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The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

With multiple sclerosis (MS), medicines are given to suppress or modulate the immune system and control symptoms. Medicines only help in managing the condition, and some slow the disease process. They do not cure MS.

Prescription Medications

  • Corticosteroids
  • Immunosuppressive drugs
  • Anticonvulsants
  • Muscle relaxers
  • Bladder control medicines
  • Medicines used to treat fatigue
  • Antidepressants
  • Other medicines used to treat MS

Over-the-Counter Medications

  • Nonsteroidal anti-inflammatory drugs
  • Pain relievers

Prescription Medications

Corticosteroids

Common names include:

  • Methylprednisolone (Solu-Medrol)
  • Prednisone (Cordrol, Deltasone)
  • Betamethasone (Celestone)

Corticosteroids are used to reduce nerve tissue inflammation and shorten MS flare-ups. How these drugs work is not fully understood. These drugs are usually given short term. Do not suddenly stop taking these medicines. Carefully follow your doctor’s instructions for tapering the dose or alternating the days you use them.

Possible side effects include:

  • Increased risk of infection
  • Weight gain
  • High blood pressure
  • High blood sugar
  • Mood swings
  • Difficulty sleeping
  • Bone density loss
  • Bowel problems

For people who do not respond well to corticosteroids, other therapies may be used. For example, immunoglobulin therapy involves injecting antibodies into the blood. So far, though, the study results are inconsistent. Another treatment is plasmapheresis . This involves exchanging plasma in the blood. The results have been inconsistent with this type of treatment too.

Immunomodulating Drugs
Beta Interferon

Common brand names include:

  • Avonex
  • Betaseron
  • Rebif

Beta interferon is an agent used to modulate the immune system. The drug seems to decrease the number of flare-ups and slow progression of physical disabilities. It may limit destruction of the myelin sheath. Beta interferon is given by injection.

Possible side effects include:

  • Fever and chills
  • Sweating
  • Muscle aches
  • Fatigue
  • Depression

Glatiramer Acetate

Common brand name: Copaxone

Glatiramer acetate helps prevent MS relapses, possibly by blocking the immune system from attacking myelin. The drug is given by an injection. It may take months for this drug to show any benefits.

Possible side effects include:

  • Swelling and skin tenderness
  • Systemic reactions after injections, such as flushing, shortness of breath, palpitations, sweating, and anxiety

Fingolimod

Common brand name: Gilenya

Fingolimod is the first oral medicine to treat MS symptoms. The medicine affects blood cells in the lymph nodes, blocking these cells from moving to the brain and spinal cord. This can reduce relapses and slow the progression of MS.

When starting fingolimod, patients may have a decrease in heart rate. Increased risk of infections and serious eye problems are also possible side effects.

More common side effects include:

  • Headache
  • Influenza
  • Diarrhea
  • Back pain
  • Cough
Other Immunosuppressive Drugs

Common names include:

  • Azathioprine (Imuran)
  • Cyclophosphamide (Cytoxan)
  • Mitoxantrone (Novantrone)
  • Methotrexate (Folex, Rheumatrex)
  • Natalizumab (Tysabri)
  • Cladribine (2-CdA, Leustatin)

These immunosuppressive drugs may be given to try to prevent a relapse or progression of MS. These drugs may produce serious side effects. Some of these are prescribed by doctors who specialize in treating MS, but the medicines may not be approved by the Food and Drug Administration (FDA) for treating MS.

Possible side effects include:

  • Nausea and vomiting
  • Diarrhea
  • Increased risk of infection
  • Kidney and liver damage
  • Progressive multifocal leukoencephalopathy (a potentially fatal viral infection of the brain)—Natalizumab

Anticonvulsant Medications

Common names include:

  • Gabapentin (Neurontin)
  • Carbamazepine (Tegretol)

Anticonvulsants are used to control tremors and seizure activity. They also may be ordered to treat nerve pain. In addition, gabapentin may be given to treat spasticity, as well as unusual sensations.

Possible side effects include:

  • Drowsiness
  • Nausea

Muscle Relaxers
GABA-B Agonists

Common name: Baclofen (Lioresal)

A GABA-B agonist is used to control muscle spasticity. This drug may be taken by mouth or injected into the spinal canal. The benefits are usually short lived. Do not stop taking this medicine without consulting your doctor.

