Gilenya (generic name fingolimod) can cause an increase in blood pressure, including the development of high blood pressure (hypertension), in some patients. Clinical studies have shown that patients taking Gilenya experienced an average rise in systolic blood pressure of about 3 mmHg and diastolic blood pressure of about 2 mmHg compared to placebo. This increase typically appears after about one month of treatment and tends to persist with ongoing use. In controlled trials, hypertension was reported as an adverse effect in approximately 8% of patients taking Gilenya, compared to 4% in those taking placebo. Because of this, blood pressure monitoring is recommended for patients during treatment with Gilenya, both in adults and pediatric patients.
The mechanism behind Gilenya’s effect on blood pressure is related to its action as a sphingosine 1-phosphate receptor modulator. By affecting these receptors, Gilenya influences the cardiovascular system, which can lead to changes in heart rate and vascular tone, contributing to increased blood pressure. The initial dose of Gilenya is often given under medical supervision because of potential cardiac effects, including bradycardia (slow heart rate), but the blood pressure increase tends to develop more gradually over weeks rather than immediately.
Patients with preexisting hypertension or cardiovascular conditions should be closely monitored when starting Gilenya. If blood pressure rises significantly, healthcare providers may need to adjust antihypertensive medications or consider other interventions. It is important not to stop Gilenya abruptly without medical advice, as this can lead to worsening of multiple sclerosis symptoms.
In addition to blood pressure concerns, Gilenya has other potential side effects that require monitoring, such as liver enzyme elevations and rare but serious neurological events. However, the blood pressure increase is one of the more common and clinically relevant side effects that clinicians watch for during therapy.
In practical terms, if you or someone you know is starting Gilenya, regular blood pressure checks should be part of the treatment plan. Lifestyle measures to control blood pressure, such as diet, exercise, and avoiding excessive salt intake, may also be beneficial alongside medical monitoring. If high blood pressure develops, it can usually be managed with standard antihypertensive treatments while continuing Gilenya, but this decision must be individualized by the healthcare provider.
Overall, while Gilenya is effective for managing multiple sclerosis, it carries a risk of increasing blood pressure that requires awareness and proactive management to ensure patient safety and treatment success.
