Do you have a condition called Multiple Sclerosis (MS)? If so, your doctor may have prescribed you a medication called Fingolimod. You may know this medication by its brand name Gilenya. Many questions may come to our mind when using this medication. So, today we will talk about this medication, what it actually does, and what things to be careful about while using it.
What really happens with this medicine?
Simply put, Multiple Sclerosis (MS) is a condition in which our body's own immune system mistakenly attacks our own brain and nervous system, causing a variety of symptoms.
This drug, called Fingolimod, works by slowing down the overactive immune system, much like slowing down a speeding car. This delays the worsening of symptoms and reduces the number of flare-ups.
However, we must remember that this is not a cure for MS. This is a treatment that helps control the disease.
Things you need to tell your doctor before starting medication
Your doctor will ask you about your health before prescribing this medicine. If you have any of the following conditions, be sure to tell them without hiding anything . This is for your own safety.
| Do you have these conditions? | Why is it important to inform about it? |
|---|---|
| Diabetes | This medicine can affect the eyes, and diabetes can also affect the eyes. |
| Heart disease, high blood pressure, or irregular heartbeat | Because fingolimod can slow heart rate, it may be risky for people with these conditions. |
| Liver disease | Since the drug can affect the liver, it should be taken into account if you already have liver disease. |
| Infections such as chickenpox, or if you have recently received a vaccine | Because this medicine reduces immunity, it increases the risk of infections. |
| Lung diseases (such as asthma) | The medicine can sometimes affect the respiratory process. |
| If you are pregnant, trying to get pregnant, or breastfeeding | This is very important. This medicine can cause serious harm to the baby in the womb. |
How to use the medicine correctly?
This is a pill that you take with water. It is very important to take the pill at the same time every day . If you feel an upset stomach, take the pill with a meal. You should continue to take the pill until your doctor tells you to stop.
Special notice about the first dose
This is very important. On the day you take your first dose of this medicine, you will be monitored in a hospital or clinic under medical supervision for at least 6 hours. You will also be monitored if your dose is increased, or if you stop taking the medicine for a while and then start it again. This is because this medicine can cause your heart rate to suddenly slow down, so make sure it is safe to do so.
What if I miss a dose of medicine?
Don't worry. If you miss a dose, call your doctor as soon as you remember and ask what to do next. Never take two doses at once.
What if I take too much medicine?
If you accidentally take too much medicine, do not panic and go to the nearest hospital Emergency Department (ETU) immediately. If necessary, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.
Things to consider when taking the medicine
- Regular medical checkups: While taking this medicine, your doctor will check you regularly. He or she will ask you to have blood tests and eye exams. It is very important to have them done on time and not skip them. If you notice any changes or blurring in your vision, tell your doctor immediately.
- Skin cancer risk: This medicine may slightly increase your risk of skin cancer, especially melanoma. Therefore, check your skin regularly. Tell your doctor if you notice any new moles, warts, or changes in the size, shape, or color of an existing mole. Minimize sun exposure. If you go outside, wear clothing that covers your body well and use a good sunscreen.
- Pregnancy and birth control:
- Stopping medication: Never stop taking your medication suddenly without your doctor's advice. Doing so can cause your MS symptoms to suddenly get worse. You may experience weakness in your limbs and difficulty walking.
- Fingolimod is a drug that controls MS and slows the worsening of symptoms, but it is not a cure for the disease.
- Be sure to tell your doctor about all other medications you are taking and any medical conditions you have.
- A 6-hour medical observation period is required on the day of the first dose of the medicine.
- Protect yourself from the sun and check your skin regularly while taking the medication.
- This medication is very dangerous during pregnancy. Therefore, it is imperative to use effective birth control while taking the medication and for 2 months after stopping.
- Never stop taking medication or change the dosage without your doctor's advice.
- If any severe side effects occur, inform your doctor immediately.
This medicine is not suitable for you if you are trying to get pregnant, or if you have even the slightest suspicion that you are pregnant. Fingolimod can cause serious birth defects in an unborn baby. Therefore, you must use a highly effective form of birth control while taking the medicine and for 2 months after stopping the medicine . Talk to your doctor about this.
What are the possible side effects?
Like any medicine, Fingolimod can cause side effects in some people. Some of these can be serious, while others can be mild.
| Side Effect | Features you should be aware of |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Liver injury | Pain in the upper right side of the stomach, loss of appetite, nausea, yellowing of the skin or eyes, dark yellow/brown urine, unusual fatigue. |
| Decreased heart rate | Dizziness, fainting, difficulty breathing, unusual weakness. |
| Infections | Fever, chills, cough, sore throat, non-healing wounds. |
| PRES syndrome | Sudden onset of severe headache, confusion, vision changes, seizures (these may be signs of Posterior Reversible Encephalopathy Syndrome (PRES). |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Headache | General headache. |
| Stomach upset and diarrhea | Stomach pain, bloating. |
| Back pain | Pain in the back and limbs. |
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