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Mild to moderate toxicity: Transient mild bradycardia and atrioventricular (AV) conduction disturbances may develop. Fingolimod may increase the risk of infection and macular edema. Mild elevations in transaminase concentrations may occur.
Treatment is symptomatic and supportive. Transient bradycardia usually does not require intervention. Atropine can reverse the negative chronotropic effect of Fingolimod and may be indicated in clinically significant bradycardia.
Severe toxicity: Symptomatic bradydysrhythmias and AV blocks, dyspnea, severe infections, and hepatic injury.
Treatment is symptomatic and supportive. Atropine is indicated to treat clinically significant bradycardia. Isoproterenol may also be indicated in some patients. Monitor for atrioventricular conduction disturbances or heart block. Treat infections as indicated. Monitor hepatic enzymes for evidence of liver injury.
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