Managing Side Effects
As of yet, the perfect drug — one that is effective without side effects — does not exist. But treatment, as you'll soon discover, is a balance, one where you must weigh the risks against the benefits. The uncertainty in predicting the course of MS means that you will have to make tough treatment decisions without any guarantees that the drug will be effective for you or that the side effects will be minimal.
As with any new venture in life, arming yourself with knowledge will help you to make a well-informed decision. Knowing what to watch for when you start a new treatment is important, but try to start the treatment without any preconceived notions of what may happen to you. Side effects vary from person to person. The woman who sits next to you at your support group may react much differently to a treatment than you do. The truth is, it's hard to know beforehand just how you will react, so the best line of defense is to be informed about potential side effects without expecting them to occur.
Fact
According to respondents from a 2007 survey, the most important aspect of a drug is its effectiveness in treating MS. Number two is affordability and number three is side effects. The survey seems to say that people with MS do not consider the side effects of a drug to have as much bearing on their willingness to include it in their treatment plan as effectiveness and affordability.
Side Effects from CRAB
CRAB is an acronym for Copaxone, Rebif, Avonex, and Betaseron — the first-line disease-modifying therapies — and those often prescribed for relapsing-remitting MS. The side effects listed for these drugs differ slightly from one to the next, but here's a list of the common side effects and suggestions on how to manage them:
Flu-like Symptoms
Interferons (Avonex, Betaseran, Rebif) may cause flu-like side effects, such as fever, chills, muscle aches, and tiredness. For many people, these side effects lessen or go away over time. If you do experience these symptoms, talk to your doctor. He may be able to recommend ways to get symptom relief, such as taking over-the-counter pain medications that help reduce pain or fever. You may also want to change the time of day you take your injection. Bedtime is a good time; you may be able to sleep through the unpleasant side effects. If you need a day to rest after your injection, make sure to clear your calendar in advance.
Fatigue
Fatigue is often a common symptom of MS, but it can also be caused by interferons. Talk to your doctor. He may have some tips to help you manage fatigue, such as exercise or medication used for fatigue. Scheduling rest time in the afternoon is also a good idea.
Injection-Site Reactions
Injection-site reactions, which may be cause by subcutaneous injections (Betaseron, Rebif, Copaxon) usually involve superficial redness, minor skin irritation, minor allergic skin reaction, and possibly infection. The best line of defense is to avoid the reactions. Try rotating the injection site and don't use the same site more than once every two weeks. Be sure to leave enough room between sites used in the same general area. Keeping an injection log may be helpful to ensure proper site rotation.
Essential
Before injecting your MS drugs, be sure to wash and rinse the site with plain soap and water and then dry it well. Do not use perfume or creams on injection-site areas, as they may cause irritation. Place a cold cloth or cool pack on the injection site before and after each injection.
Side Effects for Infusion Treatments
The side effects for infusion therapy vary but can often be controlled. Some of the reported side effects include headaches, which may be helped by over-the-counter medication. Let your doctor know if you experience any side effects.
Depression is a common side effect of MS, but mood changes — such as depression — have been noted in some people who use interferon (Avonex, Betaseron, Rebif) therapy. Talk to your doctor about any changes in your mood. Antidepressants and/or counseling may be able to help you manage.
Sometimes MS treatments can cause changes in menstruation, such as irregular bleeding, or early or late periods. Speak to a gynecologist if you experience menstruation changes that concern you.
Injection treatments may cause reactions at the injection site, such as redness, bruising and pain. Rotating the injection site, placing a cold pack on the area before and after the injection, and using cortisone cream may be helpful in reducing skin irritation from injection.
No matter which treatment you decide on, learning to integrate disease-modifying therapy into your schedule and managing its side effects are important ways to help you stay on the therapy, which is your best line of defense at the moment.
