Lymphopenia and hepatic enzyme elevations are
possible side effects, and laboratory monitoring is necessary.
Herpes infections, including varicella zoster,
were seen in clinical trials, and it is recommended that
all patients have a varicella-zoster titer before the initiation
of treatment and vaccination before treatment
if no titer is detected. Macular edema has been observed
in patients receiving fingolimod (Cohen et al.,
2010; Kappos et al., 2010). Blood pressure elevations
have also been observed with fingolimod use
(Ginsberg et al., 1995).