Gilenya vs Tecfidera – detailed comparison:
Gilenya
It is the generic name of a drug called fingolimod that belongs to a group of drugs called sphingosine l-phosphate receptor modulators.
This medication works by decreasing the activity of certain cells of the immune system. In clinical trials, magnetic resonance imaging scans showed that people taking this medication had fewer or no new areas of active multiple sclerosis lesions.
It is produced by Novartis Pharmaceuticals, a multinational pharmaceutical company based in Basel. The US Food and Drug Administration first approved it in 2010.
Uses
This prescription medication is typically used to treat relapsing forms of multiple sclerosis in adults.
Note – it will not cure multiple sclerosis, but it will decrease the frequency of relapse symptoms.
Multiple sclerosis is a long-term condition that affects the central nervous system, including the spinal cord and the brain. Relapsing-remitting multiple sclerosis is characterized by repeated attacks of nervous system symptoms.
Dosage
The usual recommended dose is 0.5 mg orally once per day.
Note – higher doses than 0.5 mg are linked to a higher incidence of adverse reactions without additional benefits. It is only approved for use in adults age 18 and older.
While this medication is in your system, your white blood cell count may remain low and side effects may still occur. The medication will stay in the body for up to 2 months after you stop taking it.
Side Effects and Precautions
Common side effects may include:
- diarrhea;
- back pain;
- pain in the legs;
- pain in the arms;
- headaches;
- abnormal liver function tests;
- flu symptoms;
- a stuffy nose;
- a cough;
- stomach pain.
Rare side effects may include:
- purple spots on the skin;
- feeling very weak or tired;
- cold sores on your anal or genital area;
- dizziness;
- confusion;
- increased sensitivity to light;
- blurred vision;
- slow heart rate;
- neck stiffness;
- trouble breathing;
- nausea;
- sores in the throat and mouth;
- body aches;
- chest tightness;
- seizure (convulsions);
- having a blind spot or shadows in the center of your vision;
- sudden severe headache;
- jaundice (yellowing of the skin or eyes);
- clay-colored stools;
- eye pain;
- loss of appetite;
- vision problems;
- tired feeling;
- loss of consciousness;
- sudden numbness or weakness;
- thinking problems;
- upper stomach pain;
- buzzing in your ears.
To make sure that this medication is safe for you, tell your healthcare provider if you have:
- a history of fainting;
- an active or chronic infection;
- congestive heart failure;
- a history of Long QT syndrome;
- a very slow heart rate;
- type 2 diabetes mellitus;
- kidney disease;
- low blood pressure;
- sleep apnea;
- heart disease;
- uveitis, inflammation of the uvea of the pigmented layer which lies between the outer fibrous layer and the inner retina;
- if you take ketoconazole;
- asthma;
- high blood pressure.
Alcohol
There are no well-done studies regarding the safe use of alcohol while taking the medication.
Drug Interactions
It may negatively interact with other medications, especially the following:
- chlorpromazine;
- beta-blockers, like – carteolol (Cartrol), atenolol (Tenormin), nadolol (Corgard), labetalol (Normodyne, Trandate), timolol (Blocadren), and propranolol (Inderal);
- haloperidol (Haldol);
- calcium channel blockers, like – verapamil (Calan) and diltiazem (Cardizem);
- methadone (Dolophine);
- citalopram (Celexa);
- high blood pressure medications;
- digoxin (Lanoxin);
- medications for cancer;
- medications to control the immune system;
- ketoconazole (Nizoral);
- erythromycin (ERY-C).
Pregnancy & Breastfeeding
It can pass into breast milk and may negatively affect the infant. Therefore, don’t breastfeed while taking this medication.
Also, it is not known precisely whether this sphingosine l-phosphate receptor modulator will harm an unborn baby. Hence, tell your healthcare professional if you are pregnant or might fall pregnant before taking this drug.
Tecfidera
It is the generic name of a drug called dimethyl fumarate, which belongs to a group of drugs called Nrf2 activators.
This medication works by preventing nerve damage and decreasing inflammation which can lead to symptoms of MS.
Uses
This prescription medication is typically used to treat relapsing forms of multiple sclerosis.
Note – it may help the patient to manage symptoms of multiple sclerosis, however, it won’t cure the condition.
Dosage
The usual recommended dose is one 120 mg capsule that is taken by mouth 2 times per day for one week. Then, the dosage increases to one 240 mg capsule that is taken by mouth 2 times per day.
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Side Effects and Precautions
Common side effects may include:
- redness, warmth, or tingly feeling;
- itching;
- rash;
- diarrhea;
- vomiting;
- nausea;
- indigestion;
- stomach pain.
Rare side effects may include:
- problems with walking;
- any change in mental state;
- jaundice (yellowing of the skin or eyes);
- problems with speech;
- cold or flu symptoms;
- decreased vision;
- clay-colored stools;
- weakness on one side of the body;
- dark urine;
- pain when swallowing;
- tiredness;
- fever (high temperature);
- upper right stomach pain;
- loss of appetite.
Alcohol
There are no recommendations against consuming alcoholic beverages while taking this medication. But, it is best to see how the medication affects you by itself before you intake alcohol.
Pregnancy & Breastfeeding
It is not known exactly whether the medication will harm an unborn baby. Tell your healthcare provider if you are pregnant or plan to fall pregnant while using this drug.
Also, it is not known whether the medication passes into breast milk or if it would negatively affect the baby. Tell your doctor that you are breastfeeding a baby before taking this medication.
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Drug Interactions
It may negatively interact with other medications, especially the following:
- clonazepam;
- advil (ibuprofen);
- gabapentin;
- amantadine;
- levothyroxine;
- ampyra (dalfampridine);
- lyrica (pregabalin);
- aspirin;
- metformin;
- baclofen;
- omeprazole;
- cyclobenzaprine;
- benadryl (diphenhydramine);
- provigil (modafinil);
- cymbalta (duloxetine);
- tylenol (acetaminophen);
- ibuprofen;
- trazodone;
- imodium (loperamide);
- tizanidine;
- paracetamol (acetaminophen);
- oxybutynin;
- modafinil;
- lisinopril.
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Gilenya vs Tecfidera – Which Is Better For MS?
Gilenya (active ingredient – fingolimod) is an immunosuppressant that is used to treat relapsing multiple sclerosis in adults. The medication works by keeping immune cells trapped in the lymph nodes so they can’t reach the spinal cord and brain.
Tecfidera (active ingredient – dimethyl fumarate) is a drug that is used to treat relapsing multiple sclerosis. It acts on the central nervous system.
According to a 2017 study that was done at the Rocky Mountain MS Center at the University of Colorado, the odds of discontinuation were less for fingolimod than dimethyl fumarate.
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References https://www.novartis.com/news/media-releases/novartis-landmark-phase-iii- http://www.nejm.org/doi/full/10.1056/NEJMoa0909494 http://jnnp.bmj.com/content/jnnp/87/12/e1.58.full.pdf