Usual Adult Dose for Multiple Sclerosis:
CYP450 2C9 Genotype *1/*1, *1/*2, or *2/*2:
-Titration regimen: 0.25 mg orally once daily on Days 1 and 2, then 0.5 mg orally once daily on Day 3, then 0.75 mg orally once daily on Day 4, then 1.25 mg orally once daily on Day 5
-Maintenance dose: 2 mg orally once daily beginning on Day 6
NOTE: Use a starter pack for patients who will be titrated to the 2 mg maintenance dose.
CYP450 2C9 Genotype *1/*3 or *2/*3:
-Titration regimen: 0.25 mg orally once daily on Days 1 and 2, then 0.5 mg orally once daily on Day 3, then 0.75 mg orally once daily on Day 4
-Maintenance dose: 1 mg orally once daily beginning on Day 5
NOTE: Do not use the starter pack for patients who will be titrated to the 1 mg maintenance dose.
-If one titration dose is missed for more than 24 hours, therapy needs to be reinitiated with Day 1 of the titration regimen.
Comments:
-If one titration dose is missed for more than 24 hours, therapy needs to be reinitiated with Day 1 of the titration regimen.
-First-dose monitoring is recommended for patients with sinus bradycardia, first- or second-degree atrioventricular (AV) block, or a history of myocardial infarction or heart failure.
-Administer the first dose in a setting equipped to manage symptomatic bradycardia.
-Monitor patients for 6 hours after the first dose for bradycardia with hourly pulse and blood pressure measurements. Obtain an ECG in these patients at the end of Day 1.
-If any of the following abnormalities are present after 6 hours (even in the absence of symptoms), continue monitoring until the abnormality resolves: the heart rate 6 hours post dose is less than 45 bpm; the heart rate 6 hours post dose is at the lowest value post dose, suggesting that the maximum pharmacodynamic effect on the heart may not have occurred; the ECG 6 hours post
dose shows new onset second-degree or higher AV block.
-If post dose symptomatic bradycardia, bradyarrhythmia, or conduction related symptoms occur, or if ECG 6 hours post dose shows new onset second degree or higher AV block or QTc greater than or equal to 500 msec, initiate management, begin continuous ECG monitoring, and continue monitoring until the symptoms have resolved if no treatment is required. If treatment is required, continue monitoring overnight and repeat 6-hour monitoring after the second dose.
-After the initial titration is complete, if treatment is interrupted for 4 or more consecutive daily doses, reinitiate therapy with Day 1 of the titration regimen; also complete first-dose monitoring in patients for whom it is recommended.
 Detailed Mayzent dosage information
What happens if I miss a dose?
Call your doctor for instructions. If you miss 1 or more of your first doses, or 4 or more of your maintenance doses, you may need to take your next dose under medical observation in a medical setting.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
