Mayzent Tablets / Film-coated
Siponimod
0.25mg
NOVARTIS PHARMACEUTICALS CORPORATION
| Pack size | 12's Blister |
|---|---|
| Dispensing mode | POM |
| Source | USA |
| Agent | CITY MEDICAL STORE |
| Retail Price | 990.50 AED |
Available as:
Indications
Mayzent Tablets / Film-coated is used for:
Multiple Sclerosis
Adult Dose
Multiple Sclerosis
Indicated for relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease
Patients with CYP2C9 genotypes *1/*1, *1/*2, or *2/*2
Initiate with a 5-day titration
Maintenance dose (Day 6): 2 mg PO qDay
Use a starter pack for patients who will be titrated to the 2-mg maintenance dosage
Do not use starter pack for patients who will be titrated to the 1-mg maintenance dosage
Titration for the 2-mg/day maintenance dose
Day 1: 0.25 mg (1 x 0.25 mg) PO
Day 2: 0.25 mg (1 x 0.25 mg) PO
Day 3: 0.50 mg (2 x 0.25 mg) PO
Day 4: 0.75 mg (3 x 0.25 mg) PO
Day 5: 1.25 mg (5 x 0.25 mg) PO
Day 6 and thereafter: 2 mg (1 x 2 mg) PO qDay
atients with CYP2C9 genotypes *1/*3 or *2/*3
Initiate with a 4-day titration
Maintenance dose (Day 5): 1 mg PO qDay
Do not use the starter pack for patients who will be titrated to the 1-mg maintenance dosage
Titration for 1-mg/day maintenance dose
Day 1: 0.25 mg (1 x 0.25 mg) PO
Day 2: 0.25 mg (1 x 0.25 mg) PO
Day 3 0.50 mg (2 x 0.25 mg) PO
Day 4: 0.75 mg (3 x 0.25 mg) PO
Day 5 and thereafter: 1 mg (4 x 0.25 mg) PO qDay
Hepatic impairment
No dosage adjustment necessary
Increased unbound siponimod AUC observed with moderate and severe hepatic impairment is not expected to be clinically significant
Child Dose
Renal Dose
Renal impairment
No dosage adjustment necessary
End-stage renal disease or patients on hemodialysis: Not studied; owing to high plasma protein binding (>99.9%) of siponimod, hemodialysis is not expected to alter the total and unbound siponimod concentration and no dose adjustments are anticipated based on these considerations
Administration
Administer with or without food
Contra Indications
In the last 6 months experienced myocardial infarction, unstable angina, stroke, transient ischemic attack (TIA), decompensated heart failure requiring hospitalization, or Class III or IV heart failure
Presence of Mobitz type II second- or third-degree AV block or sick sinus syndrome, unless patient has a functioning pacemaker
Precautions
Macular edema reported; majority of cases occurred within the first 4 months of therapy
Dose-dependent reductions in absolute FEV1 observed as early as 3 months after treatment initiation
Elevated transaminases may occur; exercise caution when treating patients with a history of significant liver disease
Incidence of hypertension reported in clinical trials in patients treated with siponimod was slightly higher than those treated with placebo; monitor blood pressure during treatment and manage appropriately
Based on animal studies, fetal harm may occur (see Pregnancy)
Rare cases of posterior reversible encephalopathy syndrome reported in patients receiving a sphingosine 1-phosphate (S1P) receptor modulator; such events have not been reported for siponimod-treated patients in the development program
Severe disease exacerbation, including disease rebound, rarely reported after discontinuing S1P receptor modulator
After discontinuing, siponimod remains in the blood for up to 10 days; starting other therapies during this interval results in concomitant exposure to siponimod
May cause a decline in pulmonary function; assess pulmonary function (eg, spirometry) if clinically indicated
Pregnancy-Lactation
Pregnancy
There are no adequate data on the developmental risk associated with the use in pregnant women
Animal data
Based on animal data and its mechanism of action, fetal harm may occur when administered to a pregnant woman
Reproductive and developmental studies in pregnant rats and rabbits have demonstrated drug-induced embryotoxicity and fetotoxicity in rats and rabbits and teratogenicity in rats
Increased incidences of postimplantation loss and fetal abnormalities (external, urogenital, and skeletal) in rats and of embryofetal deaths, abortions, and fetal variations (skeletal and visceral) in rabbits observed following prenatal exposure to siponimod starting at a dose 2 times the exposure in humans at the highest recommended dose of 2 mg/day
Contraception
Before initiating treatment, counsel women of childbearing potential on the potential risks to the fetus
Advise on effective contraception during treatment
Since it takes ~10 days to eliminate drug from the body after discontinuation, potential risks to the fetus may persist and women should use effective contraception during this period
Lactation
Unknown if distributed in human breast milk
A study in lactating rats has shown excretion of siponimod and/or its metabolites in milk
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
Adverse Effects
Side effects of Siponimod :
>10%
Headache (15%)
Hypertension (13%)
Transaminase increased (11%)
Falls (11%)
1-10%
Peripheral edema (8%)
Nausea (7%)
Dizziness (7%)
Diarrhea (6%)
Bradycardia (6%)
Pain in extremity (6%)
Vascular events (eg, ischemic strokes, pulmonary embolisms, myocardial infarctions) (3%)
Seizures (1.7%)
Mechanism of Action
Sphingosine-1-phosphate (S1P) receptor modulator
Binds with high affinity to S1P receptors 1 and 5; blocks lymphocyte egress from lymph nodes, reducing the number of lymphocytes in peripheral blood
Mechanism by which siponimod exerts therapeutic effects in MS is unknown, but may involve reduction of lymphocyte migration into the central nervous system
Note
Mayzent 0.25mg Tablets / Film-coated manufactured by NOVARTIS PHARMACEUTICALS CORPORATION. Its generic name is Siponimod. Mayzent is availble in United Arab Emirates.
Farmaco UAE drug index information on Mayzent Tablets / Film-coated is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.