Disease-modifying medications for MS

There is currently no cure for MS. However, there are 2 main types of treatment available for this condition - those that can change the course of the disease and preserve ability (disease-modifying medications) and those that can be used to relieve specific MS symptoms or reduce the symptoms of relapses.

The following disease-modifying medications for MS are available in Canada:

• Avonex® PS (interferon beta-1a)
• Betaseron® (interferon beta-1b)
• Copaxone® (glatiramer acetate)
• Extavia® (interferon beta-1b)
• Gilenya® (fingolimod)
• Rebif® (interferon beta-1a)
• Tysabri® (natalizumab)

For more detailed information on each medication, click on the medication names above.

With the right treatment, you can live a normal life with MS and preserve your ability! Talk to your doctor about finding a treatment that will work for you.

Avonex® PS

What is it used for?

Avonex® PS is used for people with relapsing forms of MS to:

• slow the progression of disability
• decrease the frequency of relapses
• decrease the number and volume of active brain lesions and overall disease burden as shown on an MRI scan

Avonex® PS is also used for people with secondary progressive MS (who are still having relapses) to:

• reduce the frequency of relapses
• decrease brain lesions as shown on an MRI scan

For people who have had a single MS attack (also called a demyelinating event) plus abnormal MRI scan results, Avonex® PS may help to:

• delay the onset of clinically definite MS
• decrease the number and volume of active brain lesions and overall disease burden as shown on an MRI scan

How is it given?

This medication is given once a week as a single injection into the muscle. An injection into the muscle is also called an intramuscular (IM) injection. Before you give yourself an IM injection, be sure that you've received adequate training on the technique of giving yourself an IM injection. Your doctor will determine if you can inject the medication yourself. Avonex® PS is available in a prefilled syringe, which does not need to be mixed before injection.

What are the main side effects?

The most common side effect of Avonex® PS is flu-like symptoms, which can include fever, chills, sweating, muscle aches, and tiredness.

Other less common side effects include:

• blood problems
• depression
• heart problems
• liver problems
• thyroid problems
• seizures

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Betaseron®

What is it used for?

Betaseron® is used for people with relapsing-remitting MS. It can reduce the frequency of relapses. It can also be used to delay the onset of clinically definite MS for people who have had a single MS attack (also called a demyelinating event) combined with at least 2 MS lesions on their MRI scans.

It is also used for people with secondary progressive MS to:

• slow the progression of disability
• reduce the frequency of relapses

How is it given?

Betaseron® is given as a single injection every other day under the skin. An injection under the skin is also called a subcutaneous (SC) injection. Betaseron® must be mixed first before injection.

What are the main side effects?

The most common side effects of Betaseron® include flu-like symptoms, injection site reactions, and rash.

Other less common side effects include:

• blood problems
• liver problems
• depression
• fluid retention
• seizures

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Copaxone®

What is it used for?

Copaxone® is used for people with relapsing-remitting MS to:

• reduce the frequency of relapses
• decrease brain lesions as shown on an MRI scan

For people who have had a single MS attack (also called a demyelinating event) plus abnormal MRI scan results, Copaxone® may help to:

• delay the onset of clinically definite MS
• decrease the number and volume of active brain lesions and overall disease burden as shown on an MRI scan

How is it given?

Copaxone® is given once a day as an injection under the skin. An injection under the skin is also called a subcutaneous (SC) injection. Copaxone® is available in a prefilled syringe, which does not need to be mixed before injection.

What are the main side effects?

Side effects of Copaxone® include:

• anxiety
• chest pain
• flu syndrome
• infection
• injection site reactions
• joint aches
• muscle tightness
• nausea
• pain
• relaxing and widening of blood vessels
• weakness (loss of strength)

Copaxone® may also cause an immediate post-injection reaction. This is a reaction that sometimes occurs just after injecting the medication. During the reaction, there may be symptoms such as flushing (a feeling of warmth or redness), anxiety, trouble breathing, chest tightness or chest pain, and heart palpitations. These symptoms generally appear within minutes of an injection, last about 15 minutes, and go away by themselves without further problems.

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Extavia®

What is it used for?

