Mayzent (Siponimod) for Multiple Sclerosis

What Members SayTop TipsSide EffectsCopay HelpFAQs

Mayzent (siponimod) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat relapsing forms of multiple sclerosis in adults.

What Members Say

MHT logo These insights are based on 1,079 comments about Mayzent from MyMSTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Once-daily oral dosing
Starter-pack titration to help ease treatment initiation
Patient assistance programs to reduce out-of-pocket costs

Considerations:

Headaches, dizziness, and high blood pressure
Swelling in the hands, ankles, or face
Infection risk and low white blood cell counts that require monitoring

How Mayzent Works and How It’s Taken

Mayzent works by attaching to certain signals on immune cells. These signals are called S1P receptors. This keeps some immune cells in the lymph nodes and lowers the number in the blood. The exact way Mayzent helps multiple sclerosis is not fully known. It may help by reducing immune cells that enter the brain and spinal cord.

Doctors prescribe Mayzent when an adult has a relapsing form of multiple sclerosis. The medication is given as a tablet taken by mouth once a day. Treatment starts with a step-up schedule over four or five days before moving to a daily dose.

Top Advice From Members on Mayzent

These insights are based on 1,079 comments about Mayzent from MyMSTeam members.

Members who use Mayzent often say the most helpful steps are staying in close contact with their neurology team, keeping up with required testing, and paying attention to side effects early. Many also mention practical issues like the starter pack, insurance approvals, and patient assistance as important parts of getting started and staying on treatment.

1

Get the recommended tests before starting.

“My neurologist had me get the Shingrix, Prevnar 20, and meningitis A and B vaccines before I started Mayzent. I also had the recommended ECG, and saw my eye doc to test for macular degeneration.”
2

Keep track of side effects and tell your doctor.

“I was on Mayzent for six months but stopped using it because it drove my blood pressure up to crazy high numbers. I know this because I monitor mine weekly due to my family history.”
3

Ask about cost help and pharmacy support early.

“With the copay program, I have not had to pay anything so far.”

Connect with others who understand life with multiple sclerosis. Join MyMSTeam for free.

Mayzent Side Effects

In clinical studies of Mayzent for relapsing forms of multiple sclerosis in adults, the most common side effects occurred in between 11 percent and 15 percent of people. These side effects included:

Headache
Hypertension (high blood pressure)
Increased liver enzymes on blood tests

Serious Side Effects and Warnings

Mayzent can cause serious side effects that require immediate medical attention. These include:

Serious infections (Mayzent lowers certain white blood cells, which can raise infection risk)
Progressive multifocal leukoencephalopathy, or PML (a rare brain infection that can lead to severe disability or death)
Macular edema (swelling in the back of the eye that can affect vision)
Slow heart rate and heart rhythm or conduction problems, including atrioventricular, or AV, block (changes in how the heart’s electrical signals travel)
Breathing problems
Liver injury (liver damage that can cause symptoms such as nausea, belly pain, or yellowing of the skin or eyes)
Skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma
Increased blood pressure
Posterior reversible encephalopathy syndrome, or PRES (a rare brain condition that can cause severe headache, confusion, vision changes, or seizures)
Severe worsening of multiple sclerosis after stopping Mayzent
Fetal harm during pregnancy

Get medical help right away if you think you are having a serious reaction.

How To Save on Mayzent

Novartis Pharmaceuticals, the manufacturer of Mayzent, offers the Novartis Patient Support program. Commercially insured patients may pay as little as $0 in copay.

The Novartis Patient Support program also offers support and resources. To learn more, visit the Novartis website or call 877-629-9368.

What To Know Before Taking Mayzent

Before starting Mayzent, your doctor may perform:

A test to determine your CYP2C9 genotype
An electrocardiogram (to look for certain heart rhythm or conduction problems)
A complete blood count (CBC)
A liver blood test
An eye exam (to look at the back of the eye)
A skin exam
A review of your current or prior medicines

Your doctor will test you for antibodies to varicella zoster virus (VZV). If you are not immune, you should get the VZV vaccine before starting Mayzent. Avoid live vaccines during treatment and for four weeks after stopping Mayzent.

Tell your doctor if you have any allergies to siponimod or any ingredients in Mayzent.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Also let your doctor know if you have had recent infections, plan to travel to areas where certain infections are common, or have had cancer or nervous system problems in the past.

Do not take Mayzent if you have a CYP2C9*3/*3 genotype, certain serious heart problems in the past six months, or certain heart rhythm conditions unless you have a pacemaker.

If you miss a dose during the starting schedule for more than 24 hours, you need to restart from day 1. If you miss four or more days in a row after starting daily treatment, you also need to restart from day 1.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Mayzent, talk with your doctor about the risks and benefits. Mayzent may harm an unborn baby. People who can become pregnant should use birth control during treatment and for 10 days after stopping Mayzent.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Mayzent?
In a study of 1,651 people with secondary progressive multiple sclerosis, 26 percent of people taking Mayzent got worse over time, compared to 32 percent of people taking a placebo (an inactive treatment). This means a 21 percent lower relative risk and a 6 percent lower absolute risk. Mayzent also lowered the number of relapses by 55 percent compared with placebo. It did not significantly delay worsening on the timed 25-foot walk test. The benefit was not clearly shown in people with nonactive disease.

What tests are needed before starting Mayzent for multiple sclerosis?
Before starting Mayzent, your doctor will check your CYP2C9 genotype, heart rhythm with an ECG, blood counts, and liver tests. You will also need an eye exam that looks at the back of the eye and a skin exam. Your doctor will test for varicella zoster virus antibodies and may recommend vaccination before treatment if needed.

What should I do if I miss a dose of Mayzent for multiple sclerosis?
If you miss one or more titration doses for more than 24 hours, you need to restart from day 1. If you miss four or more days in a row after starting daily treatment, you also need to restart from day 1. Take the tablets whole. You can take them with or without food.

Does Mayzent for multiple sclerosis raise the risk of infections?
Yes. Mayzent lowers certain white blood cells to about 20 percent to 30 percent of normal levels, which can increase the risk of infections. Some infections can be serious. In studies, overall infection rates were similar to placebo, but some infections like herpes, bronchitis, sinus infections, and fungal skin infections were more common. Avoid live vaccines during treatment and for four weeks after stopping. Vaccines may work less well during treatment and for up to one month after stopping.