10 Tips for Injecting MS Drugs

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Giving yourself a shot in the arm is a fact of life for many people with multiple sclerosis. Five of the drugs currently approved to treat multiple sclerosis (MS) must be given via injections on a regular basis. Getting used to sticking yourself with a needle can be difficult, but these simple tips can minimize discomfort and make it easier to follow your treatment plan.

1. Make the right choice. Discuss your multiple sclerosis treatment options with your doctor. Some MS drugs require a deep, intramuscular injection once a week. Others require a shallower injection just below the skin (called a subcutaneous injection) every other day. Pick an injection schedule you’re comfortable with.

2. Keep a log of injection sites. Include notes of any patterns you notice. For example, write it down if injections in the arm hurt more than those in other sites, like the thigh or butt.

3. Vary the injection site. Don’t rely on memory alone. Try using an injection map or log to keep track. Avoid injecting near areas where you have had skin reactions in the past.

4. Pick a good time. Some MS drugs can cause flu-like symptoms or headache after injection. If you follow an evening injection schedule, you may be able to sleep off the worst of the side effects. If side effects bother you the day after an injection, try scheduling your injection the night before a day off work.

5. Plan ahead for pain. If you often experience pain or flu-like symptoms after an injection, try taking acetaminophen or ibuprofen a few hours before your shot. Another way to reduce pain is to apply a topical anesthetic along with an ice pack for 30 to 60 seconds before you clean the site and do the injection.

6. Warm it up. If your medication is refrigerated, take it out of the refrigerator and let it warm up to room temperature before you inject. This will lessen the burning sensation. Don't put syringes in the microwave or in boiling water to warm them up.

7. Watch your technique. Poor technique is a major cause of skin reactions at injection sites. Any break in the skin can cause pain, irritation, or infection. Skin reactions to subcutaneous injections are usually mild, but they could lead to serious infection if they're not treated promptly. Reactions to intramuscular injections can include bruising and muscle pain.

To lower the risk for infection and injection site reactions, follow this routine:

  • Wash your hands.

  • Clean the injection site thoroughly.

  • Use a small pad to apply alcohol.

  • Let the alcohol dry completely.

  • Make sure the tip of the needle is dry and free of medication.

  • Insert the needle as directed.

Prevent swelling after injection with a 1 or 2%  hydrocortisone ointment. But don't use this if you see any sign of infection.
8. Keep your needle skills sharp. Review your technique regularly with your doctor. Also, check out the patient support material provided by the drug’s manufacturer. Ask whether a smaller needle or auto-injection pen is available to reduce pain or anxiety.

9. Use your imagination. If self-injecting makes you very nervous, try using a relaxation method called guided imagery at injection time. Many health care providers and MS support groups offer information on guided imagery.

10. Develop a routine. A routine that offers comfort and relaxation around the time of the injection can also help fight anxiety about using a needle. Try a warm bath, meditation, or a sweet treat before or after the injection to reward yourself for a job well done.

Key Takeaways

  • Pick an MS drug injection routine you can stick with. Discuss your options with your doctor.

  • Keep a log of your injection sites and vary the location to avoid complications.

  • Plan ahead for your injections to ease anxiety, pain, and side effects.

  • Keep your technique and needle skills sharp by reviewing them regularly with your doctor.

  • Reward yourself with a treat or time to relax after a successful injection.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 31

  1. Dr. Elliot Frohman on Managing Injection Site Reactions. National Multiple Sclerosis Society. https://secure.nationalmssociety.org/docs/HOM/IMSApr05-ElliotFrohman.pdf

  2. Easing the Stress of Injections. National Multiple Sclerosis Society. https://secure.nationalmssociety.org/docs/HOM/IMSAug06-EasingInjectionStress.pdf

  3. Long-Term Treatments for MS. Multiple Sclerosis Association of America. http://www.mymsaa.org/about-ms/treatments/long-term/

  4. Wells Courtney S. An Introduction to Guided Imagery and Its Potential Benefits for Individuals with MS. Multiple Sclerosis Association of America. http://www.mymsaa.org/publications/motivator/winter-08/cover-story/

  5. Where You Can Learn More About Taking Rebif. http://www.rebif.com/taking-rebif/index

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