A high-dose inactivated flu vaccine (Fluzone High Dose) is available for people over age 65. The Centers for Disease Control does not specifically recommend the high-dose vaccine for people over age 65 and the high-dose vaccine has not been studied in people with MS of any age. For these reasons, the National MS Society continues to support influenza vaccination (flu shots) for people with MS but recommends that only the standard dose be used. If additional data for Fluzone high dose in MS patients become available, the recommendation may be revised.
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Fingolimod may decrease heart rate, especially after the first dose. Patients should be observed for signs and symptoms of low heart rate for 6 hours after the first dose. Fingolimod may increase the risk of infections. Signs and symptoms of infection should be monitored during treatment and for two months after discontinuation of treatment. Fingolimod should not be administered to patients who have an infection. Fingolimod may cause inflammation of the eye ( uveitis ) and other eye problems. Therefore, visual acuity should be checked prior to starting therapy, 3 to 4 months after initiation of therapy, and during routine patient evaluation. Fingolimod has also been associated with difficulty breathing . Fingolimod reduces the white blood cell count, and this effect may last for 2 months after treatment is discontinued.