MAYZENT (Siponimod)

What is this medication?

MAYZENT (Siponimod)
Sphingosine 1-Phosphate (S1P) Receptor Modulator

MAYZENT (Siponimod) 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.

How does this medication work? 

MAYZENT (Siponimod) is a sphingosine-1-phosphate (S1P) receptor modulator that binds to sphingosine 1-phosphate receptors 1 and 5.  This inhibits lymphocyte release from lymph nodes, thereby decreasing the number of lymphocytes available to the CNS which reduces central inflammation.

How should I take this medication? 

Oral: CYP2C9 Genotype *1/*1, *1/*2, or *2/*2: Take 0.25 mg once daily on Days 1 and 2, then 0.5 mg once daily on Day 3, then 0.75 mg once daily on Day 4, then 1.25 mg once daily on Day 5 then maintain on 2mg once daily Day 6 and on.

Oral: CYP2C9 Genotype *1/*3 or *2/*3: Take 0.25 mg once daily on Days 1 and 2, then 0.5 mg once daily on Day 3, then 0.75 mg once daily on Day 4 then maintain on 1mg once daily Day 5 and on.

How to Take: Administer with or without food. Swallow tablets whole; do not chew, crush, or split. Cases of rebound syndrome (clinical and radiological signs of severe exacerbation beyond what was expected) have been reported with discontinuation of another sphingosine 1-phosphate receptor modulator. Monitor for development of severe increase in disability following discontinuation and begin appropriate treatment as needed. Avoid immunization with live attenuated vaccines during and for 4 weeks after treatment. Vaccines may not be as effective if administered during therapy; discontinuation of treatment 1 week before and 4 weeks following a planned vaccination is recommended.

Note: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance so avoid starting any new medications without consulting prescriber.  Avoid missing dosages. 

What should I watch for while using this medication? 

Before starting MAYZENT (Siponimod), make sure your physician is aware of any allergies or medications you currently take, if you have cardiovascular disease, hepatic impairment, CYP2C9*3/*3 genotype, if you are immunocompromised, have an active infection, active malignancy, are pregnant, or breastfeeding. Siponimod use has been associated with rare but serious adverse events such as atrioventricular conduction delays, bradycardia, hepatic effects, hypertension, increased risk of infection, macular edema, malignancy, neurotoxicity, progressive multifocal leukoencephalopathy, QT prolongation, and reduced respiratory function.

What if I miss a dose?

If a dose is missed for more than 24 hours during the initial titration regimen, reinitiate with Day 1 of the titration regimen. If treatment with Siponimod is interrupted for 4 or more consecutive daily doses after completion of initial titration, reinitiate treatment with Day 1 of the titration regimen, including first-dose monitoring when appropriate. 

How should I store this medication?

Keep out of the reach of children at all times. Store unopened containers in a refrigerator between 2°C to 8°C (36°F to 46°F); may be stored at 20°C to 25°C (68°F to 77°F) for ≤3 months after dispensing to the patient. Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Hypertension, headache, falling, increased serum transaminases, peripheral edema, bradycardia, first degree atrioventricular block, dizziness, nausea, diarrhea, increased serum bilirubin, increased serum alanine aminotransferase, limb pain.

Note this is not a complete list of side effects for MAYZENT (Siponimod), only common ones.