Treatment Options: Oral Medications


MSMonday: Treatment Options: Oral Medications 

Last week we discussed inject-able medications. This week let’s discuss the oral medication options that are available. Oral medications didn’t hit the market until just recently. Before then, people with MS were stuck with injection only options, which was clearly not ideal. As patients, we would hear about oral medications being an option someday in the future, but we didn’t know when it would actually happen. Until it eventually did in 2010 when Gilenya was approved by the FDA. Currently there are only three oral medications on the market approved for relapsing remitting MS. Let’s take a closer look at each of these medications.

Gilenya

Gilenya is in a new class of medication called sphingosine 1-phosphate receptor modulator (that’s a mouthful). Scientist think that it works by keeping certain white blood cells in the lymph nodes, thereby making it impossible for them to cross the blood brain barrier and get into the central nervous system. Making it so the cells cannot get into the central nervous system, reduces inflammation and damage to nerve cells. In several studies done, Gilenya was shown to be effective. Gilenya cut relapses by 52% when compared to Avonex in a one year study. It also prevented relapses by 54% when compared to placebo over a two year period. The FDA approved the use of Gilenya in 2010 for relapsing remitting MS.
There are several side effects associated with Gilenya. Headache, slowed heart beat, weakness, fatigue, infection, elevated liver enzyme’s and diarrhea were noted. An uncommon side effect is macular edema, which is the swelling of an area of the retina which is responsible for central vision. Gilenya is also known to slow the heart rate significantly, especially in the first month of treatment. An individual also might feel really tired, have heart palpitations or chest pain or feel dizzy. Usually if someone experiences the symptoms, they will disappear within the first day or two of treatment.
In 2012 the FDA updated the regulations around a patient’s first dose of Gilenya. It is now required that an individual have an ECG before receiving the first dose and again six hours after the first dose. Is also recommended that the first dose be taken under medical observation. This is due to a patient unfortunately passing away in late 2011 after taking their first dose of Gilenya. As far as I know, the has not been definitively linked to Gilenya.

Tecfidera

Tecfidera, also known as dimethyl fumarate, is an oral medication taken twice a day that was specifically developed for people with relapsing remitting MS. A similar chemical compound called Fumaderm, has been used in Germany for many years to treat flares of psoriasis. The specific way Tecfidera works is still unknown, but scientist think that it activates certain pathways in the body that help to protect nerve cells from damage and inflammation. In one study, in a two year period 27% of people who are taking Tecfidera experience a relapse compared to 46% of people in the placebo group. Tecfidera was approved by the FDA in 2014 for the use in relapsing remitting MS.
Common side effects of Tecfidera  include flushing, stomach pain, nausea and diarrhea. Side effects seem to be present more so at the beginning of treatment, and then will dissipate as treatment progresses. There have been cases of PML reported in patients who are taking Tecfidera, 4 of them actually. PML is a rare and deadly brain disease that can happen when individual is taking an immuno-suppressant medication. In order to develop PML, individual must be positive for the JC virus first. Routine blood test to monitor JC virus status is recommended when taking most MS meds.

Aubagio

Aubagio, also known as teriflunomide, is a pyrimidine synthesis inhibitor. It works by reducing the number of white blood cells in the central nervous system, decreasing inflammation overall and protecting nerves in people with MS. In several studies, Aubagio was proven to be effective over placebo, reducing relapses by 31%, reducing disability progression by 30% and showing an 80% decrease in brain lesions. Aubagio was approved in 2012 by the FDA for use in relapsing remitting MS.
Common side effects of Aubagio include headache, nausea, hair loss, diarrhea, elevated liver tests, like symptoms and numbness or tingling in in the hands or feet. Less common but more serious side effects include elevated blood pressure, increased risk for infections and liver damage. While taking Aubagio  you will need to have regular blood test to monitor liver function and blood cell counts. Aubagio is also associated with severe birth defects, and neither women nor man should be taking Aubagio if pregnancy as planned. Aubagio can remain in your body for up to two years after discontinuing the medication, so a special treatment may be needed to remove the drug from your system if you’re planning on becoming pregnant. Usually when taking the medication, it is required that an individual be on an effective birth control method.
I took Aubagio for about a year. Unfortunately I went into the treatment already in a “active disease state “, and had two relapses while taking the medication. I liked how I could just take a pill instead of the daily injections of my previous Copaxone, but I soon experienced side effects of (a lot of) hair loss and irregular blood cell counts. Due to the relapses, I eventually changed medications. 
The arrival of oral medications has been a welcome relief for many MS patients. They represent the constant advancement of research and development. Hopefully the future will bring many more options to the table.

I’M ALISSA!

I help women who have also been diagnosed with Multiple Sclerosis make specific and personalized diet, lifestyle & subconscious changes so that they can begin to heal their body, reduce disease symptoms, and return to a life they love.hey there,

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It’s amazing what taking a few minutes to breathe and reassure yourself can do, ya know??

