Exploring your MS medication options

What to consider when choosing your MS medication

• Don’t rush your decision. MS management is a long-term proposition, and there is usually time to make this important decision after careful reflection.
• Read widely about the various options. Information from other MS charities as well as online resources such as the Live Well Hub can help find impartial guidance as well as what others have experienced with a particular medication.
• Consider changing a medication if it is not working, or if the side effects are too difficult to tolerate. The next drug may suit you better. Talk to your MS team about this. 
• Have a conversation with your MS team about stopping a drug, as well as starting it, before starting any medication.
• Some drugs, particularly natalizumab (Tysabri) and fingolimod (Gilenya), present the potential for a serious rebound in disease activity when you stop taking the drug. Your doctor should have a plan should this arise.
• Consider medication choices with regard to fertility and pregnancy. Familiarise yourself with medication advice specific to the pre-conception, antenatal and post-partum stages of motherhood. A woman’s MS journey will be affected by, and affect, her pregnancy and early newborn stages, so her medication needs may change during this time. Risks with regards to mum’s MS relapse rate, symptom severity and pregnancy safety will need to be considered when choosing medication, and this will be individual to each woman.
• Ask many questions – be the captain of your own health ship.
• Choose carefully based on risk vs. benefit. The higher the reduction in relapse rate and disability progression risk, the more likely it is that side effects will be serious. Some people prefer a less effective medication like glatiramer (Copaxone) because it has fewer side effects.

Pills or needles?

Every drug has a different delivery method. These may require you to attend hospital appointments, or you may be able to take pills or self-inject at home. You can read in more detail about how each drug is delivered in each of their individual pages.  

• Some of the newer agents like fingolimod (Gilenya), dimethyl fumarate (Tecfidera)and teriflunomide (Aubagio) are taken as pills, whilst others like alemtuzumab (Lemtrada), natalizumab (Tysabri) or ocrelizumab (Ocrevus) are given as intravenous infusions in hospital. 
• The older beta-interferons and Copaxone are given as injections (which need to be kept refrigerated). Very active or aggressive disease may require more potent medication with potentially more serious side effects.
• High-efficacy medications such as natalizumab (Tysabri), a monthly infusion, may be required to gain control of your MS early in the disease course.