What is this medication?

Siponimod (si PON i mod) may help prevent relapses of multiple sclerosis. This medicine is not a cure.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): MAYZENT

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• cancer
• diabetes
• eye disease
• heart disease
• high blood pressure
• immune system problems
• infection especially a viral infection such as chickenpox, cold sores, or herpes
• irregular heartbeat or rhythm
• liver disease
• low blood counts (white cells, platelets, or red blood cells)
• lung disease
• recent or upcoming vaccine
• stroke
• an unusual or allergic reaction to siponimod, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

Take this medicine by mouth with water. Take it as directed on the prescription label at the same time every day. You can take it with or without food. If it upsets your stomach, take it with food. Keep taking it unless your health care provider tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your health care provider about the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

It is important not to miss any doses. Talk to your health care provider about what to do if you miss a dose.

What may interact with this medication?

Do not take this medicine with any of the following medications:

• cisapride
• dronedarone
• fingolimod
• pimozide
• saquinavir
• thioridazine

This medicine may also interact with the following medications:

• alemtuzumab
• certain antivirals for HIV or hepatitis
• certain medicines for blood pressure, heart disease, irregular heart beat
• certain medicines for fungal infections like ketoconazole, itraconazole, or posaconazole
• certain medicines for seizures like carbamazepine, phenobarbital, phenytoin
• digoxin
• live virus vaccines
• medicines that lower your chance of fighting infection
• modafinil
• other medicines that prolong the QT interval (an abnormal heart rhythm)
• rifampin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your health care provider for regular checks on your progress. Tell your health care provider if your symptoms do not start to get better or if they get worse.

In some patients, this medicine may cause a serious brain infection that may cause death. If you have any problems seeing, thinking, speaking, walking, or standing, tell your health care provider right away. If you cannot reach your health care provider, urgently seek other source of medical care.

Your vision may be tested before and during use of this medicine. Tell your health care provider right away if you have any change in your eyesight.

You may need blood work done while you are taking this medicine.

This medicine may increase your risk of getting an infection. Call your health care provider for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Talk to your health care provider if you have not had chickenpox or the vaccine for chickenpox.

This medicine can decrease the response to a vaccine. If you need to get vaccinated, tell your health care provider if you have received this medicine within the last 4 weeks. Extra booster doses may be needed. Talk to your health care provider to see if a different vaccination schedule is needed.

If you stop taking this medicine, your MS symptoms may get worse. You may have more weakness, trouble using your arms or legs, or changes in balance. Talk to your health care provider right away if your symptoms get worse.

Do not become pregnant while taking this medicine. Women must use a form of birth control while taking this medicine. Women will also need to take it for 10 days after stopping the medicine. There is potential for serious harm to an unborn child. Tell your health care provider right away if you think you might be pregnant.

This medicine can make you more sensitive to the sun. Keep out of the sun, if you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps or tanning beds/booths.

Talk to your health care provider about your risk of cancer. You may be more at risk for certain types of cancer if you take this medicine.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)
• changes in vision
• confusion
• heartbeat rhythm changes (trouble breathing; chest pain; dizziness; fast, irregular heartbeat; feeling faint or lightheaded, falls)
• infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• liver injury (dark yellow or brown urine; general ill feeling or flu-like symptoms; loss of appetite, right upper belly pain; unusually weak or tired, yellowing of the eyes or skin)
• meningitis (stiff neck; sensitivity to light; headache; drowsiness; fever; nausea, vomiting; rash)
• stroke (changes in vision; confusion; trouble speaking or understanding; severe headaches; sudden numbness or weakness of the face, arm or leg; trouble walking; dizziness; loss of balance or coordination)
• seizures
• trouble breathing
• unusually slow heartbeat

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• dizziness
• headache
• pain in legs or arms

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

You will be instructed on how to store this medicine. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.