If you have MS and this gives you an immediate uncomfy feeling in your gut because you never advocate for yourself and your needs, 

You need to come to my next Masterclass:
Managing Stress to Manage MS

We’ll be talking about:
* How Stress Works: Discover how your body’s stress response system operates and why it plays such a big role in your overall health.
* Stress and MS: Understand how stress impacts MS symptoms and why it can sometimes make symptom flares worse.
* Building Your Resilience: Get simple, effective strategies to boost your stress resilience and help ease MS symptoms for a healthier, more balanced life.

Happening February 10th at 6pm EST!
Comment NEEDS below and I’ll send you the link to register! 

#multiplesclerosis #lissms #nervoussystemregulation #nervoussystemhealing #healingmultiplesclerosis #thisisms

It’s amazing what taking a few minutes to breathe and reassure yourself can do, ya know??

If you have MS and this gives you an immediate uncomfy feeling in your gut because you never advocate for yourself and your needs,

You need to come to my next Masterclass:
Managing Stress to Manage MS

We’ll be talking about:
* How Stress Works: Discover how your body’s stress response system operates and why it plays such a big role in your overall health.
* Stress and MS: Understand how stress impacts MS symptoms and why it can sometimes make symptom flares worse.
* Building Your Resilience: Get simple, effective strategies to boost your stress resilience and help ease MS symptoms for a healthier, more balanced life.

Happening February 10th at 6pm EST!
Comment NEEDS below and I’ll send you the link to register!

#multiplesclerosis #lissms #nervoussystemregulation #nervoussystemhealing #healingmultiplesclerosis #thisisms
...

4 1
This is hard!!

We feel like “we should be able to” still do the cleaning, chores, putting things away etc etc etc.. 

But in reality- our bodies need and crave rest and recovery first.

If we don’t give our bodies what they need voluntarily, they’ll find a way to make us.

Really struggle with this idea of listening to and caring for your body?
(I get it- it’s not a skill we’re taught)

I’m hosting a (free) masterclass on this and “managing stress” in January, comment CLASS and I’ll send you the link to sign up!! 

#multiplesclerosis #nervoussystemregulation #nervoussystemhealing #stressmanagement #lissms #thisisms #becausems #seasonaldepression #anxiety

This is hard!!

We feel like “we should be able to” still do the cleaning, chores, putting things away etc etc etc..

But in reality- our bodies need and crave rest and recovery first.

If we don’t give our bodies what they need voluntarily, they’ll find a way to make us.

Really struggle with this idea of listening to and caring for your body?
(I get it- it’s not a skill we’re taught)

I’m hosting a (free) masterclass on this and “managing stress” in January, comment CLASS and I’ll send you the link to sign up!!

#multiplesclerosis #nervoussystemregulation #nervoussystemhealing #stressmanagement #lissms #thisisms #becausems #seasonaldepression #anxiety
...

14 5
I get it..

It seems like it would be good.

Because others around you are taken care of..
Because others around you feel good..
Because others around you are happy..

But what about you??

In reality, that’s just making it harder for you to help yourself heal and probs making your MS symptoms worse.

I’ve worked with so many people with MS and autoimmune disease… 1 thing (among many) that they all have in common is a habit of putting others before themselves, saying yes way too much and forgetting about what they want themselves.

Feel a little called out?
Then my course Embodied Resilience is for you.

This is a course all about managing + improving your stress tolerance- since stress is the number 1 trigger of symptom flares and relapses

And- it’s on sale for Black Friday!!
Comment SALE below and I’ll send you the link!!

#lissms #multiplesclerosis #healingmultiplesclerosis #thisisms #becausems

I get it..

It seems like it would be good.

Because others around you are taken care of..
Because others around you feel good..
Because others around you are happy..

But what about you??

In reality, that’s just making it harder for you to help yourself heal and probs making your MS symptoms worse.

I’ve worked with so many people with MS and autoimmune disease… 1 thing (among many) that they all have in common is a habit of putting others before themselves, saying yes way too much and forgetting about what they want themselves.

Feel a little called out?
Then my course Embodied Resilience is for you.

This is a course all about managing + improving your stress tolerance- since stress is the number 1 trigger of symptom flares and relapses

And- it’s on sale for Black Friday!!
Comment SALE below and I’ll send you the link!!

#lissms #multiplesclerosis #healingmultiplesclerosis #thisisms #becausems
...

24 7
✨Moving your body✨

Notice I didn’t say exercise, although yes that also helps.

Stress hormones can get stuck in our bodies, our cells, our muscle tissue for various reasons.

Making it super easy for us to carry stress around with us- which shows up often as:

Pain
Tension
Trouble breathing
Difficulty with balance

It’s no coincidence that these are often prominent MS symptoms too. Sometimes it’s hard to tell where effects of MS end and effects of stress begin.

Being able to offload accumulated stress is key to being able to improve MS symptoms.

My course Embodied Resilience shows you exactly how to do this, and it’s gonna be on sale for Black Friday.

Comment ME below and I’ll send you the sale link when it’s ready!! 

#lissms #multiplesclerosis #nervoussystemhealing #nervoussystemregulation #stressmanagement #thisisms #becausems

✨Moving your body✨

Notice I didn’t say exercise, although yes that also helps.

