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What drugs are used to treat the relapsing form of multiple sclerosis?

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There are five drugs that you take by mouth to treat the relapsing form of multiple sclerosis (MS):

  • Cladribrine (Mavenclad)  is a pill taken once a day for five days for one month and once a day again for the second month. You may need another course in a year. It is not for treating relapsing forms of MS, including relapsing-remitting disease and active secondary progressive disease. It can affect your immune system and make you susceptable to other infections, so you will need to be monitored. You could also have hair loss and experience some rashes.   

  • Dimethyl fumarate (Tecfidera)  is a tablet you take twice a day. It can lower your immune cells, so the doctor will do regular blood tests to keep an eye on them. The drug's most common side effects are flushing, stomach pain, diarrhea, nausea, and vomiting. An active ingredient similar to the one in Tecfidera is linked to four cases of PML.

  • Fingolimod (Gilenya)  is also a once-daily tablet. If you haven’t had chickenpox, you’ll need a vaccine. Common side effects include headache, diarrhea, back pain, cough, and abnormal liver tests. Because the medicine may slow your heart rate, the doctor will watch you closely after your first dose. The drug is also linked to progressive multifocal leukoencephalopathy (PML), a rare brain infection.

  • Siponimod (Mayzent)  is a tablet taken daily after a 5 day build up to the proper does. It can affect your immune system and had been linked to clottinf iun the extremities. The most common side effects are diarrgea, dizziness, swelling in gthe extremities, high blood pressure, headaches and aslowed heartbeat. You sholdn't take siponimod if you are pregnant.

  • Teriflunomide (Aubagio)  is a tablet you take once a day. The most common side effects include diarrhea, abnormal liver tests, nausea, and hair loss. It does carry a "black box" warning, the FDA's most serious warning, because it can lead to liver problems and birth defects. If you take it, your doctor will likely do regular tests to check how well your liver is working. Don’t take it if you're pregnant.

National Multiple Sclerosis Society: "Disease Management Consensus Statement," "Fingolimod," "Novantrone (mitoxantrone),"  "Exacerbations,"  "FDA Approves Plegridy (Pegylated Interferon Beta) For Relapsing MS."

John Ratchford, MD, assistant professor of neurology, Johns Hopkins School of Medicine.

NINDS: "Multiple Sclerosis Information Page."

Goldman, L.  , Saunders Elsevier, 2007. Cecil Medicine

FDA: "Safety Update on Progressive Multifocal Leukoencephalopathy (PML) Associated with Tysabri," "FDA approves new multiple sclerosis treatment Aubagio," "FDA investigating rare brain infection in patient taking Gilenya (fingolimod)."

Reviewed by Christopher Melinosky on June 29, 2020

National Multiple Sclerosis Society: "Disease Management Consensus Statement," "Fingolimod," "Novantrone (mitoxantrone),"  "Exacerbations,"  "FDA Approves Plegridy (Pegylated Interferon Beta) For Relapsing MS."

John Ratchford, MD, assistant professor of neurology, Johns Hopkins School of Medicine.

NINDS: "Multiple Sclerosis Information Page."

Goldman, L.  , Saunders Elsevier, 2007. Cecil Medicine

FDA: "Safety Update on Progressive Multifocal Leukoencephalopathy (PML) Associated with Tysabri," "FDA approves new multiple sclerosis treatment Aubagio," "FDA investigating rare brain infection in patient taking Gilenya (fingolimod)."

Reviewed by Christopher Melinosky on June 29, 2020

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What should you do if drugs for the relapsing form of multiple sclerosis don't work for you?

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