Disease-modifying therapies for multiple sclerosis can help slow the progression of the disease. They differ in how they are taken and in common side effects.
Disease-modifying therapies (DMTs) can be an important part of managing multiple sclerosis (MS). They can prevent flare-ups and delay or prevent the progression of MS to more advanced types.
Many different DMTs are available, so it might be confusing to try and keep them all straight.
DMTs vary when it comes to how often you take them. They can be:
- daily medications
- taken a few times per week or month
- taken even less often
The frequency depends on the type of DMT and its actions in your body.
The chart below covers approved DMTs, how they’re taken, and common side effects to be aware of.
| DMT | How it’s taken | Most common side effects |
|---|---|---|
| interferon beta-1a (Avonex, Plegridy, Rebif) | self-injected once weekly (Avonex), once every 2 weeks (Plegridy), or 3 times weekly (Rebif) | flu-like symptoms, pain or reaction at injection site |
| interferon beta-1b (Betaseron, Extavia) | self-injected every 2 days | flu-like symptoms, reaction at injection site |
| glatiramer acetate (Copaxone, Glatopa, generic) | self-injected daily or 3 times weekly | reaction at injection site, dizziness or shortness of breath at time of injection |
| ofatumumab (Kesimpta) | self-injected once per month | respiratory infection, injection-site reactions, headache |
| alemtuzumab (Lemtrada) | IV infusion daily for 5 days, then 1 year later, daily for 3 days | itching, headaches, nausea, dizziness, pain, infections, joint pain |
| mitoxantrone (Novantrone) | IV infusion every 3 months | nausea, infections, mouth sores |
| ocrelizumab (Ocrevus) | IV infusion every 2 weeks for first 2 doses, then every 6 months after that | infections, reactions at infusion site |
| natalizumab (Tysabri) | IV infusion every 4 weeks | headaches, joint pain, fatigue |
| teriflunomide (Aubagio) | oral once daily | headaches, nausea, hair thinning |
| monomethyl fumarate (Bafiertam) | oral twice daily | itching, stomach problems, diarrhea |
| fingolimod, FTY720 (Gilenya) | oral once daily | diarrhea, headaches, back pain |
| cladribine (Mavenclad) | oral; taken over 4 to 5 days during 2 treatment weeks per year for 2 years | upper respiratory infections, headaches |
| siponimod (Mayzent) | oral once daily | high blood pressure, headaches, abnormal liver function tests |
| dimethyl fumarate (Tecfidera) | oral twice daily | stomach upset, lower white blood cell counts, feeling of heat or itching on the skin |
| diroximel fumarate (Vumerity) | oral twice daily | stomach upset, flushing, itching, rash |
| ozanimod (Zeposia) | oral once daily | back pain, blood pressure changes, upper respiratory infections, frequent and painful urination |
| ponesimod (Ponvory) | oral once daily | infections, elevated liver enzymes, high blood pressure |
Keeping in touch with your care team is an important part of taking care of yourself.
Regular appointments are an opportunity for you and your doctor to check in. You’ll discuss whether current treatments are working or a change in therapy is needed.
In the chart above, some of the most common side effects are listed; however, it’s possible you may experience others.
Some side effects are more common with certain types of medication. For example:
- Injected medications. These can cause flu-like symptoms or changes in some blood work results.
- Infusions. These can cause headaches and nausea, and they can increase the risk of some infections.
- Oral medications. These can cause stomach upset and headaches.
The goal of any treatment is for the benefits to outweigh any bothersome side effects. Your doctor will be able to discuss your options with you to figure out the best treatment approach.
Talk with your doctor if you’re concerned about side effects or if you notice any changes in your health when starting a DMT.
There are no DMTs that are proven safe for pregnancy or breastfeeding. It’s important to let your doctor know if you think you’re pregnant or are considering a pregnancy.
DMTs can help manage MS and slow its progression. There are many DMTs available and different reasons for choosing one over another. Your doctor will help determine the DMT that’s best for you.