Prophylaxis of organ rejection
in patients receiving allogenic renal transplants (sphingosine-1-phosphate receptor).
Fingolimod is a novel immune modulator that prolongs allograft transplant survival in numerous models by inhibiting lymphocyte emigration from lymphoid organs.
ChEBI: An aminodiol that consists of propane-1,3-diol having amino and 2-(4-octylphenyl)ethyl substituents at the 2-position. It is a sphingosine 1-phosphate receptor modulator used for the treatment of relapsing-remitting multiple sclerosis. A prodrug, fingolimo
is phosphorylated by sphingosine kinase to active metabolite fingolimod-phosphate, a structural analogue of sphingosine 1-phosphate.
Sphingosine 1-phosphate receptor modulator:Treatment of highly active relapsing-remitting
multiple sclerosis
Potentially hazardous interactions with other drugs
Anti-arrhythmics: possible increased risk of
bradycardia with amiodarone, disopyramide and
dronedarone.
Antifungals: concentration increased by
ketoconazole.
Beta-blockers: possibly increased risk of bradycardia.
Calcium channel blockers: possible increased risk of
bradycardia with diltiazem and verapamil.
Transformed by reversible stereoselective phosphorylation
to the pharmacologically active (S)-enantiomer of
fingolimod phosphate. It is eliminated by oxidative
biotransformation mainly via the cytochrome P450
4F2 isoenzyme and subsequent fatty acid-like
degradation to inactive metabolites, and by formation of
pharmacologically inactive non-polar ceramide analogues
of fingolimod. The main enzyme involved in the
metabolism of fingolimod is partially identified and may
be either CYP4F2 or CYP3A4.
81% excreted as inactive metabolites in the urine and
<2.5% in the faeces as metabolites and unchanged drug.
