Onboarding

For guidance on a successful switch to MAYZENT, select the MS treatment your patients are currently receiving from the tabs below¹

Interferon beta or glatiramer acetate

No dosing gap is required if the patient's lymphocyte counts are normal.²

Dimethyl fumarate

No dosing gap is required if the patient's lymphocyte counts are normal^2,3

Teriflunomide

Patients should undergo an accelerated elimination of 11-14 days or a >3.5-month safety dosing gap.^2,4,5

Natalizumab

Patients should observe a safety dosing gap of 8-12 weeks before initiating MAYZENT.⁶

Alemtuzumab

Switching patients to MAYZENT from alemtuzumab is not recommended²

Ocrelizumab

Patients should undergo at least a 14-week washout period.²

Cladribine

Depending on lymphocyte count recovery, a safety gap of 6-8 months should be considered.^7*

Fingolimod

Patients can initiate MAYZENT with no dosing gap.^8†

AV=atrioventricular; MS=multiple sclerosis; S1P=sphingosine 1-phosphate; SPMS=secondary progressive MS.
*Based on median time to lymphocyte recovery of 28 weeks, as reported in the cladribine label.^7
†MAYZENT and fingolimod reduce lymphocyte count to 20%-30% of baseline through S1P receptor modulation; no major additional reduction is expected after a direct switch from fingolimod to MAYZENT. The transient effects of fingolimod and MAYZENT on heart rate during initial dosing derive from initial S1P receptor agonism followed by S1P receptor internalization and desensitization to heart rate effects. Direct switch from fingolimod to MAYZENT should not require a titration dose and starting with the maintenance dose (2 mg or 1 mg) is not expected to result in heart rate or AV conduction effects.^5,8,9

Reference: 1. MAYZENT [Summary of Product Characteristics]. Novartis Pharmaceuticals AG. 2021. 2. Data on file. CBAF312AUS02 protocol amendment. Novartis Pharmaceuticals Corp. [January 15, 2020.] 3. Tecfidera [package insert]. Cambridge, MA: Biogen Inc; January 2021. 4. Aubagio [package insert]. Cambridge, MA: Genzyme Corporation; April 2021. 5. Mayzent [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; January 2021. 6. Sellner J, Rommer PS. A review of the evidence for a natalizumab exit strategy for patients with multiple sclerosis. Autoimmun Rev. 2019;18(3):255-261. 7. Mavenclad [package insert]. Darmstadt, Germany: Merck KGaA; April 2019. 8. Data on file. Switching safely from Gilenya to siponimod. Novartis Pharmaceuticals Corp. [June 27, 2019.] 9. Gilenya [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; December 2019.