Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
Free CME credits
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
Brand Name :
Gilenya, Tascenso ODT
Synonyms :
fingolimod
Class :
Selective immunosuppressants; Multiple Sclerosis Treatments; Sphingosine 1-Phosphate Receptor Modulators
Brand Name :
Gilenya, Tascenso ODT
Synonyms :
fingolimod
Class :
Selective immunosuppressants; Multiple Sclerosis Treatments; Sphingosine 1-Phosphate Receptor Modulators
Dosage Forms & StrengthsÂ
oral disintegrating, tabletÂ
0.25mg Â
capsuleÂ
0.5mgÂ
0.25mgÂ
Dosage Forms & StrengthsÂ
oral disintegrating, tabletÂ
0.25mg Â
capsuleÂ
0.5mgÂ
0.25mgÂ
below 10 years: Safety and effectiveness have not been demonstrated
above 10 years old, weight less than 40 kg: 0.25 mg Orally every Day
above 10 years old and weight more than 40 kg: 0.5 mg orally every Day
Doses more than 0.5 mg are linked with an increased risk of adverse reactions without any additional benefit.
Dosage Modifications
Renal impairment
Mild-to-moderate: Not recommended
Severe: Blood levels of some fingolimod metabolites are enhanced (up to 13-fold); the toxicity of these metabolites is unknown.
Hepatic impairment
Mild-to-moderate: dose adjustments are not required.
Severe: Monitor treatment; in severe hepatic impairment, drug exposure may be doubled.
Refer to the adult dosing regimenÂ
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may decrease the therapeutic effect when combined with vaccines
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with fingolimod
fingolimod: they may increase the bradycardic effect of Bradycardia-Causing Agents
fingolimod: they may increase the bradycardic effect of Bradykinin receptor antagonists
fingolimod: they may decrease the therapeutic effect of vaccines
measles, mumps, rubella, and varicella vaccine, live 
fingolimod: they may decrease the therapeutic effect of vaccines
measles mumps and rubella vaccine, live
fingolimod: they may decrease the therapeutic effect of vaccines
fingolimod: they may decrease the therapeutic effect of vaccines
smallpox (vaccinia) vaccine, live
fingolimod: they may decrease the therapeutic effect of vaccines
may increase the bradycardia effect
may increase the bradycardic effect of bradycardiac agents
may increase the bradycardic effect of bradycardia causing agents
moexipril/hydrochlorothiazideÂ
may increase the bradycardic effect of bradycardia causing agents
may increase the bradycardic effect of bradycardia causing agents
may increase the bradycardic effect of Bradycardia-Causing Agents
may have an increased QTc-prolonging effect when combined with amiodarone
respiratory syncytial virus vaccine, adjuvanted
fingolimod may diminish the therapeutic effect of vaccines (Inactivated/Non-Replicating)
respiratory syncytial virus (RSV) vaccine
fingolimod may diminish the therapeutic effect of vaccines (Inactivated/Non-Replicating)
It may enhance the QTc interval when combined with efavirenz
By immunosuppressive effects, the both the drugs action either decreases and results in risk of infection.
when both drugs are combined, there may be an increased effect of immunosuppressive activities of fingolimod  
when both drugs are combined, there may be an increased effect of immunosuppressive activities of fingolimod  
when both drugs are combined, there may be an increased immunosuppressive effect of fingolimod by paclitaxel  
when both the drugs are combined, carmustine increases the immunosuppressive effects of fingolimod    
when both drugs are combined, there may be an increased effect of immunosuppressive activity of Fingolimod.  
