If you have certain forms of multiple sclerosis (MS), your doctor might suggest Copaxone (glatiramer acetate) as a treatment option. You may be wondering what side effects, sometimes referred to as adverse effects, this drug may cause.

Copaxone is a prescription medication that’s used in adults for the following indications (conditions):

  • Clinically isolated syndrome. This is an episode of MS-like symptoms that lasts at least 24 hours. It may or may not develop into MS.
  • Relapsing-remitting MS. This is the most common form of MS. It involves periods of relapse (in which symptoms flare up) and periods of remission (in which symptoms ease or go away).
  • Active secondary progressive MS. This is a form of MS that gets gradually worse over time, even with treatment. There are also periods of relapse in which symptoms get noticeably worse for a while.

Copaxone helps reduce the number of relapses you have. It also helps slow down worsening of your condition. It’s meant to be used as a long-term treatment.

You’ll receive Copaxone as an injection under your skin. The drug comes in single-dose prefilled syringes. A healthcare professional can also teach you to give yourself the injections at home.

For more information about Copaxone, including details about its uses, see this in-depth article on the drug.

Like other drugs, Copaxone can cause mild or serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Copaxone treatment. Certain side effects are more common than others. Examples of Copaxone’s more commonly reported side effects include:

  • injection site reactions, such as:
    • pain
    • itching
    • swelling
    • redness
    • discoloration
    • lumps in the place where you have the injection
  • flushing (temporary warmth, redness, or deepening of skin color)
  • rash
  • shortness of breath
  • chest pain*

* To learn more about this side effect, see “Side effects explained” below.

Most side effects reported with Copaxone are mild. Examples of mild side effects that have been reported with Copaxone include:

  • injection site reactions, such as:
    • pain
    • itching
    • swelling
    • redness
    • discoloration
    • lumps in the place where you have the injection
  • rash
  • flushing (temporary warmth, redness, or deepening of skin color)
  • shortness of breath
  • palpitations (feeling like your heart is racing, pounding, or fluttering)
  • nausea and vomiting
  • weakness
  • infection, such as the common cold or the flu
  • anxiety
  • pain in your back or other parts of your body
  • sweating more than usual
  • weight gain or weight loss*

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be temporary. Some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Copaxone unless your doctor recommends it.

Copaxone may cause mild side effects other than the ones listed above. See the Copaxone patient counseling information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Copaxone, visit MedWatch.

Serious side effects that have been reported with Copaxone include:

* To learn more about this side effect, see “Side effects explained” below.

If you develop serious side effects while using Copaxone, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Below you’ll find answers to some frequently asked questions about Copaxone’s side effects.

Are there any long-term side effects of Copaxone?

Yes, some side effects of Copaxone may be long term.

For example, it’s possible to have skin damage in the places where you inject Copaxone.* While this isn’t common, it can cause permanent pitting of the skin in those areas. To help reduce the risk of skin damage, you should use a different injection site each time you inject Copaxone.

If you have any other side effects with Copaxone that don’t go away, talk with your doctor.

* To learn more about this side effect, see “Side effects explained” below.

Will stopping Copaxone cause withdrawal symptoms or other side effects?

Stopping Copaxone won’t cause withdrawal symptoms. If you stop treatment, you don’t need to do this gradually like you do with some medications. But stopping Copaxone might make your MS relapse, causing your symptoms to come back or get worse.

If you want to stop using Copaxone, talk with your doctor first. They can advise if stopping treatment is the right thing to do. They can also discuss other treatment options with you.

Is hair loss a side effect of Copaxone?

No, it’s not known to be. Hair loss is a possible side effect of some other MS treatments, such as interferon beta-1a (Avonex, Rebif), interferon beta-1b (Betaseron, Extavia), and teriflunomide (Aubagio). But hair loss hasn’t been reported in studies of Copaxone.

Talk with your doctor if you’re concerned about hair loss while using Copaxone. They can investigate the possible cause.

Do side effects of Copaxone differ depending on the strength (20 mg/mL or 40 mg/mL)?

The types of side effects seen with Copaxone are similar with both strengths of the drug. But certain side effects occur more commonly in people using Copaxone 20 milligrams per milliliter (mg/mL) than in people using Copaxone 40 mg/mL. The dosage for the 20 mg/mL strength is once per day, whereas the dosage for the 40 mg/mL strength is three times per week.

Side effects that are more common with Copaxone 20 mg/mL include injection site reactions, skin damage, post-injection reactions, and chest pain. To read more about these side effects, see “Side effects explained” below.

I’m deciding between Glatopa and Copaxone for MS treatment. How do the side effects of these drugs compare?

Glatopa is a generic version of Copaxone. It comes in the same forms and strengths as Copaxone. Glatopa and Copaxone can have exactly the same side effects.

Copaxone may not be right for you if you have certain medical conditions or other factors that affect your health. Some of these factors are contraindications for this drug. A contraindication is a factor that makes a drug unsafe for you to use.

Talk with your doctor about your health history before you use Copaxone. Below are some factors to consider.

Allergic reaction

If you have had a past allergic reaction to Copaxone or any of its ingredients, including mannitol, you should not use Copaxone. Ask your doctor what other medications are better options for you.

