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Sphingosine-1-phosphate receptor modulator

Ozanimod

Brand names: Zeposia

Adult dose

Dose: Day 1–4: 0.23mg OD; day 5–7: 0.46mg OD; from day 8: 0.92mg OD
Route: PO
Frequency: OD

Clinical pearls

  • Relapsing-remitting MS; moderate-severe ulcerative colitis
  • Pre-treatment ECG, ophthalmic, VZV serology, LFTs, dose titration to reduce first-dose bradycardia

Contraindications

  • Recent (≤6mo) MI/stroke/severe HF
  • High-grade AV block without pacemaker
  • Severe untreated sleep apnoea
  • Concurrent MAOI
  • Pregnancy
  • Severe hepatic impairment

Side effects

  • Bradycardia/AV block (esp. first dose)
  • Macular oedema
  • Hepatotoxicity
  • Increased infection risk (incl. PML)
  • Hypertension
  • Reduced FEV1

Interactions

  • MAOIs (avoid)
  • Tyramine-rich foods
  • β-blockers
  • Live vaccines

Monitoring

  • LFTs
  • FBC
  • BP
  • Ophthalmic
  • ECG

Reference: BNF; NICE TA706/TA828; SmPC; https://bnf.nice.org.uk/drugs/ozanimod/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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