Fingolimod Hydrochloride

1 INDICATIONS AND USAGE Fingolimod capsules are indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in patients 10 years of age and older. Fingolimod hydrochloride is a sphingosine 1-phosphate receptor modulator indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in patients 10 years of age and older. ( 1 )

6 ADVERSE REACTIONS The following serious adverse reactions are described elsewhere in labeling: Bradyarrhythmia and Atrioventricular Blocks [ see Warnings and Precautions (5.1) ] Infections [ see Warnings and Precautions (5.2) ] Progressive Multifocal Leukoencephalopathy [ see Warnings and Precautions (5.3) ] Macular Edema [ see Warnings and Precautions (5.4) ] Liver Injury [ see Warnings and Precautions (5.5) ] Posterior Reversible Encephalopathy Syndrome [ see Warnings and Precautions (5.6) ] Respiratory Effects [ see Warnings and Precautions (5.7) ] Fetal Risk [see Warnings and Precautions (5.8) ] Severe Increase in Disability after Stopping Fingolimod Hydrochloride [see Warnings and Precautions (5.9) ] Tumefactive Multiple Sclerosis [see Warnings and Precautions (5.10) ] Increased Blo...

8.1 Pregnancy Risk Summary Based on findings from animal studies, fingolimod hydrochloride may cause fetal harm when administered to a pregnant woman. Data from prospective reports to the fingolimod pregnancy registry are currently not sufficient to allow for an adequate assessment of the drug-associated risk for birth defects and miscarriage in humans. In oral studies conducted in rats and rabbits, fingolimod demonstrated developmental toxicity, including an increase in malformations (rats) and embryolethality, when given to pregnant animals.

5 WARNINGS AND PRECAUTIONS Infections: Fingolimod hydrochloride may increase the risk. Obtain a complete blood count (CBC) before initiating treatment. Monitor for infection during treatment and for 2 months after discontinuation. Do not start in patients with active infections. ( 5.2 ) Progressive Multifocal Leukoencephalopathy (PML): Withhold fingolimod hydrochloride at the first sign or symptom suggestive of PML. ( 5.3 ) Macular Edema: Examine the fundus before and 3 to 4 months after treatment start. Diabetes mellitus and uveitis increase the risk. ( 5.4 ) Liver Injury: Obtain liver enzyme results before initiation and periodically during treatment. Closely monitor patients with severe hepatic impairment. Discontinue if there is evidence of liver injury without other cause. 4 CONTRAINDICATIONS Fingolimod capsules are contraindicated in patients who have: in the last 6 months experienced myocardial infarction, unstable angina, stroke, transient ischemic attack (TIA), decompensated heart failure requiring hospitalization or Class III/IV heart failure a history or presence of Mobitz Type II second-degree or third-degree AV block or sick sinus syndrome, unless patient ha...