OMUDHOME OGBRU, Pharm.D.Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. Dr. graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Fingolimod is an oral medication used for treating
multiple sclerosis (MS). Its mechanism of action is unknown, although it may
work by reducing the number of circulating lymphocytes (a type of white blood
cell), leading to reduced migration of white blood cells into the central
nervous system. White blood cells cause inflammation and destruction of nerves
in patients with MS. Fingolimod does not cure MS. It decreases the number of MS
flares and slows down the development of physical disability caused by MS. The
FDA approved fingolimod in September 2010.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Capsules: 0.5 mg.
STORAGE: Fingolimod should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Fingolimod is used for reducing the frequency of relapses and
for delaying the occurrence of physical disability in patients with relapsing
forms of multiple sclerosis.
DOSING: The recommended dose is 0.5 mg orally once daily, with or without
food. Doses higher than 0.5 mg cause more adverse reactions without providing additional benefit.
DRUG INTERACTIONS: The blood levels of fingolimod are increased when combined
with ketoconazole (Nizoral, Extina, Xolegel, Kuric). This may increase the incidence of side effects.
Vaccines may be less effective during and up to 2 months after
discontinuation of fingolimod treatment. Live attenuated vaccines should not be
administered during and for 2 months after fingolimod treatment because of the
risk of infection.
When combined with drugs that decrease heart rate (for example, atenolol
[Tenormin])
there is an additional 15% reduction of heart rate.
PREGNANCY: Fingolimod has not been adequately studied in
pregnant women.
NURSING MOTHERS: It is not known whether fingolimod is secreted in
breast
milk.
SIDE EFFECTS: The most common side effects are headache, flu, diarrhea,
back
pain, elevations of liver enzymes and
cough. Fingolimod may decrease heart rate,
especially after the first dose. Patients should be observed for signs and
symptoms of low heart rate for 6 hours after the first dose. Fingolimod may
increase the risk of infections. Signs and symptoms of infection should be
monitored during treatment and for two months after discontinuation of
treatment. Fingolimod should not be administered to patients who have an
infection. Fingolimod may cause inflammation of the eye (uveitis) and other eye
problems. Therefore, visual acuity should be checked prior to starting therapy,
3 to 4 months after initiation of therapy, and during routine patient evaluation. Fingolimod has also been associated with difficulty breathing. Fingolimod
reduces the white blood cell count, and this effect may last for 2 months after
treatment is discontinued.
Reference: FDA Prescribing Information for Gilenya (fingolimod)
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and spinal cord, reflected by alterations of virtually every sensory or motor function in the body. The cause of MS is primarily unknown. There are different types of MS including relapsing-remitting MS, primary-progressive MS, and secondary-progressive MS. Symptoms of MS rang from mild to severe and examples include visual disturbances, muscle weakness, spasm, and fatigue. Decreased concentration, memory loss, and impaired judgment. Treatment for MS is generally with medications.
Multiple sclerosis (MS) is a disease in which the nerves of the central nervous system (brain and spinal cord) degenerate. Myelin, which provides a covering or insulation for nerves, improves the conduction of impulses along the nerves and also is important for maintaining the health of the nerves. In
multiple sclerosis, inflammation causes the myelin to disappear. Consequently, the electrical impulses that travel along the nerves decelerate, that is, become slower. In addition, the nerves themselves are damaged. As more and more nerves are affected, a
person experiences a progressive interference with functions that are controlled by the nervous system such as vision, speech, walking, writing, and memory.
About 350,000 people in the U.S. have multiple sclerosis. Usually, a person is diagnosed with
multiple sclerosis between 20 and 50 years of age, but multiple sclerosis has been diagnosed in children and in the elderly.
Multiple...