Uses

Ponesimod is indicated for the treatment of relapsing forms of multiple sclerosis (MS) in adults, including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS.

Do not use if

Contraindicated in patients with recent (within 6 months) myocardial infarction, unstable angina, stroke, TIA, decompensated heart failure, or Class III/IV heart failure. Also contraindicated with Mobitz type II second-degree or third-degree AV block, sick sinus syndrome (without pacemaker), or severe untreated sleep apnea.

Side effects

Common adverse reactions include upper respiratory tract infections, hypertension, and elevated liver enzymes. Serious risks include bradyarrhythmia, atrioventricular conduction delays, pulmonary effects, increased blood pressure, macular edema, and posterior reversible encephalopathy syndrome.

Warnings

Requires a dose-titration schedule to minimize cardiac effects at initiation. Obtain baseline ECG, CBC, and liver function tests before starting. Monitor for infections during treatment and for 1–2 weeks after stopping. Risk of macular edema, particularly in patients with diabetes or history of uveitis.

How it works

Ponesimod is a selective sphingosine 1-phosphate (S1P) receptor 1 modulator. By binding with high affinity to S1P receptor 1, it sequesters lymphocytes within lymph nodes, thereby reducing peripheral blood lymphocyte counts and limiting lymphocyte migration into the central nervous system, which may reduce MS-associated inflammation.

Storage

Store at room temperature (20–25°C). Keep in original packaging to protect from moisture. Keep out of reach of children.