Medications for Multiple Sclerosis (MS)

Common names are:

• Interferon beta-1a or 1b and pegylated interferon beta 1a
• Glatiramer acetate
• Fingolimod
• Teriflunomide
• Dimethyl fumarate
• Cladribine
• Natalizumab
• Alemtuzumab
• Daclizumab
• Rituximab
• Ocrelizumab
• Ofatumumab
• Ozanimod
• Ponesimod
• Siponimod

These drugs lower the number of flare-ups and slow the disease. Some may limit harm to the myelin sheath. Others stop the blood cells in lymph nodes from moving to the brain and spine. Some of these drugs are pills, others are injections a person gives themself, and some are infusions. Some drugs may work faster than others. Side effects differ between drugs.

Problems may be:

• Fever and chills
• Headache
• Feeling tired
• Diarrhea
• Back pain
• Sweating
• Skin problems
• Cough
• Muscle aches or spasms
• Depression
• High risk of infection
• Kidney and liver harm
• Progressive multifocal leukoencephalopathy (a brain virus that can cause death)
• Problems after shots, such as flushing, problems breathing, rapid heartbeat, sweating, and anxiety

Common names are:

• Azathioprine
• Mitoxantrone
• Cyclophosphamide
• Methotrexate

These drugs limit what the immune system can do to the body. They may be given to try to put off a flare up. These drugs may cause harmful reactions.

Problems may be:

• Upset belly and vomiting
• Diarrhea
• Fever
• Feeling tired
• Hair loss
• High risk of infection
• Menstrual problems
• Liver harm
• Progressive multifocal leukoencephalopathy (a brain virus that may cause death)—azathioprine
• Problems after shots, such as flushing, breathing problems, rapid heartbeat, sweating, and anxiety
• Leukoencephalopathy (non-infectious)—methotrexate
• Kidney injury—methotrexate
• Bleeding from the bladder—cyclophosphamide

A GABA-B agonist is used to control muscle spasticity. It may be taken as a pill or given as a shot into the spine. It often helps only a short time. It should not be stopped without talking to one's doctor first.

Problems may be:

• Feeling tired
• Lightheadedness
• Weakness

Common names are:

• Tizanidine
• Clonidine

These drugs affect nerve pathways. They are used to treat spasticity. Clonidine may also help with insomnia. Liver function tests may be needed when taking these drugs.

Problems may be:

• Drowsiness
• Dry mouth
• Low blood pressure

Dantrolene is used to control muscle cramps and spasms in people who are not able to walk. It can worsen muscle weakness.

Problems may be:

• Diarrhea
• Nausea
• Lack of hunger

Common names are:

• Diazepam
• Clonazepam

These drugs relax the muscles. They are used to control nighttime muscle spasms and spasticity in people who are not able to take other drugs. Clonazepam can also help control shaking.

Problems may be:

• Feeling tired
• Lightheadedness

Botulinum toxin is made from a type of bacteria. It is given as a shot into certain muscle groups that cause painful contractions. The shot blocks the signal from the nerves to the muscles. It helps for a short time.

Problems may be:

• Nausea
• Feeling tired
• Flu-like symptoms
• Headache

Common names are:

• Oxybutynin
• Propantheline

These drugs control urinary urgency, frequency, and incontinence. They also increase bladder capacity.

Problems may be:

• Dry mouth
• Rapid heartbeat
• Constipation
• Urinary retention

This drug helps ease frequent urination at night. It makes urine more concentrated. It can lower sodium levels, so blood tests may be done while a person is on it. This is a nasal spray used at bedtime.

Problems may be:

• Headache
• Nasal congestion

Amantadine is an antiviral drug used to treat fatigue.

Problems may be:

• Nausea
• Dizziness
• Problems sleeping

Modafinil is used to treat fatigue. It is a wakefulness agent. A person may have headaches with this drug.

This drug helps nerves send their signals better. It has helped people with MS walk better.

Problems may be:

• Urinary tract infection
• Problems sleeping
• Dizziness
• Headache
• Nausea
• Weakness
• Back pain
• Problems with balance