What to consider when choosing your MS medication
- Don’t let anyone rush you. 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 forums such as the Overcoming MS forum can be helpful in finding out what others have experienced with a particular medication.
- Consider changing a medication if it is not working, or if the side effects are too hard to tolerate. The next drug may suit you better. Talk to your doctor about this.
- Have a conversation with your doctor 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 the drug’s safety with regard to pregnancy. If you wish to have a family someday, you may choose drugs that are safer in pregnancy (like glatiramer (Copaxone)) rather than those with known effects on the baby (like fingolimod (Gilenya).
- 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, 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) or natalizumab (Tysabri) 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 side effects.
- Medications such as natalizumab (Tysabri), a monthly infusion, may be required to gain control of your MS early in the disease course.