Can fingolimod (Gilenya) be used to treat relapsing-remitting multiple sclerosis (MS) (RRMS) in patients who are also on cardiac medications?

Updated: Oct 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

The following are recommendations for the use of fingolimod with concomitant medications that slow the heart rate or AV conduction:

  • Experience is limited when coadministered with drugs that slow the heart rate or AV conduction (eg, beta-blockers, heart rate–lowering calcium channel blockers such as diltiazem, verapamil, or digoxin).

  • Because the initiation of fingolimod treatment is also associated with slowing of the heart rate, coadministration of other drugs that cause bradycardia may be associated with severe bradycardia or heart block.

  • The possibility to switch to drugs that do not slow the heart rate or AV conduction should be evaluated by the prescribing physician before initiating fingolimod. In patients who cannot switch, overnight continuous ECG monitoring is recommended after the first dose.


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