Stress hormones can get stuck in our bodies, our cells, our muscle tissue for various reasons.

Making it super easy for us to carry stress around with us- which shows up often as:

Pain
Tension
Trouble breathing
Difficulty with balance

It’s no coincidence that these are often prominent MS symptoms too. Sometimes it’s hard to tell where effects of MS end and effects of stress begin.

Being able to offload accumulated stress is key to being able to improve MS symptoms.

My course Embodied Resilience shows you exactly how to do this, and it’s gonna be on sale for Black Friday.

Comment ME below and I’ll send you the sale link when it’s ready!!

#lissms #multiplesclerosis #nervoussystemhealing #nervoussystemregulation #stressmanagement #thisisms #becausems
...

9 2
I’ve seen myself and tons of clients through behavior change to help improve their MS + autoimmune disease symptoms.

There are SO MANY things that can help us.

But the one I’ve seen move the needle the most?

Working on your mindset and stress management tools.

We can change our diet
Change how we move 
Change the products we’re using
Change the supplements we take..

But if we’re still in the high stress state that most of us are in.. all those will only go so far.

Stress is my biggest symptom trigger, and 99% of my clients feel the same.

My biggest course sale is coming Black Friday, included is my course Embodied Resilience, all about learning how to actually manage stress- so you’re not constantly battling MS flares too.

My email list is gonna get first dibs..
Comment LIST below and I’ll add you so you’re notified first!!

I’ve seen myself and tons of clients through behavior change to help improve their MS + autoimmune disease symptoms.

There are SO MANY things that can help us.

But the one I’ve seen move the needle the most?

Working on your mindset and stress management tools.

We can change our diet
Change how we move
Change the products we’re using
Change the supplements we take..

But if we’re still in the high stress state that most of us are in.. all those will only go so far.

Stress is my biggest symptom trigger, and 99% of my clients feel the same.

My biggest course sale is coming Black Friday, included is my course Embodied Resilience, all about learning how to actually manage stress- so you’re not constantly battling MS flares too.

My email list is gonna get first dibs..
Comment LIST below and I’ll add you so you’re notified first!!
...

18 8
And my period started to add to the joy 🙃🙃

We can do hard things y’all,
breathe in, breathe out,
all will be well.

#Electionstress #seasonaldepression #anxiety #multiplesclerosis

And my period started to add to the joy 🙃🙃

We can do hard things y’all,
breathe in, breathe out,
all will be well.

#Electionstress #seasonaldepression #anxiety #multiplesclerosis
...

19 4
Home stretch!!

Do what you need to do today to take care of yourself friends.

#Electionday #Govote #Vote

Home stretch!!

Do what you need to do today to take care of yourself friends.

#Electionday #Govote #Vote
...

10 1
I think 90% of my clients have talked about already feeling the shift to Fall and Winter hardddd.

They are worried about seasonal depression coming back with a vengeance, feeling sad summer is gone and so many other things.

I know when so many feel the same way, you might too.
I know I feel this way too.

I’m working with them to put habits in place NOW that will support them through the winter months.

Here are 2 small shifts we talked about this week:

1. Get sunlight into your eyeballs as soon as you can in the morning.☀️☀️

Ideally this is outside, there will be many science bro’s out there telling you that anything else “doesn’t count” but I say that’s BS.
Yes, the sunlight will have a greater impact if you’re viewing outside, but even if you’re behind a window it will do something.

2. Move your body!! 💃🏃‍♀️

The change in seasons to colder weather makes it super easy to hibernate and move wayyy less than we were in the summer.
I know I’ve been guilty of that this week and it’s showing in my sleep.
But moving our bodies can be so helpful for regulating so many things in our bodies.
Ideally you’re moving in the morning, but again- any time of day will do. 

These are 2 small shifts that can make it easier for your body to transition to, and live with the Winter months.

Let’s crowdsource… what else helps you in winter?? 
I know there are many other things that can!!

I think 90% of my clients have talked about already feeling the shift to Fall and Winter hardddd.

They are worried about seasonal depression coming back with a vengeance, feeling sad summer is gone and so many other things.

I know when so many feel the same way, you might too.
I know I feel this way too.

I’m working with them to put habits in place NOW that will support them through the winter months.

Here are 2 small shifts we talked about this week:

1. Get sunlight into your eyeballs as soon as you can in the morning.☀️☀️

Ideally this is outside, there will be many science bro’s out there telling you that anything else “doesn’t count” but I say that’s BS.
Yes, the sunlight will have a greater impact if you’re viewing outside, but even if you’re behind a window it will do something.

2. Move your body!! 💃🏃‍♀️

The change in seasons to colder weather makes it super easy to hibernate and move wayyy less than we were in the summer.
I know I’ve been guilty of that this week and it’s showing in my sleep.
But moving our bodies can be so helpful for regulating so many things in our bodies.
Ideally you’re moving in the morning, but again- any time of day will do.

These are 2 small shifts that can make it easier for your body to transition to, and live with the Winter months.

Let’s crowdsource… what else helps you in winter??
I know there are many other things that can!!
...

11 4

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