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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This is how I slowly helped myself the most:
Making small changes to my life,
* Intentional awareness to my morning
* Noticing when I’m being mean to myself
* Noticing when I’m reactive or in a state of fight or flight..

Some “small” ideas for you too:
* don’t grab your phone first thing in the morning, take some deep breaths, think about how you want your day to go
* drink an extra glass of water (bonus if it’s in the morning too)
* get up and move every hour
* say something nice to yourself when you catch yourself being mean
* step outside for a few minutes a few times a day

Small changes add up to big steps forward,
don’t get fooled by these not being “enough”,
they absolutely are.

Wanna hear more about how Ive helped myself and my clients to lessen our MS symptoms so we feel better in our bodies?

I detail it in my chapter in Resilience Redefined.. comment “Book” and I’ll send you the link!!

20 5

Open

This is how I slowly helped myself the most:
Making small changes to my life,
* Intentional awareness to my morning
* Noticing when I’m being mean to myself
* Noticing when I’m reactive or in a state of fight or flight..

Some “small” ideas for you too:
* don’t grab your phone first thing in the morning, take some deep breaths, think about how you want your day to go
* drink an extra glass of water (bonus if it’s in the morning too)
* get up and move every hour
* say something nice to yourself when you catch yourself being mean
* step outside for a few minutes a few times a day

Small changes add up to big steps forward,
don’t get fooled by these not being “enough”,
they absolutely are.

Wanna hear more about how Ive helped myself and my clients to lessen our MS symptoms so we feel better in our bodies?

I detail it in my chapter in Resilience Redefined.. comment “Book” and I’ll send you the link!!

20 5

You don’t always have to love the hard action you’re taking to reach your goals.

You just have to show up.

You can do this… keep going 🧡🧡

*after discerning there’s no *actual* issue (pain, injury, illness etc) preventing me from working out, only that I’m a toddler and don’t wanna.

26 4

Open

You don’t always have to love the hard action you’re taking to reach your goals.

You just have to show up.

You can do this… keep going 🧡🧡

*after discerning there’s no *actual* issue (pain, injury, illness etc) preventing me from working out, only that I’m a toddler and don’t wanna.

26 4

Have you pre ordered your copy of Resilience Redefined yet??

This is a chronicling of 7 individuals who have autoimmune disease (5 of which have MS too!!) and how they take care of themselves in the best ways they can.

Pre orders are open until October 24th!!

If you pre order your copy through me before October 24th you’ll also get:

• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Comment Book below and I’ll send you the link!!

10 3

Open

Have you pre ordered your copy of Resilience Redefined yet??

This is a chronicling of 7 individuals who have autoimmune disease (5 of which have MS too!!) and how they take care of themselves in the best ways they can.

Pre orders are open until October 24th!!

If you pre order your copy through me before October 24th you’ll also get:

• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Comment Book below and I’ll send you the link!!

10 3

“Resilience is the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.”

Resilience has become such a cornerstone word of the work I do this past year.
It makes sense this book I collaborated on with 6 other awesome & resilient authors was destined to have resilience in the title.

Did you see??

Pre Orders are open!

If you pre order your copy through me before October 24th you’ll also get:
• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Grab your copy here:

https://liss-ms.com/product/resilience-redefined-thriving-with-autoimmune-disease/

Or comment Book below and I’ll send you the link!!

13 0

Open

“Resilience is the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.”

Resilience has become such a cornerstone word of the work I do this past year.
It makes sense this book I collaborated on with 6 other awesome & resilient authors was destined to have resilience in the title.

Did you see??

Pre Orders are open!

If you pre order your copy through me before October 24th you’ll also get:
• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Grab your copy here:

https://liss-ms.com/product/resilience-redefined-thriving-with-autoimmune-disease/

Or comment Book below and I’ll send you the link!!

13 0

Struggling to start with exercise?

Try this tip!!

Creating a new habit (any of them) necessitate us to become someone new, someone different than we were.

Because we’re trying to do something different after all.

This is gentle way of starting that identity shift process.

Become who you want to be in your mind first.

Does this help?
What other habits do you need help with? Let me know in the comments!!

31 3

Open

Struggling to start with exercise?

Try this tip!!

Creating a new habit (any of them) necessitate us to become someone new, someone different than we were.

Because we’re trying to do something different after all.

This is gentle way of starting that identity shift process.

