10 Drugs Commonly Prescribed for Multiple Sclerosis
Multiple sclerosis (MS) is a chronic neurological condition. It affects the central nervous system, which includes the brain and spinal cord. For unknown reasons, a person’s immune system starts attacking the protective covering—or myelin—around nerves. Damage to the myelin disrupts normal nerve signal flow. This is what causes the symptoms and disability with MS. Common MS symptoms include fatigue, weakness, and difficulty walking.
MS affects nearly 400,000 Americans. It can occur at any age, but typically strikes young adults. Likewise, both men and women can get MS, but it’s up to four times more common in women compared to men.
In the most common form of the disease, symptoms flare in attacks or relapses that can last for weeks. Then the disease stabilizes for a period of time with no progression. Medications can help decrease the frequency of attacks and manage symptoms when they occur.
There currently is no cure for MS. However, comprehensive MS treatment can delay disability and maintain your quality of life. Doctors follow expert practice guidelines when choosing medicines to treat MS. Classes of MS drugs include:
Disease-modifying agents reduce disease activity and progression. Doctors typically start these as soon as possible after diagnosis to minimize nerve damage. Side effects depend on the specific drug.
Agents for managing relapses primarily include corticosteroids. These powerful anti-inflammatory drugs can help control a relapse and shorten its duration. Long-term use can cause problematic side effects.
Agents for managing symptoms include a wide variety of drugs because there are many different symptoms.
Your doctor will monitor your MS after you start treatment. Your doctor will want to know if you continue to have symptoms and how severe they are. This will help your doctor gauge how well your treatment is working. Your doctor will also track your disease and treatment with imaging exams, such as MRI.
Your doctor has choices to make within each class of MS medicines. Finding the right treatment for you may involve some trial and error. Here are 10 drugs commonly prescribed for MS:
Baclofen (Gablofen, Lioresal) is a muscle relaxant. It improves muscle movement and relieves pain, muscle tightness, and cramping from spasticity (when your muscles continuously contract). It is available as a tablet and an infusion system that delivers the drug into the spinal canal.
Dalfampridine (Ampyra) improves walking or gait difficulties. It is the only drug with FDA approval for this MS symptom. It comes as a tablet you take twice daily.
Dexamethasone (Decadron) is corticosteroid for managing relapses. Typically, doctors use the IV form for several days. A slow taper using an oral corticosteroid—either dexamethasone or prednisone—may be necessary afterwards.
Dimethyl fumurate (Tecfidera) is a disease-modifying agent. It is a capsule you take twice a day. Taking it with food will decrease the side effect of flushing.
Fingolimod (Gilenya) is a disease-modifying agent. It comes as a once-daily capsule. Fingolimod is effective for reducing the relapse rate in patients with Relapsing-Remitting MS. Because it can cause an abnormally slow heartbeat, you will take the first dose in a setting where a doctor can monitor your heart for six hours.
Glatiramer acetate (Copaxone, Glatopa) is a synthetic protein that acts as a disease-modifying agent. It is a once-daily injection that goes under the skin (subcutaneous). You will learn to give yourself these injections.
Interferon Beta-1a (Avonex, Rebif) is a biologic disease-modifying agent. Avonex is an intramuscular injection you give can give yourself once a week. Rebif is an injection under the skin three times a week.
Interferon Beta-1b (Betaseron, Extavia) is also a biologic disease-modifying agent. Both brands are injections under the skin you administer every other day.
Teriflunomide (Aubagio) is a disease-modifying agent. It comes as a tablet you usually take once daily.
Tizanidine (Zanaflex) is a muscle relaxant. It improves muscle tone and relieves the symptoms of spasticity. It comes as both a tablet and a capsule. However, you can’t substitute one for the other. Check your prescription fill to be sure you always receive the same form.
When deciding on treatment, talk with your doctor about the risks and benefits. Disease-modifying agents come with potential problems you should consider. Your doctor can guide you to the right decision based on your disease severity, overall health, and other factors. Also, talk with your doctor about physical therapy and other ways to improve your symptoms and maintain your health.
Researchers continue to study MS causes and treatments. This includes clinical trials of stem cell therapy and a strategy to repair myelin. Clinical trials can give people access to experimental treatments not currently on the market. If you are interested in participating in a trial, talk with your doctor.