Medication Options: Injectable Medications
Injectable medications were the first treatment options to be approved for multiple sclerosis, with Betaseron being the first in this category to be approved in 1993. Since then, numerous other treatments have entered the picture, including many other injectable, infusion and oral medications. The primary role of each of these injectable medications is to target inflammation in the central nervous system. Let’s take a closer look at each of them.
Interferon beta-1a (Avonex, Rebif), peginterferon beta-1a (Plegridy), and interferon beta-1b (Betaseron) are all forms of injectable drugs that help reduce symptoms of relapsing remitting MS and progressive relapsing MS. It is thought that proteins in these drugs keep certain white blood cells that can damage your myelin from entering your central nervous system. In turn, this prevention would help slow the damage these cells create and would help prevent the number of future relapses you have. All of these medications have a different injection schedule. Avonex is injected one time a week. Betaseron is injected every other day. Extavia is injected every other day. Rebif is injected three times a week and Plegridy is injected every two weeks. These injections can be made on the back of your arm, or thigh, and some can be injected into the stomach and lower back as well. Injection sites should be rotated daily.
These medications come with their fair share of side effects unfortunately. The biggest side effects for interferon meds are flu like symptoms, such as fatigue, chills, fever, muscle aches and sweating. The area where are you inject may also become swollen, red and painful. Some individuals report having trouble with their mood as well. Feeling sad, anxious, irritable, having trouble concentrating and having difficulty sleeping have all been reported. (Why can’t any of the side effects be good? Why can’t one give you happiness?)
Glatiramer Acetate (Copaxone)
Copaxone is a man-made substance that is made to resemble the basic protein of natural myelin. It’s supposed to work because your body will start to attack the medication, instead of the actual myelin. It’s used to treat relapsing remitting and progressive relapsing forms of MS. For years, you would have to inject yourself every day when taking Copaxone. In 2014 the FDA approved a higher dose version where injections are needed only three times a week, yay. You can inject Copaxone into your upper arm, stomach, lower back or upper thigh and sites should be rotated daily.
One of the major side effects of Copaxone is the injection site reaction’s. These can be anything thing from pain to a serious reaction. Some of the more common reactions are pain, redness, swelling and blisters. Another common reaction is permanent loss of fat tissue and skin tissue death at the injection site. One of the biggest reactions is the immediate injection site reaction that makes you feel like you’re about to pass out and die. This reaction is characterized by chest pain, fast heart rate, flushing, shortness of breath, throat construction and just a general feeling of terror. Thankfully, these symptoms do go away (somewhat quickly).
When I was on Copaxone, I struggled with the side effects. After every injection, the injection site would become swollen, warm and painful. I also experienced significant skin and fat tissue break down and now I have indents everywhere! My ultimate reaction was when I experienced the dreaded immediate injection site reaction and thought I was going to die in my boyfriends room. I knew what was happening cognitively, but I felt like I was going to pass out and vomit all at the same time. He freaked out as well, and brought me to the ER. That was the end of Copaxone.
Zinbryta is a monoclonal antibody that affects the immune system. Monoclonal antibodies are made to target and destroy only certain cells in the body, and this may help protect healthy cells in the body from damage. Zinbryta is usually reserved for use once several other medications have failed. This is a once a month injection that is given just under the skin, like Copaxone. Zinbryta can have MAJOR side effects on the liver, and therefore constant monitoring via blood tests is necessary when taking this medication.
Having to inject your medication is not fun. On top of making you feel like you have the flu and are a swollen lump, piercing your skin on the reg can lead to severe feelings of resentment towards your disease. (At least it did for me.) Finding a medication that works for you 1. because it keeps relapses at bay, but 2. works with your life, is key.