Please be aware of this paper:
Espinosa PS, Berger JR. Delayed fingolimod associated asystole. Multiple Sclerosis 2011; 17:1387-9.
A patient with MS developed asystole and sustatined bradycardia 21 hours after the first dose of fingolimod. Patient was a 20 yo male with no prior treatment with DMT's, no personal or family history of cardiac disease.He had mild mental retardation and was taking risperidone. He received IVMP and on day 4 began fingolimod. The period of asystole lasted only seven seconds, was associated with brief LOC and convulsive like activity and was captured. He remained bradycardic for two more days. The f. was discontinued. Authors suspect a synergistic response between fingolimod and risperidoneand possibly other psychotropic medication.
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