Injectable Therapies

Not everyone will experience every one of these side effects. Some adverse effects are common, and others are very infrequent but may be serious. Periodic lab testing is recommended for all individuals taking an interferon medication.



Agent - Self-Injected
Glatiramer Acetate36 (Copaxone®)(Glatopa®) 20mg SC daily or 40mg SC three times weekly.
Indication: relapsing forms of MS
Pregnancy Cat: B
Proposed MoA
Mechanism of action in MS is not fully understood. Subsequent research suggests:
  • promotes differentiation into Th2 and T-reg cells, leading to bystander suppression in CNS 37
  • increased release of neurotrophic factors from immune cells 37
  • deletion of myelin-reactive T cells 37
Side Effects
  • injection site reactions
  • lipoatrophy
  • vasodilation
  • rash
  • dyspnea
  • chest pain
Warnings / Precautions
  • immediate transient post-injection reaction (flushing, chest pain, palpitations, anxiety, dyspnea, throat constriction, and/or urticaria)
  • lipoatrophy and skin necrosis
  • potential effects on immune response

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Agent - Self-Injected
Interferon Beta-1a38 (Avonex®) IM 30mcg weekly.
Indication: relapsing forms of MS
Pregnancy Cat: C
Proposed MoA
Mechanism of action in MS is not known. Subsequent research suggests:
  • promotes shift from Th1-Th2
  • reduces trafficking across BBB 39,40
  • restores T-reg cells 37
  • inhibits antigen presentation 37
  • enhances apoptosis of autoreactive T-cells 37
Side Effects
  • flu-like symptoms
  • depression
  • increased hepatic transaminases
Warnings / Precautions
  • depression, suicide, psychosis
  • hepatic injury
  • anaphylaxis and other allergic reactions
  • congestive heart failure
  • decrase in peripheral blood counts
  • seizures
  • other autoimmune disorders

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Agent - Self-Injected
Interferon Beta-1a41 (Rebif®) SC 22mcg or 44mcg three times weekly.
Indication: relapsing forms of MS
Pregnancy Cat: C
Proposed MoA
Mechanism of action in MS is not known. Subsequent research suggests:
  • promotes shift from Th1-Th2
  • reduces trafficking across BBB 39,40
  • restores T-reg cells 37
  • inhibits antigen presentation 37
  • enhances apoptosis of autoreactive T-cells 37
Side Effects
  • injection site reactions
  • flu-like symptoms
  • abdominal pain
  • depression
  • increased hepatic transaminases
  • hematologic abnormalities
Warnings / Precautions
  • depression, suicide
  • hepatic injury
  • anaphylaxis and other allergic reactions
  • injection-site reactions including necrosis
  • decreased peripheral blood counts
  • flu-like symptoms
  • seizures

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Agent - Self-Injected
Interferon Beta-1b42,43 (Betaseron®) (Extavia®) 0.25mg SC every other day.
Indication: relapsing forms of MS
Pregnancy Cat: C
Proposed MoA
Mechanism of action in MS is not known. Subsequent research suggests:
  • promotes shift from Th1-Th2
  • reduces trafficking across BBB 39,40
  • restores T-reg cells 37
  • inhibits antigen presentation 37
  • enhances apoptosis of autoreactive T-cells 37
Side Effects
  • flu-like symptoms
  • injection site reactions
  • increased hepatic transaminases
  • decreased WBC
  • see warnings 42, 43
Warnings / Precautions
  • hepatic injury
  • anaphylaxis and other allergic reactions
  • depression and suicide
  • congestive heart failure
  • injection-site necrosis
  • decreased WBC
  • flu-like symptoms
  • seizures

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Agent - Self-Injected
Peginterferon Beta-1a44–46 (Plegridy®) SC 125mcg every two weeks.
Pregnancy Cat: C
Proposed MoA
Mechanism of action in MS is not known. Subsequent research suggests:
  • promotes shift from Th1-Th2
  • reduces trafficking across BBB 39,40
  • restores T-reg cells 37
  • inhibits antigen presentation 37
  • enhances apoptosis of autoreactive T-cells 37
Side Effects
  • flu-like symptoms
  • injection-site reactions
  • increased hepatic transaminases
  • decreased WBC
  • see warnings 38, 41
Warnings / Precautions
  • depression, suicide
  • hepatic injury
  • anaphylaxis and other allergic reactions
  • congestive heart failure
  • decrease peripheral blood counts
  • seizures
  • other autoimmune disorders

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Agent - Self-Injected
Daclizumab (Zinbryta®) SC 150mg monthly.
Pregnancy Cat: There are no adequate data on the developmental risk associated with use in pregnant women.
Proposed MoA
Mechanism of action in MS is not known. Subsequent research suggests:
  • involves modulation of IL-2 mediated activation of lymphocytes
  • binds to CD25, a subunit of the high-affinity IL-2 receptor
Side Effects
  • upper respiratory tract infection
  • flu
  • pain or swelling in nose, throat, or mouth
  • bronchitis
  • abnormal liver function tests
  • dry,itchy, scaly, or inflamed skin (eczema)
  • rash
  • swollen lymph glands
Warnings / Precautions
  • depression, suicide
  • hepatic injury
  • immune-mediated disorers
  • acute hypersensitivity
  • infections

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