162359-55-9

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Prophylaxis of organ rejection in patients receiving allogenic renal transplants (sphingosine-1-phosphate receptor).

ChEBI: An aminodiol that consists of propane-1,3-diol having amino and 2-(4-octylphenyl)ethyl substituents at the 2-position. It is a sphingosine 1-phosphate receptor modulator used for the treatment of relapsing-remitting multiple sclerosis. A prodrug, fingolimo is phosphorylated by sphingosine kinase to active metabolite fingolimod-phosphate, a structural analogue of sphingosine 1-phosphate.

Sphingosine 1-phosphate receptor modulator:
Treatment of highly active relapsing-remitting multiple sclerosis

Potentially hazardous interactions with other drugs
Anti-arrhythmics: possible increased risk of bradycardia with amiodarone, disopyramide and dronedarone.
Antifungals: concentration increased by ketoconazole.
Beta-blockers: possibly increased risk of bradycardia.
Calcium channel blockers: possible increased risk of bradycardia with diltiazem and verapamil.

Transformed by reversible stereoselective phosphorylation to the pharmacologically active (S)-enantiomer of fingolimod phosphate. It is eliminated by oxidative biotransformation mainly via the cytochrome P450 4F2 isoenzyme and subsequent fatty acid-like degradation to inactive metabolites, and by formation of pharmacologically inactive non-polar ceramide analogues of fingolimod. The main enzyme involved in the metabolism of fingolimod is partially identified and may be either CYP4F2 or CYP3A4. 81% excreted as inactive metabolites in the urine and <2.5% in the faeces as metabolites and unchanged drug.