Extavia® is used for people with relapsing-remitting MS. It can reduce the frequency of relapses. It can also be used to delay the onset of clinically definite MS for people who have had a single MS attack (also called a demyelinating event) combined with at least 2 MS lesions on their MRI scans.

It is also used for people with secondary progressive MS to:

• slow the progression of disability
• reduce the frequency of relapses

How is it given?

Extavia® is given as a single injection every other day under the skin. An injection under the skin is also called a subcutaneous (SC) injection. Extavia® must be mixed first before injection.

What are the main side effects?

The most common side effects of Extavia® include flu-like symptoms, injection site reactions, rash, and fluid retention (swelling) in ankles or legs.

Other less common side effects include:

• blood problems
• depression or suicidal thoughts
• liver problems
• seizures

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Gilenya®

What is it used for?

Gilenya® is used for people with relapsing-remitting MS to:

• reduce the frequency of relapses
• slow the progression of physical disability

Gilenya® is generally recommended for people who cannot take other MS treatments or for whom other MS treatments have not worked.

How is it given?

Gilenya® is an oral capsule. It is taken by mouth once a day with or without food. It should be taken with half a glass of water.

What are the main side effects?

The most common side effects of Gilenya® include:

• abnormal liver function tests
• back pain
• cough
• diarrhea
• flu-like symptoms (tiredness, chills, sore throat, joint or muscle aches, fever)
• headache

Other less common side effects can include:

• slow heartbeat
• bronchitis (cough with phlegm, chest pain, or fever)
• symptoms of infection from herpes virus (shingles or herpes zoster) such as blisters, burning, itching, or pain around the mouth or genitals. Other symptoms may include fever followed by numbness, itching, and red patches or blisters on the face or trunk, with severe pain
• symptoms of gastroenteritis such as vomiting, nausea, diarrhea, or fever

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Rebif®

What is it used for?

Rebif® is used for people with relapsing forms of MS to:

• slow the progression of physical disability
• reduce the frequency and severity of relapses
• reduce the number of hospitalizations for MS
• decrease the need for corticosteroid medications
• decrease brain lesions as shown on an MRI scan

Rebif® is also used for people with secondary progressive MS (who are still having relapses) to:

• reduce the frequency of relapses
• decrease brain lesions as shown on an MRI scan

How is it given?

Rebif® is given 3 times per week as an injection under the skin. An injection under the skin is also called a subcutaneous (SC) injection. Rebif® is available in a prefilled syringe, which does not need to be mixed before giving.

What are the main side effects?

The most common side effects of Rebif® include flu-like symptoms and injection site reactions, reduction in white blood cell count, and elevation of liver enzymes.

Other less common side effects can include:

• anemia
• depression
• diarrhea
• difficulty sleeping
• dizziness
• hair loss
• inflammation of the liver
• itching
• loss of appetite
• nervousness
• palpitations
• rash
• relaxing and widening of blood vessels
• thyroid dysfunction
• vomiting

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Tysabri®

What is it used for?

Tysabri® is used for people with relapsing-remitting MS to:

• reduce the frequency of relapses
• decrease the number and volume of active brain lesions as shown on an MRI scan
• delay the progression of physical disability

Tysabri® is generally recommended for people who cannot take other MS treatments or for whom other MS treatments have not worked.

How is it given?

Tysabri® is given as an intravenous (IV) infusion (a slow injection into a vein) once every 4 weeks. The infusion must be given by a health care professional in an infusion clinic. The infusion usually lasts for one hour. During the infusion and for one hour after the infusion is finished, you will be monitored by a health care professional to check for any reactions (known as infusion reactions) to the medication.

What are the main side effects?

Common side effects of Tysabri® include:

• dizziness
• fever
• headache
• joint pain
• nausea or vomiting
• stuffy nose
• sore throat
• tiredness
• urinary tract infection

Other less common side effects can include:

• PML (progressive multifocal leukoencephalopathy), a rare but serious brain infection that can lead to further disability and even death (symptoms of PML are similar to MS relapse)
• infusion-related reactions (headache, dizziness, fatigue, hives, or chills occurring within 2 hours of the start of the infusion)

If you notice any new MS symptoms or if your MS seems to be getting worse, this may be a sign of PML. Speak to your doctor as soon as possible if this happens.

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