American Board of Internal Medicine (ABIM) Certification Practice Exam

Fingolimod is contraindicated in which population?

1. Patients with renal failure

2. Women who are pregnant

3. Individuals with a history of seizures

4. Athletes undergoing drug testing

The correct answer is: Women who are pregnant

Fingolimod is an oral medication used primarily in the treatment of multiple sclerosis. One of the well-established contraindications for fingolimod use is in women who are pregnant. This is due to the risk of teratogenic effects, meaning it could potentially cause harm to a developing fetus. Fingolimod can affect the immune system and has been shown to have adverse effects on fetal development in animal studies, leading to the recommendation that it should not be used during pregnancy. The importance of avoiding this medication during pregnancy is underscored by the necessity of effective contraception in women of childbearing age who are on this treatment. Other considerations for fingolimod include its potential effects in those with renal failure or a history of seizures, but these are not outright contraindications. Athletes undergoing drug testing may have different concerns related to performance-enhancing drug regulations, but this is not a clinical contraindication for the medication itself. Thus, the choice regarding the pregnant population highlights the critical need for careful consideration of treatment options during pregnancy.