Glatiramer belongs to a group of medications known as immunomodulators. Immunomodulators modify the way our body's defence system works. Glatiramer is used to treat the relapsing-remitting form of multiple sclerosis (MS). This medication is also used to delay the onset of MS for people who have experienced a single flare-up of symptoms and have changes that suggest MS in their magnetic resonance imaging (MRI) scans.

MS is a disease that affects the way the nerves in our body work. It is an autoimmune disease (the immune system attacks the body) and cannot be spread from person to person. In MS, damage occurs to the myelin sheath, a protective layer that wraps around a nerve, like insulation around electrical wiring. Normally, this sheath allows electrical messages to be sent down the nerve quickly and efficiently. If this insulation is injured, electrical signals in the central nervous system will not be sent properly. For unknown reasons, in MS, the immune system sees the myelin as foreign and attacks it.

It is thought that glatiramer works by altering the immune system to reduce its harmful effects on the myelin sheath. It does not cure MS, but it may decrease the frequency of relapses and reduce the number of damaged brain areas as seen on MRI scans.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The recommended dose of glatiramer is 20 mg injected subcutaneously (under the skin) once a day or 40 mg injected subcutaneously 3 times per week. Your doctor will decide which dosing regimen is best for you. If you are receiving glatiramer 3 times per week, the injections should be at least 48 hours apart.

Glatiramer is available as an injection only. It comes in single-use prefilled syringes or pens (40 mg/mL only).

There are special directions enclosed in the package with the injection. Read these directions carefully before using the medication. Follow the instructions closely to avoid accidentally contaminating the medication or needle and giving yourself an infection, damaging the equipment, or losing the medication.

Glatiramer is used with the guidance and supervision of a doctor. Your doctor or nurse will assist you in the preparation and injection of your first dose (or first few doses). Do not attempt to inject this medication on your own until you completely understand how to inject a dose.

Rotate the injection sites (arms, thighs, upper buttocks, or stomach) to minimize injection site skin irritation.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, inject it as soon as you remember. If you are injecting glatiramer once daily, and it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. If you are injecting glatiramer three times a week, and it is less than 48 hours until your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not inject a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store the prefilled syringes and pens in the refrigerator (2°C to 8°C) and protect from light. They may also be stored at room temperature for up to one month. Keep this medication out of the reach of children.

20 mg/mL
Each 1.0 mL prefilled syringe contains 20 mg of glatiramer. Nonmedicinal ingredients: mannitol and sterile water for injection.

40 mg/mL
Each 1.0 mL prefilled syringe or pen contains 40 mg of glatiramer. Nonmedicinal ingredients: mannitol and sterile water for injection.

Do not use this medication if you are allergic to glatiramer or any ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• back pain
• headache
• injection site reactions (e.g., bleeding, hard lump, hives or welts, itching, pain, redness, or swelling)
• joint pain
• nausea
• neck pain
• a "dent" in the skin at injection site

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• anxiety
• breathing problems
• chest pain
• fast or racing heartbeat
• high blood pressure (e.g., headache, dizziness, blurred vision, or shortness of breath)
• hives
• low blood pressure (e.g., dizziness, fatigue, nausea)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of infection, symptoms may include:
• fever or chills
• headache
• listlessness
• prolonged dizziness
• severe diarrhea
• shortness of breath
• stiff neck
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin rash
• vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• signs of a post-injection reaction, i.e.:
• anxiety
• chest pain or tightness
• difficulty breathing
• dizziness
• flushing
• hives forming immediately after injection
• irregular heartbeat
• skin eruptions with irritation
• sweating
• throat tightness
• swelling or puffiness of face
• signs of a serious allergic reaction, i.e.:
• abdominal cramps
• difficulty breathing
• nausea and vomiting
• swelling of the face and throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Breathing problems: Glatiramer can cause shortness of breath and difficulty breathing, causing symptoms of lung disease to worsen. If you have chronic obstructive pulmonary disease, asthma, or a history of severe allergic reactions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Cardiovascular effects: This medication may have effects on the heart and circulatory (blood vessels) system. If you have heart disease, high blood pressure, and other diseases of the heart and blood system, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Chronic progressive multiple sclerosis (MS): The safety and effectiveness of using this medication by people with chronic progressive MS have not been established. Currently, glatiramer is only recommended for people with the relapsing-remitting form of MS.

Immunosuppression (weak immune system): Glatiramer can modify the immune response and could interfere with useful immune function. If you have a suppressed or reduced immune system, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infections: Glatiramer may increase the risk of infections. If you notice any signs of an infection such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness, contact your doctor immediately.

Kidney disease: Glatiramer has not been studied for use by people with reduced kidney function. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: In rare cases, glatiramer can cause liver damage. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Post-injection reaction: Some people have a rare reaction that starts immediately after the injection and consists of flushing, chest tightness with racing or pounding heartbeat, anxiety, and difficulty breathing. The symptoms of this reaction usually go away without further problems. Nevertheless, if you experience any dizziness, hives and itching, sweating, chest pain, or difficulty breathing, you should contact a doctor right away.

Pregnancy: Glatiramer has not been adequately studied for use by pregnant people. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if glatiramer passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children and adolescents under 18 years old.

Seniors: The safety and effectiveness of using this medication have not been established for people over 65 years of age.

For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.