There are a variety of treatments for multiple sclerosis (MS) designed to:

  • change how the disease progresses
  • manage relapses
  • help with symptoms

Disease-modifying therapies (DMTs) for MS fall into three categories:

Some of these medications can be taken at home, while others must be given in a clinical setting. Each type of medication has certain benefits as well as potential side effects.

With so many options, it can be hard to decide which treatment to try first.

Your doctor can help you weigh the pros and cons of each choice and how they affect your lifestyle.

Here’s more information on each type of medication to help you make an informed decision.

Many MS medications are given by injection, which you can do yourself. You’ll receive training from a healthcare professional and learn the proper way to inject yourself safely.

The Food and Drug Administration (FDA) has approved the following self-injectable medications for the treatment of MS:

  • glatiramer acetate (Copaxone, Glatopa)
  • interferon beta-1a (Avonex, Rebif)
  • interferon beta-1b (Betaseron, Extavia)
  • ofatumumab (Kesimpta)
  • peginterferon beta-1a (Plegridy)

You can inject these medications either subcutaneously (beneath the skin) or intramuscularly (directly into the muscle). Injections may involve a needle or an injection pen.

The frequency of injections ranges from daily (for some people taking Copaxone or Glatopa) to once per month (for people who’ve taken Kesimpta for at least 3 weeks).

Who should take them?

If you’re comfortable self-injecting and prefer not to take oral medications daily, injectable treatments might be a good choice for you.

Side effects and safety

The side effects of most injectable medications are unpleasant but usually short-lived and manageable.

You may experience pain, swelling, or skin reactions at the injection site. Many of these medications may cause flu-like symptoms as well as liver test abnormalities.

Daclizumab (Zinbryta) is an injectable medication that had previously been used to treat MS. Its manufacturers voluntarily removed it from the global market in 2018 due to concerns about safety, including reports of severe liver damage and anaphylaxis.

Infusion medications are given intravenously in a clinical setting. You can’t take them at home, so you must be able to get to infusion appointments.

The FDA-approved infusion medications for MS are:

  • alemtuzumab (Lemtrada)
  • mitoxantrone hydrochloride
  • natalizumab (Tysabri)
  • ocrelizumab (Ocrevus)

The schedules for infusion medications vary:

  • Lemtrada is given in two courses. You receive daily infusions for 5 days. One year later, you receive your second set of infusions, consisting of daily infusions for 3 days.
  • Mitoxantrone hydrochloride is given once every 3 months.
  • Tysabri is given once every 4 weeks.
  • The first two doses of Ocrevus are given 2 weeks apart. Later infusions are given every 6 months.

Who should take them?

If you want the help of a healthcare professional when administering your medication and don’t want to take pills every day, infusion medications might be a good choice for you.

Side effects and safety

Common side effects include nausea, headache, and abdominal discomfort. In rare cases, these medications may cause serious side effects such as infection and heart damage.

Your doctor will help you weigh the risks of taking these drugs against the potential benefits.

You may be able to take your MS medication in pill form, if that’s what you prefer.

The FDA-approved oral medications for MS are:

  • cladribine (Mavenclad)
  • dimethyl fumarate (Tecfidera)
  • diroximel fumarate (Vumerity)
  • fingolimod (Gilenya)
  • monomethyl fumarate (Bafiertam)
  • ozanimod (Zeposia)
  • siponimod (Mayzent)
  • teriflunomide (Aubagio)

Aubagio, Gilenya, Mayzent, and Zeposia are taken once per day. Tecfidera and Bafiertam are taken twice per day.

In your first week on Vumerity, you’ll take one pill twice per day. Afterward, you’ll take two pills twice per day.

Mavenclad is a short-course therapy.

Over the course of 2 years, you’ll have either 16 or 20 treatment days. On your treatment days, your dose will consist of either one or two pills. Your weight will determine whether your dose contains one or two pills.

Who should take them?

Oral medications are easy to take and are a good option if you don’t like needles.

Taking your medication as prescribed is important for it to be effective, so you’ll need to follow an organized schedule if you take daily oral doses.

Setting up reminders for yourself can help you stick to a schedule and take each dose on time.

Side effects and safety

Side effects of oral medications may include headache and abnormal liver tests.

DMTs are available in different forms, such as self-injectable, infusion, and oral treatments. Each of these forms has side effects as well as benefits.

Your doctor can help you choose a medication that’s right for you based on your symptoms, preferences, and lifestyle.