Fingolimod Washout Period Requirements

Pharmacological Basis and Recommended Washout Period

The British Journal of Dermatology recommends a traditional washout period of four times a drug's terminal half-life when switching from fingolimod to another disease-modifying therapy, to minimize the "immunosuppressive burden" and allow for proper pretreatment assessments 1, 2
A washout period is necessary when switching from fingolimod to another DMT, with clinical trials requiring patients to discontinue biologic therapy for at least 3 months prior to initiating new biologic therapies, as recommended by the British Journal of Dermatology 1, 2

The British Journal of Dermatology warns of an increased risk of infections with overlapping immunosuppressive therapies, and difficulty in accurately assessing baseline disease severity and performing pretreatment assessments 1, 2
The British Journal of Dermatology also notes that inadequate washout may lead to difficulty in assessing baseline disease severity, due to the prolonged pharmacodynamic effects of fingolimod 1