Ponvory (ponesimod) for multiple sclerosis
Last updated May 27, 2025, by Lindsey Shapiro, PhD
Fact-checked by Inês Martins, PhD
What is Ponvory for MS?
Ponvory (ponesimod) is an oral therapy that is approved for adults with relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and active secondary progressive MS (SPMS).
Taken once daily in the form of oral tablets, it has been proven in clinical trials to reduce relapse rates and new lesions, and it may also reduce the risk of disability progression.
Ponvory works by selectively modulating sphingosine-1-phosphate (S1P) receptors. These are proteins found at the surface of immune cells that control their migration from the lymph nodes — organs where some immune cells are matured and stored — into the bloodstream.
Essentially, Ponvory aims to “trap” immune cells in the lymph nodes, preventing them from getting into the nervous system and causing the inflammation that drives MS.
The effects of Ponvory are reversible, wearing off within about one week after treatment discontinuation. This allows the therapy to be easily paused and later restarted if necessary, for example, if a person gets an infection, needs a vaccine, or is considering pregnancy.
Ponvory is currently marketed by Vanda Pharmaceuticals in the U.S. and Canada while Juvisé Pharmaceuticals holds the rights elsewhere.
Therapy snapshot
| Brand name: | Ponvory |
| Chemical name: | Ponesimod |
| Usage: | Used to reduce disease activity in relapsing forms of MS |
| Administration: | Oral tablets |
Who can take Ponvory?
Ponvory is approved in the U.S. for adults with CIS, RRMS, and active SPMS.
The medication is contraindicated for people:
- who have had certain cardiovascular events in the last six months, including heart attack, some forms of chest pain (unstable angina), stroke or mini-stroke, or certain types of heart failure
- with certain types of heart block or abnormal heart rhythms, unless they have a functioning pacemaker device.
It also should not be given to people with uncontrolled high blood pressure, severe and untreated sleep apnea, moderate to severe liver impairment, or who previously received another MS therapy called Lemtrada (alemtuzumab).
Ponvory is also approved elsewhere, including in the European Union, where it is indicated for adults with relapsing forms of MS and active disease, defined by clinical or imaging features.
How is Ponvory administered?
Ponvory is taken as oral tablets, which must be swallowed whole and can be taken with or without food.
The recommended dosage is 20 mg once daily. However, when first initiating the medication, patients begin with a lower, 2 mg dose, and gradually increase it over two weeks to the full 20 mg dose.
A two-week starter pack is available for those initiating the therapy for the first time or those who missed a dose for at least four consecutive days.
Because Ponvory treatment can cause a decrease in heart rate, people with certain heart conditions might need to be monitored for a few hours after taking their first dose.
Ponvory in clinical trials
Ponvory’s approval was mainly supported by data from the Phase 3 OPTIMUM trial (NCT02425644), which enrolled 1,133 adults with RRMS or active SPMS and randomly assigned them to receive either Ponvory or the approved oral therapy Aubagio (teriflunomide) for about two years. OPTIMUM showed that:
- Ponvory significantly lowered relapse rates compared with Aubagio, by 30.5%
- It outperformed Aubagio in controlling fatigue and reducing the number of combined unique active lesions, which comprise new lesions with active inflammation as well as new or enlarging lesions
- It was as effective as Aubagio at reducing the risk of confirmed disability progression, with about nine out of 10 patients showing no disability progression over two years.
Ponvory side effects
The most common side effects associated with Ponvory include:
- upper respiratory tract infections
- elevated levels of liver enzymes, indicating liver damage
- high blood pressure.
Some patients taking Ponvory may experience more serious or potentially life-threatening side effects, for which careful monitoring or adjustments to the treatment plan may be necessary:
- infections, which can possibly be life-threatening
- temporary decreases or disturbances in heart rate and rhythm
- reduced lung function
- liver damage, which may require treatment discontinuation
- increased blood pressure
- skin cancer
- swelling in parts of the eye, which can lead to permanent vision loss
- swelling and narrowing of blood vessels in the brain, which may lead to stroke if left untreated.
Patients will be monitored for these issues before and throughout treatment and will be advised on the signs and symptoms to look out for.
Ponvory may cause fetal harm, and women of childbearing potential should use effective contraception during and for one week after stopping Ponvory. Ponvory should be stopped if a woman becomes pregnant.
When stopping Ponvory, patients should also be monitored for severe exacerbations in disease severity, which are rare, but possible.
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
FAQs about Ponvory
Ponvory was approved by the U.S. Food and Drug Administration in March 2021 for adults with relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS.
Animal studies suggest that Ponvory may cause harm to a developing fetus, so it is not recommended for use during pregnancy. People with the potential to become pregnant should use effective contraception while on Ponvory and for one week after stopping treatment.
No interactions between Ponvory and alcohol have been reported. Still, alcohol can sometimes exacerbate disease symptoms or interfere with medications, so patients should discuss with their healthcare provider whether it is safe to drink alcohol while on Ponvory.
Ponvory works quickly to reduce immune cell levels in circulation, but it could take several months before clinical effects are noticeable. As multiple sclerosis manifests very differently among patients, and responses to treatment also vary, patients should talk with their healthcare team to understand how the medication might help in their specific case.
Weight gain has not been reported in clinical trials as a side effect associated with Ponvory. Hair loss, however, was reported by a small percentage of patients in the OPTIMUM Phase 3 trial. Patients are advised to discuss with their healthcare provider if they experience any unexpected problems when starting a new multiple sclerosis therapy.
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