when both drugs are combined, there may be an increased risk of severe and potentially life-threatening infections   
when both drugs are combined, there may be an increased risk of severe life-threatening infections  
when both drugs are combined, there may be an increased effect of immunosuppressive activities of fingolimod  
when both drugs are combined, there may be an increased risk of severe and potentially life-threatening infections  
when both drugs are combined, there may be an increased risk or severity of adverse effects  
QTc interval is increased both by lenvatinib and fingolimod
when used together, azithromycin and fingolimod both increase the QTc interval
midostaurin and fingolimod, when used simultaneously, increase the QTc level
midostaurin and fingolimod, when used simultaneously, increase the QTc level
the toxicity of either of the drugs is increased by immunosuppressive activity
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
fingolimod may enhance the QTc-prolonging effect of QT-prolonging Agents
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
fingolimod: they may increase the QTc-prolonging effect of QT-prolonging Agents
fingolimod: they may increase the QTc-prolonging effect of QT-prolonging Agents
fingolimod: they may increase the QTc-prolonging effect of QT-prolonging Agents
fingolimod: they may increase the QTc-prolonging effect of QT-prolonging Agents
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
may have an increased immunosuppressive effect when combined with corticosteroids
when fingolimod and melphalan combine the immunosuppressive effects of both the drugs are enhanced and lead to increased risk of infection
when thiotepa and fingolimod combine, thiotepa increases the effects of fingolimod by immunosuppressive effects     
interaction increases the risk of excessive immunosuppression
may enhance the risk of serious infections due to increased immunosuppressive effects
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
risk of severe infection due to immunosuppressive effects
dactinomycin increases the effects of fingolimod and the risk of infection by immunosuppressive effects
when both drugs are combined, both increase the QTC interval  
cladribine increases the effects of fingolimod and the risk of infection by immunosuppressive effects
the effect of fingolimod is decreased by fluorouracil through immunosuppression/risk of infection
may increase excessive immunosuppressive effects
may increase the risk of severe infection due to excessive immunosuppression
may increase the QT-prolonging effect
when both drugs are combined may enhance the bradycardia effect and raise blood pressure
when both drugs are combined may enhance the bradycardia effect and raise blood pressure
may enhance the risk of serious infections due to increased immunosuppressive effects
may increase the QTc prolonging effect of QT-prolonging agents
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
may have an increased immunosuppressive effect when combined with immunosuppressants
Actions and spectrum:Â
fingolimod is a sphingosine 1-phosphate receptor modulator that acts as an immunomodulatory agent. It is used to treat relapsing forms of multiple sclerosis (MS).
fingolimod prevents immune cells from leaving the lymph nodes, which helps to reduce the number of immune cells that enter the central nervous system and cause damage to the myelin sheath surrounding nerve fibers.
By reducing inflammation and immune cell activity, fingolimod can slow the progression of MS and reduce the frequency of relapses.Â
Frequency definedÂ
>10%Â
Cough (12%)Â
Diarrhea (12%)Â
Influenza viral infection (11%)Â
Abdominal pain (11%)Â
Sinusitis (11%)Â
Nausea (13%)Â
Increased Liver transaminase (ALT/AST/GGT) (15%)Â
Headache (25%)Â Â
1-10%Â
Herpes zoster (2%)Â
Asthenia (2%)Â
Leukopenia (2%)Â
Tinea versicolor (2%)Â
Actinic keratosis (2%)Â
Basal cell carcinoma (2%)Â
Eye pain (3%)Â
Increased triglycerides (3%)Â
Bradycardia (3%)Â
Alopecia (3%)Â
Skin papilloma (3%)Â
Tinea infections (4%)Â
Blurred vision (4%)Â
Bradycardia (4%)Â
Gastroenteritis (5%)Â
Paresthesia (5%)Â
Weight decreased (5%)Â
Migraine (6%)Â
Hypertension (6%)Â
Sinusitis (7%)Â
Lymphopenia (7%)Â
Dizziness (7%)Â
Depression (8%)Â
Bronchitis (8%)Â
Hypertension (8%)Â
Dyspnea (9%)Â
Herpes virus infections (9%)Â
Pain in extremity (10%)Â
Back pain (10%)Â Â
<1%Â
Macular edema (0.4%)Â
Seizures (0.9%)Â Â
Post marketing ReportsÂ
lymphatic system and blood disorders:Â
Thrombocytopenia and hemolytic anemiaÂ
Hepatobiliary Disorders: injury to liverÂ
Infections: human papilloma virus (HPV), Cryptococcal infections, including dysplasia, papilloma, HPV-related cancer, and wartsÂ
Black Box Warning:Â
fingolimod has a black box warning for the risk of serious infections, like progressive multifocal leukoencephalopathy (PML), a rare and potentially fatal brain infection, and the risk of macular edema, which can cause vision impairment or blindness. Other warnings include bradyarrhythmia, fetal risk, respiratory effects, and liver injury.Â
Contraindication/Caution:Â
Contraindication:Â
Caution:Â
Comorbidities:Â
Pregnancy consideration: US FDA pregnancy category: Not assigned.Â
Lactation: It is not known if fingolimod is excreted in human milk Â
Pregnancy category:Â
Pharmacology:Â
fingolimod is a sphingosine 1-phosphate receptor modulator that affects the immune system. It is an immunosuppressive drug that inhibits the egress of lymphocytes from lymphoid organs, resulting in reduced lymphocyte counts in the peripheral blood.Â
fingolimod is phosphorylated by sphingosine kinase 2 to its active form, FTY720-phosphate, which binds to sphingosine 1-phosphate receptors on the surface of lymphocytes, thereby preventing the lymphocytes from exiting lymph nodes and entering the bloodstream. This results in a reduction in the number of lymphocytes in peripheral blood.
