Drug & supplement interaction

Ipriflavone + Siponimod

Siponimod brand name: Mayzent.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Siponimod falls into 2 drug categories that Ipriflavone can interact with; the most serious is rated moderate. Ipriflavone is thought to competitively inhibit cytochrome P450 2C9 (CYP2C9).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ipriflavone and Siponimod

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Ipriflavone interacts with whole categories of medication. Siponimod falls into 2 of those categories, so it can interact with Ipriflavone in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Siponimod

Siponimod falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Ipriflavone interacts with.

Ipriflavone is thought to competitively inhibit cytochrome P450 2C9 (CYP2C9). Theoretically, concurrent use of ipriflavone and drugs metabolized by these enzymes might result in decreased drug elimination, increased serum levels, and potential toxicity. Some drugs metabolized by CYP2C9 include amitriptyline (Elavil), diazepam (Valium), estradiol (Estrace), tacrine (Cognex), verapamil (Calan), warfarin (Coumadin), zileuton (Zyflo), and others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Mayzent (siponimod): your liver leans heavily on an enzyme called CYP2C9 to clear this drug. Ipriflavone is thought to slow that same enzyme down. If it does, siponimod could clear more slowly and build up to higher levels than expected, which may add to its effects and side effects.

With more siponimod hanging around, you might notice a slower heart rate, headaches, swelling, higher blood pressure, or a bigger dip in your immune cells (raising infection risk). I'll be honest, though: this concern comes only from lab studies, not real patients, so it's theoretical. Since your siponimod dose is matched to your genetics, even small shifts matter. Please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Monostory K, Vereczkey L, Levai F, et al. Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 1998;123:605-10. PubMed
Moderate

IMMUNOSUPPRESSANTS

2 of 2

Siponimod also falls under IMMUNOSUPPRESSANTS.

Concurrent use of ipriflavone and immunosuppressant drugs might have additive effects on inhibiting immune function. Some patients taking ipriflavone experience subclinical lymphocytopenia; avoid concurrent use. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
Severity Moderate Likelihood Possible Evidence A

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about Siponimod (Mayzent): it works by quieting down certain immune cells to protect your nerves in MS. One known effect is that it lowers your white blood cell count, which is part of how it does its job, but it also leaves you more open to infections.

Ipriflavone can independently nudge white blood cell counts down too (some folks taking it develop a quiet, symptomless drop in lymphocytes). Stack the two together and those effects can add up, leaving your immune defenses lower than intended. This isn't about one drug breaking down the other, it's two things pushing in the same direction. Because of that overlap, I'd hold off on combining them and check with your neurologist or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: A randomized controlled trial. JAMA 2001;285:1482-8.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ipriflavone Also Interacts With Other Medications

Ipriflavone has 390 moderate known drug interactions in our database — the Siponimod one above is among them. If you take anything else, check it against the full list below.

Moderate 390 No known interaction 2,440 (incl. Siponimod)
Taking anything else?

Check Another of Your Medications Against Ipriflavone

Covers the 2,830 medications we’ve checked against Ipriflavone. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Siponimod

This page covers Ipriflavone only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Siponimod page lists 190 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 147 moderate · 40 minor.

From our pharmacist’s overview on the Siponimod page

“Siponimod (Mayzent) treats secondary progressive multiple sclerosis, and because its blood level depends heavily on two liver enzymes, this is a supplement list to respect. Most of these entries can nudge siponimod levels up or down; the three rated major are grapefruit, which raises them, St.”

Reviewed by 2 · Jul 18, 2026

Open the Siponimod interaction page

One more smart check

Taking Ipriflavone as Part of a Dietary Supplement Product? Check It for Interactions

We hold 204 real supplement products containing Ipriflavone, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ipriflavone. Your product may carry other ingredients that interact with Siponimod too, on top of Ipriflavone — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ipriflavone and Siponimod Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ipriflavone
Top half

#528 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Siponimod
Steady interest

#2,383 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ipriflavone

What is Ipriflavone?

Ipriflavone
  • Bone density and osteoporosis
  • Postmenopausal bone loss
  • Athletic performance
  • Tinnitus related to bone disorders

Ipriflavone is a synthetic isoflavone studied mainly for bone health and osteoporosis, but high-quality research has not shown that it reliably prevents fractures or builds strong bone. Because it can lower white blood cell counts in some people and its long-term safety is not well established, talk with your pharmacist or doctor before using it.

Read the full Ipriflavone monograph & all interactions
Medication

About Siponimod

What Is Siponimod Used For?

Brand name: Mayzent

Mayzent (siponimod) is approved for adults with relapsing forms of multiple sclerosis (MS). This includes three specific types: clinically isolated syndrome (a first episode of MS-like symptoms), relapsing-remitting MS (periods of attacks followed by recovery), and active secondary progressive MS (a phase where the disease gradually worsens but still has active relapses).

It is taken by mouth once daily and is intended as a long-term treatment to reduce relapses and slow disease progression.

See full Siponimod drug information
Keep checking

Other Drugs & Ipriflavone

Browse every other medication we’ve checked against Ipriflavone — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
390Moderate
0Minor
2,439No known interaction
390 Moderate 2,439 No interaction
Moderate

390 interactions

Showing 60 of 390 moderate interactions — see all 390 on the Ipriflavone page.

No interaction 2,439 drugs checked — show the list

We also checked Ipriflavone against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,439 medications checked with no known interaction — see the full Ipriflavone list.

See the full Ipriflavone interactions page
See every supplement checked against Siponimod, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Ipriflavone monograph › Uses, safety, and every drug interaction in one place Siponimod supplement interactions › Every supplement checked against Siponimod, ranked by severity Siponimod drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ipriflavone and Siponimod Together: Common Questions

Can you take Ipriflavone with Siponimod?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Ipriflavone and Siponimod?
Siponimod belongs to more than one drug category, and Ipriflavone interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Ipriflavone and Siponimod interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Siponimod and Ipriflavone?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.