Patients need to be screened for bradycardia, long QT, AV block, and other arrhythmia risk factors before initiation, the first dose must be given as an in-patient treatment for hourly blood pressure measurements, and cardiac monitoring for bradycardia from atrioventricular block (related to fingolimod binding to S1PR3) can occur. This evidence concerns the gene S1PR3 and Bradycardia.