Medications for Multiple Sclerosis (MS)

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 medications. 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
• Bone density loss

Beta Interferon]]>

Common brand names include:

• Avonex
• Betaseron
• Rebif

Beta interferon is an anti-viral agent used to suppress the immune system. It may help inhibit a substance involved in flare-ups of the disease. 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 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

Other Immunosuppressive Drugs

Common names include:

• Azathioprine]]> (Imuran)
• ]]>Cyclophosphamide]]> (Cytoxan)
• ]]>Mitoxantrone]]> (Novantrone)
• ]]>Methotrexate]]> (Folex, Rheumatrex)
• Immunoglobulin injections
• ]]>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 used by MS specialists, but are not FDA approved for treating MS.

Possible side effects include:

• Nausea and vomiting
• Diarrhea
• Increased risk of infection
• Kidney and liver damage
• Progressive Multifocal Leukoencephalopathy (PML) can be seen with Natalizumab use. PML is a potentially fatal viral infection of the brain.

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 medication without consulting your doctor.

Possible side effects include:

• Drowsiness
• Dizziness
• Weakness

Noradrenergic Alpha-2 Agonists

Common name:

• Tizanidine]]> (Zanaflex)

Tizanidine affects nerve pathways and is used to treat spasticity. Your doctor may order regular lab tests while you are taking this drug to check liver function.

Possible side effects include:

• Drowsiness
• Dry mouth
• Low blood pressure

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 that occur in some MS patients. You should not stop taking these drugs without consulting your doctor.

Possible side effects include:

• Drowsiness
• Nausea

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. Do not stop these drugs without consulting with your doctor.

Possible side effects include:

• Drowsiness
• Dizziness

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:

• Dry mouth
• Palpitations
• Constipation
• Urinary retention

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 periodic blood tests may be ordered. This drug is a nasal spray used at bedtime.

Possible side effects include:

• Headache
• Nasal congestion

Amantadine

Common brand name:

• Symmetrel]]>

Amantadine is an antiviral drug used to treat fatigue. It is usually taken twice daily. The method of action in the treatment of MS-related fatigue is unknown.

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.

4 Amino Pyridine

Blocks potassium channels in neurons. This helps demyelinated axons (nerves that have lost or damaged myelin sheaths) transmit their signals better.

Possible side effects include confusion and seizures.

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 their pain-relieving abilities. They may improve your pain threshold and help you 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 (during or within 14 days of MAO therapy).

Possible side effects include:

• Blurred vision
• Dry mouth
• Dizziness, lightheadedness when standing up

]]> 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

Analgesics

Common 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 medications.