Glatiramer (Subcutaneous)

Glatiramer is a central nervous system agent used as part of treatment for certain forms of MS, and is designed to reduce the frequency of relapses associated with RMMS.

Overview

Glatiramer is a central nervous system agent prescribed for patients with relapsing-remitting multiple sclerosis (RMMS). This drug is a protein that is believed to help prevent the immune system from attacking nerves in the spinal cord and brain. While it is not a cure for the condition, it is meant to help extend the amount of time between relapses.

Typically, glatiramer is used as part of a long-term treatment plan for patients with RMMS. Besides decreasing the number of relapses, it can also delay the onset of disability associated with the condition or (in some cases) prevent associated disabilities from appearing.

Conditions Treated

  • Relapses associated with relapsing-remitting multiple sclerosis (RMMS)

Type Of Medicine

  • Central nervous system agent

Brand Names or Other Names:

  • Copaxone

Side Effects

While side effects (or adverse reactions) happen occasionally when taking medication as part of the course of treatment for a specific condition, they are not a common occurrence. Whether the adverse effects are mild or severe, common or rare, you should always have a conversation about them with your doctor if you believe you are experiencing them.

In the case of glatiramer, no more than 10-15% of patients using the drug experience adverse reactions when using it correctly. The more common side effects generally subside within a short period of time after a dose is administered. If you have questions or concerns about these effects, talk to your doctor or healthcare professional. They may have suggestions or advice about how to ease these short-term effects as they occur.

Some of the more common side effects for glatiramer include:

  • Anxiety

Other, less common side effects for glatiramer have been known to occur. While they are typically not life-threatening, you should mention them to your doctor if you experience them. Those effects include:

  • Aching muscles

While most side effects are not as serious and can be resolved with a quick conversation with a doctor or medical professional, others are more pressing and you will need to speak with your doctor or seek medical intervention immediately if you find yourself experiencing them. A list of these side effects includes:

  • Blisters or cold sores on the lips, nose, eyes, or genitals that are painful

The list of potential side effects listed here is long, but it is far from exhaustive. There are many potential side effects not listed above. Before you start taking glatiramer, talk to your doctor about all of the possible side effects. You should also consult your doctor if you believe you are experiencing a side effect that was not included in this list.

Very rarely, a serious allergic reaction (also known as anaphylaxis) could occur for patients using glatiramer. If you experience any of the following symptoms, you should seek medical attention immediately.

Symptoms of a serious allergic reaction include:

  • Anaphylactic shock;

An overdose is a rare possibility while using this medication. If you see someone experiencing symptoms of an overdose, call for emergency medical intervention immediately.

Signs of an overdose include:

  • Passing out

If you have any questions or concerns about possible side effects or allergies related to this drug, you should talk to your doctor.

Dosage

Exact dosages for glatiramer may vary, depending on the medical condition you are taking it for, your age, other medications or supplements you might be taking, and other medical conditions you are aware of having. The manufacturers have created a set of recommendations for usage of this drug, but your doctor will determine more precisely how much you should be given and how often you should take it. While the manufacturers know which medical condition it was created to help treat and the amount that works best under optimal conditions, your doctor knows you and your overall medical condition.

The manufacturers recommendation is for one of two possible dosages for glatiramer for adults. The first one is 20 mg administered subcutaneously once a day, while the second one is 40 mg given subcutaneously three times a week and at least forty-eight hours apart. Your doctor will have you give yourself the first injection in the office, and you will have the option of administering the medication to yourself at home from that point onward.

Instructions for administering glatiramer are as follows:

  • If you are refrigerating the dosages of glatiramer, pull the prepackaged dose out of the refrigerator about twenty minutes beforehand and let it warm to room temperature.

Glatiramer is not indicated for use in patients under the age of 18, as the safety and efficacy of its use in that age group has yet to be established. Its use has also not been studied in elderly patients, so doctors prescribing it for patients in that age group should do so with caution.