Become who you want to be in your mind first.

Does this help?
What other habits do you need help with? Let me know in the comments!!

31 3

It’s only fitting that I announce my 2nd book (along with 7 other authors) on my 14 year anniversary with MS.

This is a book that I would have loved to read early on in my journey.
It’s about how we moved through our diagnosis and came out the other side for the better.

““Resilience Redefined” is not just a collection of stories; it is a call to action. The authors challenge those living with an autoimmune disease to not only survive but to thrive”

So… drumroll please…
Pre orders are officially open!!

If you pre order your copy through me before October 24th you’ll also get:
• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Grab your copy here: https://liss-ms.com/product/resilience-redefined-thriving-with-autoimmune-disease/

Or comment “book” below and I’ll send you the link!!

33 15

Open

It’s only fitting that I announce my 2nd book (along with 7 other authors) on my 14 year anniversary with MS.

This is a book that I would have loved to read early on in my journey.
It’s about how we moved through our diagnosis and came out the other side for the better.

““Resilience Redefined” is not just a collection of stories; it is a call to action. The authors challenge those living with an autoimmune disease to not only survive but to thrive”

So… drumroll please…
Pre orders are officially open!!

If you pre order your copy through me before October 24th you’ll also get:
• Signed copy of Resilience Redefined
• The MS Handbook E-book
• Resilience Bookmark
• LissMS Sticker Pack (first 10 pre orders)

Grab your copy here: https://liss-ms.com/product/resilience-redefined-thriving-with-autoimmune-disease/

Or comment “book” below and I’ll send you the link!!

33 15

If you like being outside, check out the America the Beautiful Access Pass!

This is a pass for those with disabilities to get into National Parks, Monuments and more for FREE!!

You can get it online or at the entrance of a national park!

Share with anyone who also might like this!!

32 2

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If you like being outside, check out the America the Beautiful Access Pass!

This is a pass for those with disabilities to get into National Parks, Monuments and more for FREE!!

You can get it online or at the entrance of a national park!

Share with anyone who also might like this!!

32 2

This is obvs one option of many on how to help yourself through these moments.

But when you’re stuck in negative worrying, don’t forget there can be a positive outcome too!

This is rewiring your brain in action.

You notice you’re doing something you always did,
Then do something different.

And boom! A new pathway is born.

It needs some love and attention to grow,
so keep practicing!

22 0

Open

This is obvs one option of many on how to help yourself through these moments.

But when you’re stuck in negative worrying, don’t forget there can be a positive outcome too!

This is rewiring your brain in action.

You notice you’re doing something you always did,
Then do something different.

And boom! A new pathway is born.

It needs some love and attention to grow,
so keep practicing!

22 0

This isn’t a you problem, it’s your brain acting as it should.

Are you going through some change and upheaval right now too?

I see you.

Comment any questions on how to deal below and I’ll make a part 2!

38 2

Open

This isn’t a you problem, it’s your brain acting as it should.

Are you going through some change and upheaval right now too?

I see you.

Comment any questions on how to deal below and I’ll make a part 2!

38 2

We have a new space for my (free) LissMS Healing Community!!

Come on in…

Let me show you around!

This is a space created by an MSer (me), for other MSers (you) to be able to come together and support each other, learn new tools to help manage MS and maybe find a few new internet friends!

Wanna join us?

Comment “community” below and I’ll send you the link!!

16 1

Open

We have a new space for my (free) LissMS Healing Community!!

Come on in…

Let me show you around!

This is a space created by an MSer (me), for other MSers (you) to be able to come together and support each other, learn new tools to help manage MS and maybe find a few new internet friends!

Wanna join us?

Comment “community” below and I’ll send you the link!!

16 1

There’s so much buzz about everything needing to feel good if it’s right for you.

Sure, there’s a time and a place for alignment.

But, growth often happens in the uncomfortable moments.

Just a reminder.
Keep going.
❤️

32 9

Open

There’s so much buzz about everything needing to feel good if it’s right for you.

Sure, there’s a time and a place for alignment.

But, growth often happens in the uncomfortable moments.

Just a reminder.
Keep going.
❤️

32 9

Boating! I forgot to add boating to the list 🛶

Regulation is found in the micro moments.

Which of these have you done lately?

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Boating! I forgot to add boating to the list 🛶

Regulation is found in the micro moments.

Which of these have you done lately? ...

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