Administration and Side Effects

Four of the five approved long-term treatments for MS are easily administered. Betaseron, Copaxone, and Rebif are injected just under the skin (subcutaneously), while Avonex is injected into the muscle (intramuscularly). The frequency ranges from once per week to once per day, depending on which medication is used. Although this means some changes to one's normal routine, most people quickly adapt to these changes.

Additionally, these types of injections may be self-administered, or given by a family member or other care partner, in the comfort of one's home. Pharmaceutical companies have made injections even easier by offering pre-filled syringes (Avonex, Copaxone, and Rebif) and "auto-injectors," which give a quick, pre-measured injection under the skin with the touch of a button (Betaseron, Copaxone, and Rebif). Auto-injectors also reduce injection-site reactions (redness, soreness, and swelling).

The fifth drug, Novantrone, is given via intravenous injection once every three months for two to three years. This may only be performed at an IV infusion facility.

Each of the approved treatments has side effects that are usually manageable. With the interferons (Avonex, Betaseron, and Rebif), these may include temporary flu-like symptoms, headache, injection-site reactions, and blood count or liver test abnormalities -- depending on the drug. A few individuals taking Copaxone may experience injection-site reactions and a brief systemic reaction (such as anxiety, flushing, chest tightness, dizziness, palpatations, and/or shortness of breath), that quickly subsides without the need for any treatment.

Although Novantrone is usually well tolerated, side effects may include nausea, thinning hair, loss of menstrual periods, bladder infections, and mouth sores. Individuals using this treatment should not be alarmed if their urine and whites of the eyes turn a bluish color -- this is just a temporary side effect of the drug. As mentioned earlier, Novantrone carries the risk of cardiotoxicity and may not be given beyond the two-to-three year limit.

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