If you miss a dose, administer it as soon as you remember that you missed it. If you do not remember until sometime close to the time for your next dose, skip the dose you missed and take the next dose at its normally scheduled time. You should not use double doses in order to catch up.

Do not use more or less than your prescribed dosages of glatiramer, and do not administer it more frequently than the prescription states that you do so. Also, do not give yourself more than the maximum amount recommended per dose, and do not use it for any more or less than the amount of time your doctor directs to.

If you have any questions about glatiramer, how to administer it, or possible side effects or interaction, discuss them with your doctor or pharmacist.

When used as part of a treatment plan for relapsing-remitting multiple sclerosis (RMMS), glatiramer is intended to reduce the number of relapses and prevent or delay the disabilities that can occur with the condition. It is not fast acting, and it may be several months before the drug is fully effective in your body. If you find yourself experiencing no relief or a worsening of symptoms, talk to your doctor. They may need to adjust your dosage or find another treatment option that works more effectively.

Interactions

Glatiramer is a drug that was designed to increase the amount of time between relapses for patients with RMMS. How it interacts inside of each body will be different, depending on what other medications that patient is taking, what kind of a diet they are on, and what other medical issues may be present. Sometimes the interactions are helpful, but many times the interactions can cause a decrease in efficacy.

There is only one drug that is currently known to interact with glatiramer. That medication is natalizumab, which is another medication often used as part of a treatment plan for RMMS.

However, there is always the potential for currently unknown interactions to occur while you are on glatiramer. You should always discuss your medical history, as well as all of the medications and supplements you are taking with your doctor prior to starting this.

Warnings

There is a risk of immediate post-injection reactions during the first several months of treatment using glatiramer. These reactions include, but are not limited to transient chest pain, flushing, palpitations, anxiety, and throat constriction. If any of these symptoms go on for a prolonged period of time, seek medical attention immediately.

Be sure to rotate injection sites on a daily basis, as skin necrosis and lipoatrophy may occur at sites that are used more frequently.

Do not use glatiramer if you have an auto-immune disease or your immune system is impaired in some way, as glatiramer can interfere with immune function and impair your body's ability to fight off infections.

Talk to your doctor before using glatiramer if your medical history includes chest pains, heart attack, or other signs of heart disease.

Talk with your doctor about using glatiramer if you are pregnant or planning to become pregnant, as there are potential risks involved with usage of this drug.

Also talk to your doctor if you are nursing, as it is not currently known if glatiramer is excreted through breast milk.

Tell your doctor or dentist about all of the drugs and supplements you are taking, including glatiramer, before having surgery of any kind.

Storage Instructions

If possible, refrigerate syringes in their cartons at a temperature above freezing (between 36-46 degrees Fahrenheit or 2-8 degrees Celsius). Do not freeze this medication, and do not use syringes that you think may have been frozen.

If you are not able to refrigerate the syringes, you can store them at a room temperature somewhere between 59-86 degrees Fahrenheit or 15-30 degrees Celsius for as long as one month.

Store this medication is a location away from direct light and do not expose it to high temperatures. Keep it and all other medications away from any children and pets that may be in the household.

Disposal:
Unless you have been instructed by your doctor or pharmacist to do so, do not flush glatiramer down the toilet or pour it down a sink drain.

Do not hold onto extra doses that are past their expiration date or once your doctor has you stop taking the medication. While it may seem like a good idea, the chances are that you will never need to use it again.

Talk to your doctor or pharmacist about how to safely and properly dispose of this medication once it has expired or you no longer need to use it. If by chance you do, the medicine will mostly have expired and not be effective anymore.

Summary

Glatiramer is one of a variety of medications that is designed to help patients with RMMS manage their condition. It can be greatly beneficial in helping patients sustain an overall better quality of life, but it is only part of an overall management plan for the condition. Management plans for specific conditions are their most effective when a patient is honest and communicative with the doctors who are helping them put that plan into action. Therefore, it is imperative that patients communicate as openly and honestly as they possible can with their doctors about their medical history, all aspects of their current medical condition, as well as their diet and any exercise regimen they may currently be utilizing.

