Table 6.

FDA Black Box warning and contraindications.

Natalizumab	Progressive Multifocal Encephalopathy (PML)
	Contraindicated if history of PML.
Teriflunomide	Contraindicated in patients with pre-existing acute or chronic liver disease
	contraindicated in women of childbearing potential
	Hepatotoxicity and risk of teratogenicity
Alemtuzumab	Risks of serious and sometimes fatal autoimmune conditions, infusion reactions, and various malignancies.
	It is contraindicated in human immunodeficiency virus due to CD4 + lymphocyte count reductions
Daclizumab	Daclizumab is contraindicated in Hepatitis B and C or liver impairment
	Removed from US market due to Autoimmune encephalitis
	Risk of severe liver injury and immune-mediated disorders, such as skin reactions, lymphadenopathy, and noninfectious colitis
Fingolimod	Fingolimod is contraindicated: if there is a cardiac event or vascular event like a stroke or TIA, irregular heart rate in the past 6 months and or medication that slows the QTc
Siponimod	Patients with a CYP2C9*3/*3 genotype (4)
	In the last 6 months, experienced myocardial infarction, unstable angina, stroke, TIA, decompensated heart failure requiring hospitalization, or Class III/IV heart failure (4)
	Presence of Mobitz type II second-degree, third-degree AV block, or sick sinus syndrome, unless patient has a functioning pacemaker (4)