fingolimod also has immunomodulatory effects on other immune cells such as macrophages and dendritic cells. fingolimod has a half-life of about 6-9 days, and it is primarily metabolized by the cytochrome P450 enzyme CYP4F2 and excreted in feces. Â
Pharmacodynamics:Â
fingolimod is a sphingosine-1-phosphate receptor modulator that works by reducing the number of lymphocytes in the blood by retaining them in the lymph nodes, thereby reducing inflammation and autoimmune attacks. Specifically, fingolimod binds to sphingosine-1-phosphate (S1P) receptors on lymphocytes, causing internalization and degradation of the receptor. This leads to decreased lymphocyte migration from lymphoid tissues to the central nervous system, reducing inflammation and nerve damage in patients with multiple sclerosis.Â
fingolimod also reduces the production of pro-inflammatory cytokines such as interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-Îł). Additionally, it enhances the expression of anti-inflammatory cytokines such as interleukin-4 (IL-4) and interleukin-10 (IL-10). Overall, fingolimod helps to modulate the immune system to reduce inflammation and damage to the nervous system in patients with multiple sclerosis. Â
Pharmacokinetics:Â
AbsorptionÂ
After oral administration, fingolimod is rapidly absorbed with a maximum concentration of time(Tmax) of 2 to 4 hours. The absolute bioavailability of fingolimod is approximately 93%.Â
DistributionÂ
fingolimod has a large volume of distribution (Vd/F) of approximately 1200 L.Â
MetabolismÂ
fingolimod is metabolized by cytochrome P450 (CYP) isoenzymes CYP4F2 and CYP2D6. The major circulating metabolite is fingolimod-phosphate, which is pharmacologically active.Â
Elimination and excretionÂ
fingolimod is primarily eliminated through metabolism. The half-life of fingolimod is 6 to 9 days. Approximately 85% of the dose is eliminated in the feces, with less than 2% eliminated in the urine.Â
Administration:Â
fingolimod is available in oral capsule form and is usually administered at a dose of 0.5 mg once daily. It can be taken orally with or without food. Before starting fingolimod treatment, patients need to undergo an initial evaluation, including cardiac evaluation and blood tests.
During the first dose, patients should be monitored for signs of bradycardia and/or atrioventricular block. After the first dose, patients should be monitored for at least 6 hours, and their heart rate and blood pressure should be checked hourly.Â
Patient information leafletÂ
Generic Name: fingolimodÂ
Pronounced: [ fin-GOE-li-mod]Â Â
Why do we use fingolimod?Â
fingolimod is used for the treatment of relapsing forms of multiple sclerosis (MS), including the clinically isolated syndrome, active and secondary progressive disease, and the elapsing-remitting disease, in adults. It is used in the treatment of children and adults aged 10 to 17 years with relapsing forms of MS therapies.Â
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
On course completion, you will receive a full-sized presentation quality digital certificate.
A dynamic medical simulation platform designed to train healthcare professionals and students to effectively run code situations through an immersive hands-on experience in a live, interactive 3D environment.
When you have your licenses, certificates and CMEs in one place, it's easier to track your career growth. You can easily share these with hospitals as well, using your medtigo app.
