80.: Cardiac effects of high-dose fingolimod ingestion.

Fingolimod is associated with first dose transient atrioventricular conduction defects mandating cardiac monitoring at initiation. This side effect is not seen with chronic use. Theoretically, overdose of fingolimod should not lead to cardiac side effects, but there are very few reports. We present a case and review the literature of fingolimod overdoses. We report an intentional overdose of 21 mg of fingolimod in a patient with relapsing remitting multiple sclerosis and depression. We retrospectively reviewed the clinical notes of our patient and searched for any similar reports in the literature. At the time of initial assessment and during the subsequent observation period of approximately 4 h, no cardiovascular symptoms, signs or atrioventricular conduction delay were noted. Though there has been a recent report of cardiac side effects noticed after intentional fingolimod overdose, in our patient no such side effects were observed. This highlights the relative safety of fingolimod and that the adverse effects can be variable. We expect further reports of effects of overdoses of this drug with more widespread use. [ABSTRACT FROM AUTHOR]