“In general, calcium-channel blockers and beta-blockers, if possible, should be avoided for migraine prophylactic therapy in these patients because of the possible interaction with fingolimod,” advised Dr. Applebee.
A recent study found that a beta-blocker in combination with fingolimod decreased heart rate to a statistically significant degree. A calcium-channel blocker did not have this effect, however, when it was administered with fingolimod. If a patient with MS and cardiac problems is taking fingolimod, a neurologist should consult his or her primary care doctor to determine the most appropriate medication for prophylaxis, concluded Dr. Applebee.
—Erik Greb