Do not take this medication with any of the following:
-Cisapride
-Dronedarone
-Fingolimod
-Pimozide
-Saquinavir
-Thioridazine
This medication may also interact with the following:
-Alemtuzumab
-Certain antivirals for HIV or hepatitis
-Certain medications for blood pressure, heart disease, irregular heart beat
-Certain medications for fungal infections, such as ketoconazole, itraconazole, posaconazole
-Certain medications for seizures, such as carbamazepine, phenobarbital, phenytoin
-Digoxin
-Live virus vaccines
-Medications that lower your chance of fighting infection
-Modafinil
-Other medications that cause heart rhythm changes
-Rifampin

They need to know if you have any of these conditions:
-Cancer
-Diabetes
-Eye disease
-Heart disease
-High blood pressure
-Immune system problems
-Infections, such as chickenpox, cold sores, herpes
-Irregular heartbeat or rhythm
-Liver disease
-Low blood counts (white cells, platelets, or red blood cells)
-Lung disease
-Recent or upcoming vaccine
-Stroke
-An unusual or allergic reaction to siponimod, other medications, foods, dyes, or preservatives
-Pregnant or trying to get pregnant
-Breast-feeding

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.
In some patients, this medication may cause a serious brain infection that may cause death. If you have any problems seeing, thinking, speaking, walking, or standing, tell your care team right away. If you cannot reach your care team, urgently seek other source of medical care.
Your vision may be tested before and during use of this medication. Tell your care team right away if you have any change in your eyesight.
You may need blood work done while taking this medication.
This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.
Talk to your care team if you have not had chickenpox or the vaccine for chickenpox.
This medication can decrease the response to a vaccine. If you need to get vaccinated, tell your care team if you have received this medication within the last 4 weeks. Extra booster doses may be needed. Talk to your care team to see if a different vaccination schedule is needed.
If you stop taking this medication, your MS symptoms may get worse. You may have more weakness, trouble using your arms or legs, or changes in balance. Talk to your care team right away if your symptoms get worse.
Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects if taken during pregnancy and for 10 days after stopping therapy. A reliable form of contraception is recommended while taking this medication and for 10 days after stopping therapy. Talk to your care team about effective forms of contraception.
This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps or tanning beds/booths.
Talk to your care team about your risk of skin cancer. You may be more at risk for skin cancer if you take this medication.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) for up to 3 months. If you need to store it longer than 3 months, store in the refrigerator unopened until you are ready to use. Do not refrigerate after opening. Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer wanted or have expired:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.