Treats relapsing forms of multiple sclerosis. Gilenya (Fingolimod) is an oral medication that has a lot of side effects, but it reduces the number of flare-ups, slows physical changes, and decreases the number of new brain lesions in relapsing MS.
Lowers the frequency of multiple sclerosis exacerbations. Avonex (Interferon Beta-1A) is an injectable medicine effective for relapsing, remitting MS and has manageable side effects and weekly dosing.
How it works
Gilenya (Fingolimod) is an immune modulator. Researchers don't know exactly how it works, but it seems to stop your white blood cells from attacking the nerves in your brain and spinal cord.
Avonex (Interferon Beta-1A) is an interferon that acts like the ones your body naturally makes. Researchers don't know exactly how it works, but interferons activate your immune system to control immune responses that have gotten out of control.
› Avonex (Interferon Beta-1A) can cause serious liver injury with the risk increasing during the first 6 months after you start. You'll need to have your liver enzymes tested at 1, 3, and 6 months. If liver enzymes are significantly elevated and you have appetite/weight loss, stomach discomfort, vomiting, and notice dark urine, yellowing of skin/eyes, change in stool color, and skin rash, you should stop taking Avonex (Interferon Beta-1A) until your doctor decides if it's safe to re-start.
Upsides and benefits
› Gilenya (Fingolimod) is the first once-daily pill you can take for relapsing forms of multiple sclerosis (MS).
› Studies show it lowers relapse rates better than placebo and Avonex, and it delays the progression of physical disabilites better than placebo.
› Gilenya also reduced the number of new MS lesions better than Avonex.
› One of the main treatments for relapsing MS that has been around for many years.
› Injections are given weekly, and not daily like other MS medications.
› Helps reduce the frequency of MS relapse episodes.
› Flu-like reactions are the most common side effects and usually go away with continued treatment or can be avoided by using over-the-counter pain and fever-reducing medicines before the injection (like acetaminophen or ibuprofen).
Downsides and risks
› Taking more than the 0.5 mg dose won't give more benefits, but will only cause more side effects.
› Gilenya can remain in your blood for up to 2 months after you stop taking it. Your immune response won't work as well during this time.
› Not the best choice if you've had a heart attack, stroke, or have been in the hospital for heart failure in the past 6 months. The risk of serious heart rate effects is higher when taken with certain drugs (methadone, erythromycin, citalopram, ketoconazole) or if you have low potassium or magnesium.
› If you have to re-start Gilenya after stopping it for 2 weeks or more, you'll have to take your first dose at your doctor's office again.
› If you didn't get chicken pox and never had a vaccination, you'll need to be vaccinated and wait one month before starting Gilenya.
› Injection site reactions are common, ranging from localized pain, redness, and swelling to severe skin dryness.
› Flu-like symptoms are common after interferon injections.
› It's not clear what type of problems occur if taken during pregnancy.
› Blood testing is required before and during use of Avonex (Interferon Beta-1A).
› May not be as effective as other interferons.
Tips from our pharmacists for people taking the medication
› Take one capsule daily with or without food.
› It's very important you read the Gilenya Medication Guide. Don't change your dose or stop the medicine without asking your doctor.
› You'll need to be watched for at least 6 hours in a doctor's office after taking your first dose because it can cause serious heart rate and blood pressure problems.
› Gilenya increases your risk of infections. Get blood tests 6 months before starting treatment.
› Use effective birth control or plan to stop Gilenya 2 months before getting pregnant. If you do become pregnant while on Gilenya (Fingolimod), you'll need to enroll in the Gilenya pregnancy registry.
› Tell your doctor if you've had any vaccines recently. Don't get any live vaccines while taking Gilenya.
› Your doctor will monitor your eyes, lungs, and liver for up to 2 months after stopping Gilenya.
› Inject yourself once a week in your muscle (you need to go deeper than the fat layer between your skin and muscle).
› Refrigerate the powder and pre-filled syringes and pens.
› Don't shake the medicine once it is taken out of the refrigerator or mixed.
› If using the pre-filled syringes, the tiny air bubbles won't hurt you.
› Avonex (Interferon Beta-1A) can cause flu-like symptoms (headache, fever, muscle pain) right after injections, lasting minutes or hours.
› Flu-like reactions usually go away with repeated treatments. Taking acetaminophen or ibuprofen 45 minutes before the injection can reduce the uncomfortable feeling.