PONVORY 9 mg
Ponesimod
What it does
Ponesimod is a medication used to manage certain health conditions, particularly those affecting the immune system.
Commonly used for: multiple sclerosis, autoimmune disorders
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Sourcing - Kenya onlyRegistration & product details
Source: South African Health Products Regulatory Authority · fetched 2026-04-15 21:28:23 · updated 2026-10-28 04:12:50
Drug Interactions
7Pharmacodynamic Warnings
Ponesimod appears in TABLE 6: Drugs that cause bradycardia
Severe (1)
Ponesimod - increases risk of generalised infection (possibly life-threatening)
Live vaccines might increase the risk of generalised infection (possibly life-threatening) when given with ponesimod. Avoid and for 1 week after stopping ponesimod.
Unknown (6)
Ponesimod - decreases exposure
Antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone) might decrease the exposure to ponesimod.
Ponesimod - decreases exposure
Mitotanemightdecreasetheexposuretoponesimod.o . Theoretical
Ponesimod - increases risk of generalised infection (possibly life-threatening)
Alemtuzumab is predicted to increase the risk of generalised infection (possibly life-threatening) when given with ponesimod.
Ponesimod - increases risk of generalised infection (possibly life-threatening)
Monoclonal antibodies (alemtuzumab) are predicted to increase the risk of generalised infection (possibly life-threatening) when given with ponesimod.
Ponesimod - decreases exposure
Rifamycins (rifampicin) might decrease the exposure to ponesimod. Theoretical Posaconazole → see antifungals, azoles Potassium aminobenzoate → see TABLE 16 p. 1521 (increased serum potassium)
Ponesimod - decreases exposure
Rifampicinmightdecreasetheexposuretoponesimod. oTheoretical
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About this medicine
Ponesimod is a medication used to manage certain health conditions, particularly those affecting the immune system.
What it treats
- multiple sclerosis
- autoimmune disorders
How it works
Ponesimod works by affecting the immune system to help reduce inflammation and other symptoms.
Who it's for
Ponesimod is for adults with specific immune system conditions, particularly multiple sclerosis.
Cautions
- • Be careful if you are taking other drugs that slow down the heart rate (bradycardia).
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Ponesimod
BNF-referencedPonesimod is a sphingosine-1-phosphate receptor modulator that is primarily used in the treatment of relapsing forms of multiple sclerosis (MS). By modulating the sphingosine-1-phosphate receptors, it prevents lymphocytes from exiting the lymph nodes, which reduces their availability in the bloodstream and subsequently lowers inflammation in the central nervous system. This mechanism contributes to the reduction of MS relapses and associated neurological damage.
Indications
- Relapsing forms of multiple sclerosis
Dosage
Adults: The initial dose of ponesimod is 2 mg once daily on days 1-2, increased to 3 mg on days 3-4, then to 4 mg on days 5-6. The dose is subsequently increased by 1 mg once daily from days 7-11, reaching 10 mg on days 12-14. The maintenance dose is 20 mg once daily from day 15 onwards. For re-initiation after treatment interruption, consult product literature.
Mechanism of action
Ponesimod acts as a selective modulator of sphingosine-1-phosphate (S1P) receptors, particularly S1P1. It prevents the egress of lymphocytes from lymphoid tissues, thereby reducing the number of circulating lymphocytes that can migrate to the central nervous system and contribute to the inflammatory processes seen in multiple sclerosis.
Pharmacodynamics
Ponesimod's pharmacodynamics involve the modulation of immune cell trafficking. By inhibiting the S1P1 receptor, ponesimod decreases the number of T and B lymphocytes in circulation, which lowers the inflammatory response within the central nervous system, ultimately leading to a reduction in MS-related symptoms and new lesion formation.
Pharmacokinetics
Ponesimod is administered orally and undergoes extensive hepatic metabolism, primarily via the cytochrome P450 system. It has a long half-life which allows for once-daily dosing after the initial titration period. The absorption may be influenced by food, and it is excreted mainly through the feces with a smaller portion eliminated in urine. Monitoring of liver function tests is recommended due to potential hepatotoxicity.
Contra-indications
- Active chronic infections
- Severe hepatic impairment
- History of cardiac arrest
- Cerebrovascular disease
- Symptomatic bradycardia
- Recurrent syncope
- Uncontrolled hypertension
- Severe sleep apnoea
- Significant QT prolongation
Adverse effects
- Bradycardia
- Atrioventricular conduction delays
- Heart block
- Progressive multifocal leukoencephalopathy (PML)
- Non-melanoma skin cancer
- Hypotension
- Lymphopenia
Interactions
- Live vaccines (increases risk of generalised infection, possibly life-threatening)
- Antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone) - possibly decreases exposure
- Mitotane - possibly decreases exposure
- Alemtuzumab (increases risk of generalised infection, possibly life-threatening)
- Monoclonal antibodies (increases risk of generalised infection, possibly life-threatening)
- Rifamycins (possibly decreases exposure)
- Rifampicin (possibly decreases exposure)
Precautions
- Monitor patients with pre-existing cardiac conditions for bradycardia for 6 hours after the first dose
- Obtain an ECG before dosing
- Monitor blood pressure regularly during treatment
- Monitor hepatic transaminases and bilirubin at specified intervals
Pregnancy
Avoid due to toxicity in animal studies.
Breast-feeding
Avoid as present in milk in animal studies.
Storage
Store at room temperature, away from moisture and heat.
Formulations
- 0.23 mg capsules
- 0.92 mg capsules
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Ponesimod
PubChem CID 11363176Molecular formula: C23H25ClN2O4S
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.