Immunomodulating Drugs

Common names are:

• Interferon beta-1a or 1b
• Glatiramer acetate
• Fingolimod
• Teriflunomide
• Dimethyl fumarate
• Cladribine
• Natalizumab
• Alemtuzumab
• Daclizumab
• Rituximab
• Ocrelizumab

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. These drugs can be given as a shot or pill. People taking fingolimod may have a decrease in heart rate. A higher risk of infections and eye problems may also happen. Some drugs may work faster than others. Glatiramer acetate may need to be taken for months before it starts to help.

Some problems are:

• 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)—natalizumab
• Problems after shots, such as flushing, problems breathing, rapid heartbeat, sweating, and anxiety

Immunosuppressive Drugs

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.

Some problems are:

• 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

GABA-B Agonists

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. Do not stop taking this drug without talking to your doctor.

Some problems are:

• Feeling tired
• Lightheadedness
• Weakness

Noradrenergic Alpha-2 Agonists

Common names are:

• Tizanidine
• Clonidine

These drugs affect nerve pathways. They are used to treat spasticity. Clonidine may also help with insomnia. Your doctor may order lab tests to check your liver while you take this.

Some problems are:

• Drowsiness
• Dry mouth
• Low blood pressure

Dantrolene

Dantrolene is used to control muscle cramps and spasms in people who can't walk. It can worsen muscle weakness.

Some problems are:

• Diarrhea
• Nausea
• Lack of hunger

Benzodiazepines

Common names are:

• Diazepam
• Clonazepam

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

Some problems are:

• Feeling tired
• Lightheadedness

Botulinum Toxin

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.

Some problems are:

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

Anticholinergic Drugs

Common names are:

• Oxybutynin
• Propantheline

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

Some problems are:

• Dry mouth
• Rapid heartbeat
• Constipation
• Urinary retention

Desmopressin

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

Some problems are:

• Headache
• Nasal congestion

Amantadine

Amantadine is an antiviral drug used to treat fatigue.

Some problems are:

• Nausea
• Dizziness
• Problems sleeping

Modafinil

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

Dalfampridine

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

Some problems are:

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