Fingolimod is a drug to treat the symptoms of  relapsing -remitting multiple sclerosis , such as muscle spasms, numbness, or visual disturbances.

The way fingolimod works is not known for certain, but this drug is thought to work by preventing lymphocytes from attacking nerve cells thereby reducing the frequency of relapses and relieving symptoms of recurrent multiple sclerosis . It should be noted that this drug cannot cure multiple sclerosis .

Fingolimod trademark  Gilenya

What is Fingolimod

group Prescription drug
Category Immunosuppressants
Benefit Overcoming the symptoms of recurrent multiple sclerosis
Used by Adults and children aged ≥10 years
Fingolimod for pregnant and lactating women Category D: There is positive evidence of risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation.

Fingolimod can be absorbed into breast milk. If you are breastfeeding, do not use this medication without telling your doctor.

Drug form Capsule

Warning Before Taking Fingolimod

Before taking this drug, you need to pay attention to the following things:

  • Do not take fingolimod if you are allergic to this drug. Always tell your doctor about any allergies you have.
  • Tell your doctor if in the past six months you have had angina pectoris , major heart failure, stroke, heart attack , mini stroke ( transient ischemic attack (TIA), or dangerous heart rhythm disturbances, such as AV block). Fingolimod should not be given to patients with these conditions.
  • Tell your doctor if you are taking certain antiarrhythmic drugs, such as amiodarone or quinidine . Fingolimod should not be used together with these drugs.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy. Consult with your doctor about the types  of contraceptives that are effective and suitable for preventing pregnancy while taking treatment with fingolimod.
  • Tell your doctor if you have or currently have a weakened immune system, bradycardia , hypertension, skin cancer , diabetes, sleep apnea , repeated fainting, uveitis , liver disease, kidney disease , asthma, COPD , or an infectious disease, such as tuberculosis .
  • Avoid prolonged exposure to sunlight while taking treatment with fingolimod, because this drug can cause the skin to become more sensitive to light. Always use sunscreen when doing outdoor activities.
  • Do not get vaccinated while using fingolimod or 2 months after the last dose without consulting your doctor first.
  • Tell your doctor if you have never had  chickenpox or have not received the chickenpox vaccine. You may need to receive the vaccine and wait 1 month before taking fingolimod.
  • Tell your doctor if you are taking any medications, supplements or herbal products.
  • See a doctor immediately if you have an allergic drug reaction, serious side effects, or an overdose after taking fingolimod.

Dosage and Rules for Using Fingolimod

The dose of fingolimod will be given by the doctor according to the condition and age of the patient. In general, the following is the dose of fingolimod to treat recurrent multiple sclerosis based on the patient's age:

  • Adults and children aged ≥10 years weighing ˃40 kg:  0.5 mg once daily.
  • Children aged ≥10 years weighing ≤40 kg: 0.25 mg once daily.

How to Take Fingolimod Correctly

Follow the doctor 's recommendations and read the information listed on the drug packaging before taking fingolimod. Do not reduce or increase your dose without consulting your doctor first.

Fingolimod can be taken before or after meals. Try to take fingolimod at the same time every day for maximum treatment.

Keep taking this medicine even if you feel well. Do not stop taking this medication without consulting your doctor.

If you forget to take fingolimod, it is recommended to do it immediately if the break with the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.

While undergoing treatment with fingolimod, your doctor will ask you to do blood tests , liver function tests, eye exams, or EKG regularly to monitor your body's response to the drug.

Store fingolimod in a dry place and avoid exposure to direct sunlight. Keep this medicine out of reach of children.

Fingolimod Interactions with Other Drugs

The following are drug interaction effects that can occur if fingolimod is used together with other drugs:

  • Enhanced immunosuppressive effect or suppression of the immune system when used with other antineoplastic, immunomodulatory or immunosuppressant drugs
  • Increased risk of bradycardia when used with drugs that slow the heart rate or atrioventricular conduction, such as beta-blockers or calcium antagonists
  • Increased blood concentration of fingolimod when used with  ketoconazole
  • Decreased effectiveness of the vaccine
  • Enhanced arrhythmogenic effect of   class Ia, such as quinidine, or class III antiarrhythmic drugs, such as amiodarone

Side Effects and Dangers of Fingolimod

Some of the side effects that can occur after using fingolimod are:

  • Headache
  • back pain
  • Pain in the hands or feet
  • Nausea or stomach pain
  • Diarrhea
  • Inflammation of the sinuses ( sinusitis ), cough, or flu symptoms

Check with your doctor if the side effects above don't subside immediately or get worse. Immediately see a doctor if you experience an allergic drug reaction or more serious side effects, such as:

  • Change in the size or color of the mole
  • Swollen lymph nodes ( lymphadenopathy )
  • Infectious disease, which can be characterized by fever , persistent cough, or sore throat that does not go away
  • Impaired balance or speech disorders
  • Chest pain, palpitations , fast, or irregular heartbeat
  • Blurred vision or pain in the eye
  • Impaired liver function, which may be characterized by abdominal pain, loss of appetite, persistent nausea and vomiting, or jaundice
  • Very severe headache , confusion, or seizures
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