If you or someone you know has Multiple Sclerosis (MS), your doctor may have prescribed a medication called Ponesimod. The name may sound a bit strange. But don't worry. Simply put, it's a medication that helps control relapses (relapses) of MS symptoms. However, it's not a cure for MS. So, today we'll talk about Ponesimod in a very simple way so you can understand how to use it, what to watch out for, and its side effects.
What should I tell the doctor before starting this medication?
Ponesimod is a very strong medicine, so it is very important to give your doctor a complete history of your health before starting it. Be sure to tell your doctor if you have any of the following conditions:
- Diabetes `(Diabetes Mellitus)`
- Any eye disease or vision impairment
- Heart disease , heart rhythm disorders, or high blood pressure
- Some weakness in the immune system
- Current infection (especially viral infections like chickenpox and herpes)
- Liver diseases
- If low blood counts have been reported, such as low white blood cells, platelets, or red blood cells
- Lung diseases (for example, asthma, COPD)
- If you have recently received a vaccine or are scheduled to receive one in the future
- If you have had skin cancer (skin cancer/melanoma)
- If you have had a previous stroke or transient ischemic attack (TIA)
- If you have an allergy to Ponesimod or any other medicine or food.
- If you are pregnant , trying to get pregnant , or breastfeeding , it is imperative that you inform your doctor about this.
It is very important for your safety to talk to the doctor without hiding this information.
How should I use the medicine?
The method of using this medicine is very simple. But the most important thing is to follow the doctor's instructions exactly.
- Take this pill with a glass of water .
- Try to take your medicine at the same time every day . This will help keep the medicine at the same level in your body.
- Do not break, crush, or chew the tablet. Swallow the tablet whole.
- This can be taken before or after meals. However, if you feel a little upset stomach, take it with a meal .
- Continue to use the medicine until your doctor tells you to stop.
What to do if you miss a dose of medication?
It is very important not to skip meals. If you forget to take a dose, do not panic and ask your doctor for advice on what to do next.
What if I take too much medicine?
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately. Alternatively, call the National Poisons Information Centre at the Colombo National Hospital for advice.
Most importantly: This medicine has been prescribed for you only . Never share it with anyone else or let anyone else use it.
Other drugs that may interact with this medicine (Interactions)
Ponesimod can interact with other medications you are taking. This is called an ``interaction.'' Therefore, you should tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
Below are some medications that may interact with Ponesimod.
| Drug type | Description and examples |
|---|---|
| Drugs that should never be taken with Ponesimod | |
| Other medications for MS | Ex: `fingolimod`, `siponimod` |
| Drugs that affect heart rate | Eg: `dronedarone`, `thioridazine`, `pimozide` |
| Other | `cisapride`, `saquinavir` |
| Other drugs that may interact with Ponesimod | |
| Immune-suppressing drugs | For example: `alemtuzumab` and other drugs that reduce the ability to fight infections |
| Blood pressure and heart disease medications | Some medications that affect the rhythm of the heartbeat |
| Medications for seizures | Ex: `carbamazepine`, `phenobarbital`, `phenytoin` |
| Live virus vaccines | It is not advisable to take these while taking this medicine. |
| Antiviral drugs for HIV or Hepatitis | Some antiviral medications may interact with this. |
Things to keep in mind while taking the medicine
You need to take a little extra care of your health while taking this medicine.
- Regular medical check-ups: As directed by your doctor, go to the clinic regularly to check your condition. If your symptoms do not improve or worsen, report it.
- Vision Care: Your doctor may recommend that you have your eyes checked before and during treatment with this medication. If you notice any changes in your vision, such as blurred vision, tell your doctor immediately.
- Risk of infection: This medicine may slightly weaken the body's immune system. Therefore, the risk of developing infections is higher. If you experience symptoms such as fever, chills , sore throat, and cough, do not self-medicate and talk to your doctor. Try to avoid places where sick people hang out.
- Risk of serious brain infection: Very rarely, this medicine may cause a serious brain infection called `Progressive Multifocal Leukoencephalopathy (PML). If you experience any changes or difficulty in your vision, thinking, speaking, walking, or balance , do not ignore it. Seek immediate medical attention.
- Avoid getting pregnant: This is very important. Do not get pregnant while taking this medicine and for one week after stopping . Be sure to use reliable birth control. This can be very dangerous for the unborn baby, so be very careful. If you have any suspicion that you are pregnant, tell your doctor immediately.
- Stopping the medication: Do not stop taking this medication suddenly without your doctor's advice. Doing so may cause your MS symptoms to get worse again.
Side effects of the medicine
Like any medicine, Ponesimod can cause some side effects. While most of these are minor, there are some things we should be especially aware of.
| Side effect | Description |
|---|---|
| Serious side effects that require immediate medical attention | |
| Allergic Reaction | Skin rash, severe itching, swelling of the face, lips or tongue. |
| Changes in heart rate | Difficulty breathing, chest pain, dizziness, fainting, unusually fast, slow , or irregular heartbeat. |
| Symptoms of liver damage | Dark yellow or brown urine, yellowing of the eyes or skin, pain in the upper right part of the stomach, loss of appetite, unusual fatigue. |
| Stroke symptoms | Sudden numbness or weakness of the face, arm or leg, difficulty speaking or understanding, sudden severe headache. |
| Other serious symptoms | Vision changes, confusion, seizures, difficulty breathing, symptoms of brain fever (severe headache, stiff neck). |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Dizziness | Dizziness |
| Dry mouth | Dry mouth |
| Pain in the limbs | Pain in legs or arms |
Take-Home Message
- Ponesimod is a drug that controls the recurrence of symptoms of Multiple Sclerosis (MS), but it does not completely cure the disease.
- Before starting the medication, tell your doctor about all your medical conditions and all other medications you are taking.
- Take the prescribed dose at the prescribed time, as prescribed by the doctor. Don't skip meals.
- Seek immediate medical attention if you experience any serious side effects, such as signs of infection, vision changes, changes in heart rate, or symptoms of paralysis.
- Avoid becoming pregnant while taking this medication and for one week after stopping. A reliable method of birth control is essential.
- Avoid stopping the medication without your doctor's advice.
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