One of the reasons it is in the best interest of any patient to disclose these aspects of their lives with their doctor is because of the variety of interactions and side effects that can occur with the use of glatiramer. The impact of these interactions and side effects vary, but a doctor who is aware of the potential can help their patient make adjustments to the treatment plan that lessen their severity or prevent them from occurring. A doctor who is unaware will not be able to help their patient as completely as they would like to.

When administered correctly, glatiramer is an effective way to reduce the number of relapses patients with RMMS suffer as a part of their medical condition as well as extend the periods of time between these events. RMMS is a grueling medical condition for any patient, but with the right medical team working together and the right treatment plan in place, they are able to have a much greater quality of life for much longer than they might have otherwise. The more time that patient stays healthier and is able to care for themselves, the longer they have to live, and the more they are able to continue to enjoy doing the things they love.

Links:

  • WebMD https://www.webmd.com/drugs/2/drug-835/glatiramer-subcutaneous/details
  • Glatopa
  • Cough
  • Difficult / painful urination
  • Excessive amounts of muscle tone
  • Facial swelling or puffiness
  • Flushed skin
  • Injection point reactions like bleeding, hard lumps, hives, itching, pain, redness, swelling or welts
  • Irregular, fast, racing or pounding heartbeat or pulse
  • Lymph glands that are painful in the groin / neck / armpit areas
  • Pain in joints, lower back, side, or neck
  • Pain in the chest
  • Rash
  • Trouble breathing
  • Agitation
  • Bloating
  • Chest tightness
  • Chills
  • Confusion
  • Difficult swallowing
  • Feelings of faintness, dizziness, or lightheadedness
  • Fever
  • Itching, especially of the outside genitals or vagina areas
  • Pain
  • Puffiness or swelling in the face
  • Purple spots, red streaks, or lumps underneath the skin
  • Severe / throbbing headache
  • Sweating
  • Swelling in fingers / arms / feet / legs
  • Strong urges to urinate
  • White, thick curd-like discharge from the vagina with mild to no odor
  • Throat spasms
  • Tingling, shaking, or trembling in hands or feet
  • Unusual or excessive weight loss or gain
  • Burning / stinging skin
  • Breathing too fast
  • Continuous or uncontrolled back and forth movements or rolling eye movements
  • Decline in sexual ability
  • Loose stools / diarrhea
  • Loss of appetite
  • Menstrual changes or pain
  • Mouth and tongue irritation (thrush)
  • Pain in the back
  • Pain in the ear
  • Pain in the muscles
  • Sensation of movement, typically whirling of surroundings or oneself
  • Speech issues
  • Troubles with moving
  • Urine that has blood in it
  • Vision issues
  • Hives;
  • Nausea and vomiting;
  • Difficulty breathing; or
  • Swelling in your face, lips, tongue, or throat
  • Trouble breathing
  • Before administering, do a visual check for particles or discoloration. Glatiramer in the syringe should be anywhere between clear and anywhere from colorless to slightly yellow. If you see particles or discoloring, use another dose and dispose of the one you do not use.
  • Clean the injection site with rubbing alcohol, then inject the medication under the skin of the hip, thigh, abdomen, buttock, or back of the upper arm. Rotate injection sites each time you use a dose, and only use each site once a week. Avoid injecting the medication into a vein.
  • Once you have administered the medication, pull out the needle and apply gentle pressure on the injection site.
  • Dispose of any medication left in the syringe after administering a dose, as it should not be saved for later use.
  • Mayo Clinic https://www.mayoclinic.org/drugs-supplements/glatiramer-subcutaneous-route/side-effects/drg-20064045
  • Drugs.com https://www.drugs.com/pro/glatiramer-injection.html
  • Medscape https://reference.medscape.com/drug/copaxone-glatopa-glatiramer-3431213#6
Resources
Last Reviewed:
March 26, 2018
Last Updated:
April 23, 2018