Fingolimod Hydrochloride and Formerly available as Dalmane

• Generic Name: fingolimod
• Dosage Forms: n.a.
• Other Brand Names: Gilenya

Treatment of relapsing forms of MS (e.g., relapsing-remitting MS [RRMS]).

Fingolimod is one of several disease-modifying therapies used in the management of RRMS. Although not curative, these therapies have all been shown to modify several measures of disease activity, including relapse rates, new or enhancing magnetic resonance imaging (MRI) lesions, and disability progression.

The American Academy of Neurology (AAN) recommends that disease-modifying therapy be offered to patients with RRMS who have had recent relapses and/or MRI activity. Clinicians should consider adverse effects, tolerability, method of administration, safety, efficacy, and cost of the drugs in addition to patient preferences when selecting an appropriate therapy.

Additional studies needed to determine optimal role and safety profile of fingolimod, particularly during long-term use and in comparison with other disease-modifying therapies (e.g., glatiramer acetate, interferon beta, natalizumab).

May be useful in patients who prefer to avoid parenteral administration and/or those who have had an inadequate response to other disease-modifying therapies (e.g., dimethyl fumarate, glatiramer acetate, interferon beta, teriflunomide).

Has been evaluated, but currently not FDA-labeled for treatment of primary-progressive MS.

Designated an orphan drug by FDA for treatment of chronic inflammatory demyelinating polyneuropathy.

• Generic Name: flurazepam
• Dosage Forms: n.a.
• Other Brand Names: Dalmane

Short-term management of insomnia. Has been used effectively for periods up to 4 weeks in duration.

Has been used effectively in individuals with difficulty in falling asleep, nocturnal awakenings, and/or early morning awakening.

May exhibit carryover effect (i.e., more effective on second, third, and fourth nights of use than on first night) because of accumulation of active metabolite. Effect may persist on first and sometimes second night after discontinuance.

Because of long half-life, may be more likely to result in residual sedative effects and in impaired psychomotor and mental performance during continued therapy, although partial tolerance to these effects can occur. Differences among hypnotics in residual and cumulative CNS depressant effects may be particularly important in geriatric patients, those with potentially impaired elimination of the drugs, and those whose job or life-style requires unimpaired intellectual or psychomotor function.