Alcohol use and Copaxone

If you drink alcohol, ask your doctor how much is safe to consume when using Copaxone. Alcohol doesn’t affect the way this medication works. But it could increase certain side effects, such as flushing (temporary warmth, redness, or deepening of skin color) or nausea.

Pregnancy and breastfeeding while using Copaxone

It’s not known if Copaxone is safe to use during pregnancy or breastfeeding. It’s not known if this medication can affect a developing fetus or if it can affect a child who’s breastfed.

If you’re pregnant, breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor about whether Copaxone is right for you.

Learn more about some of the side effects Copaxone may cause.

Weight gain or weight loss

Some people may gain weight while using Copaxone, but this isn’t common. Other people may have weight loss with Copaxone. Weight loss was rare in studies, and it’s not known if it was related to the drug.

What might help

If you notice a change in your weight while you’re using Copaxone, talk with your doctor. They can help you work out the possible cause.

For example, you might gain weight if you’re less active than usual because of a relapse of your MS. Taking corticosteroids to treat a flare-up of your symptoms may also result in weight gain. On the other hand, you might lose weight if you have fewer relapses as a result of Copaxone treatment.

Your doctor can give you advice on maintaining a moderate weight while using Copaxone.

Immediate post-injection reaction

Some people might have side effects within a few minutes after receiving a Copaxone injection. This is called a post-injection reaction. Post-injection reactions were commonly reported in people who used Copaxone.

You might have a reaction after your first injection. But it’s also possible to have this reaction at any time during treatment, even if you haven’t had problems before. You could also have a reaction just once or several times.

Post-injection reaction symptoms include:

  • flushing (temporary warmth, redness, or deepening of skin color)
  • anxiety
  • chest pain
  • palpitations (feeling like your heart is racing, pounding, or fluttering)
  • fast heart rate
  • shortness of breath
  • tightness in your throat
  • hives (itchy rash)

Most post-injection reactions are mild and go away quickly without treatment. But in some cases, the symptoms can be more severe and might need emergency treatment.

What might help

If you have symptoms of a post-injection reaction, call your doctor right away for advice. But if your symptoms are severe or feel life threatening, call 911 or your local emergency number right away.

If you have a post-injection reaction, you shouldn’t take another dose of Copaxone until your doctor says it’s fine to do so.

Chest pain

Some people might have chest pain when using Copaxone.

Chest pain may be part of a post-injection reaction. This is a reaction that you can get right after receiving an injection of Copaxone (see the section just above).

Chest pain can also occur at other times during treatment, and without any other symptoms. These episodes of chest pain typically begin about 1 month after starting treatment with Copaxone.

Episodes of chest pain are usually mild and get better in a few minutes.

What might help

If you have chest pain while using Copaxone, call your doctor right away for advice. But if your symptoms are severe or feel life threatening, call 911 or your local emergency number right away.

Skin damage at the injection site

Copaxone can cause skin damage at the injection site. The injections can cause lipoatrophy and, in rare cases, skin necrosis.

Lipoatrophy is damage to the fatty layer under your skin. It can leave dents or pits in your skin. Skin necrosis is death of skin cells. It can leave brown or black patches on your skin. These changes may be permanent.

What might help

To help reduce the risk of skin damage, it’s important to inject Copaxone exactly as instructed by your doctor. There are several places on your body where you can inject Copaxone. It’s important to rotate between these places as follows:

  • Each time you inject a dose, choose a different place on your body than where you injected before.
  • Keep track of the date and the place you where you injected, so you’ll remember where you injected last.
  • Don’t inject Copaxone in the same place more than once per week.
  • Don’t inject into areas of skin where you already have scars or dents.

Talk with your doctor if you’re concerned about skin damage with Copaxone injections.

Liver problems

In rare cases, Copaxone can sometimes cause serious liver problems, such as hepatitis (liver inflammation) or liver failure. Liver problems can develop at any time during treatment.

Symptoms of a liver problem may include:

  • jaundice (yellowing of your skin or the whites of your eyes)
  • nausea and vomiting
  • loss of appetite
  • dark urine
  • pale stools
  • fatigue (lack of energy)
  • bruising or bleeding more easily than usual

What might help

If you have symptoms of a liver problem, talk with your doctor right away so they can investigate possible causes. If your doctor thinks you have a liver problem that’s been caused by Copaxone, you’ll likely need to stop using it.

Allergic reaction

Like most drugs, Copaxone can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine), or a product you apply to your skin, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Copaxone, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Copaxone, they may have you switch to a different treatment.

Keeping track of side effects

During your Copaxone treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Copaxone affects you. And your doctor can use this information to adjust your treatment plan if needed.

Copaxone can be an effective treatment for MS. Some people may have side effects such as injection site reactions, but these are typically mild and short-lived. Most serious side effects of Copaxone aren’t common.

If you have questions about the possible side effects of Copaxone, talk with your doctor. They can help you decide if this drug may be a good option for you. Here are some examples of questions you might want to ask:

  • Is Copaxone safe for me if I have a heart condition?
  • Can I take Copaxone if I have a liver problem?
  • How do Copaxone’s side effects compare with side effects from other MS drugs?
  • Does Copaxone raise my risk for getting infections?
  • What could happen if I get pregnant while taking Copaxone?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.