Generic Name: fingolimod (fin-GOL-i-mod)
Brand Name: Gilenya
Fingolimod is used for:
Reducing the number of relapses and delaying disability in certain patients with multiple sclerosis (MS).
Fingolimod is a sphingosine 1-phosphate receptor modulator. Exactly how it works is not known, but it is thought to work by decreasing the number of certain white blood cells (lymphocytes) that enter the central nervous system (CNS).
Do NOT use fingolimod if:
- you are allergic to any ingredient in fingolimod
- you have an active infection, including a long-term infection
- you have had a heart attack, unstable angina, stroke, transient ischemic attack (TIA) ("mini-stroke"), or certain types of heart failure in the last 6 months
- you have a history of certain types of irregular heartbeat (eg, heart block, sick sinus syndrome) and you do not have a pacemaker
- you have a certain type of irregular heartbeat (prolonged QT interval, congenital QT prolongation)
- you are taking certain antiarrhythmics (eg, amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, sotalol)
Contact your doctor or health care provider right away if any of these apply to you.
Before using fingolimod:
Some medical conditions may interact with fingolimod. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are able to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have or have had a history of a slow heart rate, high or low blood pressure, low blood potassium or magnesium levels, or heart problems (eg, irregular heartbeat, heart block, heart failure)
- if you have a history of heart attack, angina, slow heartbeat, stroke, TIA, or brain blood vessel problems (eg, in the heart or brain)
- if you have a history of an infection that keeps coming back, fainting, eye problems (eg, an inflammation called uveitis, macular edema), lung or breathing problems (eg, sleep apnea), liver or kidney problems, high cholesterol or triglyceride levels, or diabetes
- if you have a weakened immune system or a fever, an infection, or you have not had chickenpox or the chickenpox vaccination
- if you have had a vaccine within 1 month before you start fingolimod or if you are scheduled to have a vaccine
- if you have recently received or will be receiving chemotherapy or radiation treatments, or you are taking corticosteroids (eg, prednisone)
- if you have taken another medicine for MS (eg, natalizumab) within the past 2 to 3 months
- if you are taking any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
Some MEDICINES MAY INTERACT with fingolimod. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Antiarrhythmics (eg, amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, sotalol), beta-blockers (eg, atenolol, metoprolol), beta-2 receptor agonists (eg, salmeterol), calcium channel blockers (eg, diltiazem, verapamil), chloroquine, chlorpromazine, cholinesterase inhibitors (eg, galantamine), citalopram, digoxin, domperidone, fluoxetine, haloperidol, macrolide antibiotics (eg, erythromycin), methadone, ondansetron, pilocarpine, quinine, quinolone antibiotics (eg, ciprofloxacin), tacrolimus, tetracyclic antidepressants (eg, maprotiline), tricyclic antidepressants (eg, amitriptyline), tyrosine kinase inhibitors (eg, sunitinib), or vorinostat because the risk of slow or irregular heartbeat may be increased
- Medicine for cancer, corticosteroids (eg, prednisone), medicine that may weaken your immune system, or other medicines for MS (eg, interferon beta, mitoxantrone, natalizumab) because the risk of infection may be increased
- Azole antifungals (eg, ketoconazole), macrolide antibiotics (eg, erythromycin), protease inhibitors (eg, ritonavir), or telithromycin because they may increase the risk of fingolimod's side effects
This may not be a complete list of all interactions that may occur. Ask your health care provider if fingolimod may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use fingolimod:
Use fingolimod as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Fingolimod comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get fingolimod refilled.
- Take fingolimod by mouth with or without food.
- Your first dose of fingolimod will be given in a doctor's office, hospital, or clinic. You will be observed for at least 6 hours following your first dose.
- Take fingolimod on a regular schedule to get the most benefit from it. Taking fingolimod at the same time each day will help you remember to take it.
- Continue to take fingolimod even if you feel well. Do not miss any doses.
- Do not stop taking fingolimod without checking with your doctor. If you stop fingolimod for more than 7 days during the first month of treatment or for more than 2 weeks after the first month of treatment, contact your doctor before you start to take it again.
- If you miss a dose of fingolimod within the first 2 weeks of treatment, contact your doctor. If you miss a dose of fingolimod after 2 weeks of continuous treatment, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Talk with your doctor for more information.
Ask your health care provider any questions you may have about how to use fingolimod.
Important safety information:
- Do not drive or perform other possibly unsafe tasks during the first day of treatment until you know how you react to fingolimod.
- Slow heartbeat may occur after you start fingolimod, especially after your first dose. Your health care provider will watch you for symptoms of slow heartbeat for at least 6 hours after your first dose. Symptoms can happen up to 24 hours after you take your first dose of fingolimod. If you experience slow heartbeat, your heart rate will usually return to normal within 1 month after you start fingolimod. Tell your doctor right away if you experience chest, pain, dizziness, seizures, slow or irregular heartbeat, or unusual tiredness.
- Do NOT take more than the recommended dose, change your dose, or stop taking fingolimod without checking with your doctor.
- Fingolimod may lower the ability of your body to fight infection while you take it and for up to 2 months after you stop taking it. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
- If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does.
- Do not receive a live vaccine (eg, measles, mumps) while you are taking fingolimod and for up to 2 months after you stop taking it. Talk with your doctor before you receive any vaccine.
- Cases of a certain type of blood cancer (lymphoma) have occurred in patients taking fingolimod. It is not known if these cases were related to fingolimod. Contact your doctor with any questions or concerns.
- Women who may become pregnant should use an effective form of birth control while they take fingolimod and for 2 months after they stop taking fingolimod. If you have questions about effective birth control, talk with your doctor.
- Tell your doctor or dentist that you use fingolimod before you receive any medical or dental care, emergency care, or surgery.
- Fingolimod may interfere with certain lab tests, including peripheral blood lymphocyte counts. Be sure your doctor and lab personnel know you are taking fingolimod.
- Lab tests, including electrocardiogram (ECG), complete blood cell counts, pulse and blood pressure, lung function, liver function, and eye exams, may be performed while you use fingolimod. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Fingolimod should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Fingolimod may cause harm to the fetus. Do not become pregnant while you are using it or for 2 months after you stop using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using fingolimod while you are pregnant. It is not known if fingolimod is found in breast milk. Do not breast-feed while taking fingolimod.
Possible side effects of fingolimod:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Back pain; cough; diarrhea; headache; mild hair loss; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); burning, numbness, or tingling of the skin; chest pain; confusion; depression; dizziness; eye pain; fainting; feeling cold in the hands or feet; new or worsening breathing problems (eg, shortness of breath); one-sided weakness; severe or persistent headache; slow or irregular heartbeat; skin or nail infection (eg, skin discharge, redness, swelling, or warmth); slurred speech; symptoms of infection (eg, fever, chills, severe or persistent cough or sore throat, body aches, nausea or vomiting, increased or painful urination); symptoms of liver problems (eg, dark urine; loss of appetite; pale stools; severe or persistent nausea, vomiting, or stomach pain; yellowing of the skin or eyes); unexpected weight loss; unusual tiredness or weakness; vision changes (eg, blurred vision, shadows, blind spot, sensitivity to light, unusually colored or tinted vision).
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include slow or irregular heartbeat.Proper storage of fingolimod:
Store fingolimod at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store in the original blister pack away from heat, moisture, and light. Do not store in the bathroom. Keep fingolimod out of the reach of children and away from pets.
- If you have any questions about fingolimod, please talk with your doctor, pharmacist, or other health care provider.
- Fingolimod is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take fingolimod or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about fingolimod. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to fingolimod. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using fingolimod.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.