraindication:Â
Caution:Â
Comorbidities:Â
Pregnancy consideration: US FDA pregnancy category: Not assignedÂ
Lactation: Excreted into human milk: Unknown Â
Pregnancy category:Â
Pharmacology:Â
Pharmacodynamics:Â
Pharmacokinetics:Â
AbsorptionÂ
siponimod is orally administered and is well-absorbed after oral ingestion. Its absorption is relatively slow, with peak plasma concentrations achieved within approximately 4-6 hours after administration. Food intake does not significantly affect the overall bioavailability of siponimod.Â
DistributionÂ
siponimod has a moderate volume of distribution, indicating that it distributes widely throughout the body. It extensively binds to plasma proteins, primarily to albumin, which can influence its distribution and potential interactions with other drugs.Â
MetabolismÂ
siponimod undergoes extensive metabolism in the liver, primarily via the cytochrome P450 enzyme system, specifically CYP2C9 and CYP3A4. The main active metabolite of siponimod is known as the M1 metabolite. Both siponimod and its metabolites exhibit pharmacological activity.Â
Elimination and excretionÂ
siponimod and its metabolites are eliminated through hepatic metabolism, with a small portion excreted in the feces. The elimination half-life of siponimod is 30-40 hours, indicating a long duration of action.Â
Administration:Â
siponimod is an oral medication that is typically administered once daily. It is available in the form of tablets, and the recommended dose is usually determined by the prescribing healthcare professional based on the specific medical condition being treated. The tablets should be taken whole with water, and they can be taken with or without food.Â
siponimod is commonly used to treat relapsing forms of multiple sclerosis (MS) in adults. Before starting siponimod therapy, patients may need to undergo certain medical evaluations and tests to ensure that the medication is appropriate for them and to monitor for any potential side effects.Â
Patient information leafletÂ
Generic Name: siponimodÂ
Pronounced: (sih-POH-ni-mod)Â Â
Why do we use siponimod?Â
siponimod is primarily used for the treatment of multiple sclerosis in adults. It is prescribed to help reduce the frequency of relapses & slow down the progression of disability associated with MS. siponimod works by modulating the immune system and preventing certain immune cells from entering the CNS, where they can cause inflammation and damage to nerve cells.
By controlling the immune response, siponimod aims to minimize the impact of MS on the body and improve overall quality of life for affected individuals. It is essential for patients to discuss the potential benefits and risks of siponimod with their healthcare provider before starting treatment.Â
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