Possible side effects include:

  • Drowsiness
  • Dizziness
  • Weakness

Noradrenergic Alpha-2 Agonists

Common names include:

  • Tizanidine (Zanaflex)
  • Clonidine (Catapres)

These medicines affect nerve pathways and are used to treat spasticity. Clonidine may also help with insomnia . Your doctor may order regular lab tests to check liver function.

Possible side effects include:

  • Drowsiness
  • Dry mouth
  • Low blood pressure

Dantrolene

Common brand name: Dantrium

Dantrolene is used to control muscle cramps and spasms in patients who cannot walk. It tends to worsen muscle weakness. It is given at bedtime and may be increased to include doses during the day.

Possible side effects include:

  • Diarrhea
  • Nausea
  • Loss of appetite

Benzodiazepines

Common names include:

  • Diazepam (Valium)
  • Clonazepam (Klonopin)

Benzodiazepines relax the muscles and are used to control nighttime muscle spasms and spasticity in patients who cannot tolerate other drugs used to treat this symptom. Clonazepam can also help control tremors.

Possible side effects include:

  • Drowsiness
  • Dizziness

Botulinum Toxin

Common brand name: Botox

Botulinum toxin is made from a type of bacteria. Given as an injection, botox is injected into certain muscle groups that are causing painful contractions. The injection works by temporarily blocking the signal from the nerves to the muscles.

Side effects may include:

  • Nausea
  • Fatigue
  • Flu-like symptoms
  • Headache

Bladder Control Medicines
Anticholinergic Drugs

Common names include:

  • Oxybutynin (Ditropan)
  • Propantheline (Pro-Banthine)

Anticholinergic drugs may be ordered to control urinary urgency, frequency, and incontinence. These drugs increase bladder capacity and provide some relief of urinary urgency.

Possible side effects include:

Desmopressin

Common brand name: Stimate

Desmopressin helps relieve frequent urination during the night that has not responded to other treatment. It produces more concentrated urine. It can decrease sodium levels, so blood tests may be ordered. This drug is a nasal spray used at bedtime.

Possible side effects include:

  • Headache
  • Nasal congestion

Medicines Used to Treat Fatigue
Amantadine

Common brand name: Symmetrel

Amantadine is an antiviral drug used to treat fatigue. It is usually taken twice daily.

Possible side effects include:

  • Nausea
  • Dizziness
  • Insomnia

Modafinil

Common brand name: Provigil

Modafinil is used to treat fatigue. It is a wakefulness agent, taken in the morning. Possible side effects include headache.

Antidepressants

Common names include:

  • Amitriptyline (Elavil)
  • Trazodone (Desyrel)
  • Fluoxetine (Prozac)

Antidepressants may be ordered to combat depression associated with MS. Some antidepressant drugs are also given to people with chronic pain for pain-relieving abilities. They may improve your pain threshold and help you to sleep. Antidepressants are not addictive.

Do not stop taking these drugs without checking with your doctor. Do not take an antidepressant if you have taken a MAO inhibitor in recent weeks.

Possible side effects include:

  • Blurred vision
  • Dry mouth
  • Weight loss or weight gain
  • Dizziness, lightheadedness when standing up

Other Medicines Used to Treat MS
Dalfampridine

Common brand name: Ampyra

Ampyra blocks potassium channels in neurons. This helps demyelinated axons (nerves that have lost or damaged myelin sheaths) transmit their signals better. In studies, Ampyra has improved walking in people with MS.

Common side effects include:

Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs

Common names include:

  • Naproxen sodium (Aleve)
  • Ibuprofen (Motrin)
  • Aspirin (Bayer)

These drugs work to reduce inflammation and pain. Possible side effects include:

  • Gastrointestinal bleeding
  • Stomach upset

Pain Relievers

Common brand name: Tylenol (acetaminophen)

Acetaminophen relieves minor pain. It does not prevent future headaches or treat the cause of the headache. It can cause liver problems if taken with alcohol. Do not drink alcohol while taking this drug. Do not take more than the recommended dose. Acetaminophen is unlikely to cause side effects (stomach upset, bleeding ulcers) associated with other pain medicines.

Special Considerations

Whenever you are taking a prescription medicine, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a doctor or pharmacist about drug interactions.
  • Plan ahead for refills so you do not run out.

When to Call Your Doctor

Call your doctor if your symptoms worsen or if new symptoms develop.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 09/2013 -
  • Update Date: 09/30/2013 -
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  • 9/24/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : US Food and Drug Administration. FDA approves first oral drug to reduce MS relapses. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm226755.htm . Published September 22, 2010. Accessed September 24, 2010.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.