Gilenya is an oral medication that is taken once daily.
Gilenya control the MS disease by leaving the lymphocytes in the lymph nodes. Gilenya connects to lymphocytes and does not allow the movements of the lymphocytes out of the immune system. Gilenya competes with sphingosine-1-phosphate molecule in the lymph nodes. It is a sphingosine-1-phpsphate receptor modulator. Gilenya does allow the movement of lymphocytes out of the lymph nodes into the blood circulation system and therefore less lymphocytes can enter the central nervous system.
Gilenya side effects:
Heart related effects: Gilenya may affect the heart rate especially after the first dose. Patients have to have a full cardiological work up prior to initiating the medications. Patients on cardiac anti-arrhythming medications cannot take Gilenya. Once patients are cleared cardiologically to start the drug, they need to be monitored for 6 hours after taking the first pill Gilenya. Patients need to have an EKG before taking the drug and a repeat EKG after 6 hours of taking the drug. Each hour patients have their blood pressure and heart rate monitored and they are evaluated for any cardiological signs or symptoms i.e. dizziness,chest discomfort and others.
Eye related effects: Gilenya may affect the macula inside the eye and cause vision change. Each patient need to have an ophthalmological evaluation before starting Gilenya. A repeat of ophthalmological evaluation need to be done 3-4 months after starting Gilenya and then annually. Patients that have diabetes are not candidates for Gilenya.
Lung related effects: Patients with pulmonary issues i.e. asthma, need to have pulmonary function tests.
Infections: Patients on Gilenya are at high risk for infections. Lymphocyte counts have to be monitored. If the lymphocyte count is very low – the patient’s team need to re-evaluate the safety of taking the drug. This has to be evaluated individually.