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Blake Medical Center

Medications for Multiple Sclerosis (MS)

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

With multiple sclerosis (MS), medications are given to suppress or modulate the immune system and control symptoms. Medications only help in managing the condition, and some slow the disease process. They do not cure MS.

Prescription Medications

  • Corticosteroids
  • Immunosuppressive drugs
  • Anticonvulsants
  • Muscle relaxers
  • Bladder control medications
  • Medications used to treat fatigue
  • Antidepressants
  • Other medications used to treat MS

Over-the-Counter Medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Pain relievers

Prescription Medications


Common names include:

  • Methylprednisolone
  • Prednisone
  • Betamethasone

Corticosteroids are used to reduce nerve tissue inflammation and shorten MS flare-ups. How these drugs work is not fully understood. These drugs are usually given short term. Do not suddenly stop taking these medications. Carefully follow your doctor’s instructions for tapering the dose or alternating the days you use them.

Possible side effects include:

  • Increased risk of infection
  • Weight gain
  • High blood pressure
  • High blood sugar
  • Mood swings
  • Difficulty sleeping
  • Bone density loss
  • Gastrointestinal problems

For people who do not respond well to corticosteroids, other therapies may be used. For example, immunoglobulin therapy involves injecting antibodies into the blood. So far, though, the study results are inconsistent. Another treatment is plasmapheresis . This involves exchanging plasma in the blood. The results have been inconsistent with this type of treatment too.

Immunomodulating Drugs
Beta Interferon

Common brand names include:

  • Avonex
  • Betaseron
  • Rebif

Beta interferon is an agent used to modulate the immune system. The drug seems to decrease the number of flare-ups and slow progression of physical disabilities. It may limit destruction of the myelin sheath. Beta interferon is given by injection.

Possible side effects include:

  • Fever and chills
  • Sweating
  • Muscle aches
  • Fatigue
  • Depression
Glatiramer Acetate

Common brand name: Copaxone

Glatiramer acetate helps prevent MS relapses, possibly by blocking the immune system from attacking myelin. The drug is given by an injection. It may take months for this drug to show any benefits.

Possible side effects include:

  • Swelling and skin tenderness
  • Systemic reactions after injections, such as flushing, shortness of breath, palpitations, sweating, and anxiety

Common brand name: Gilenya

Fingolimod is the first oral medication to treat MS symptoms. The medication affects blood cells in the lymph nodes, blocking these cells from moving to the brain and spinal cord. This can reduce relapses and slow the progression of MS.

When starting fingolimod, patients may have a decrease in heart rate. Increased risk of infections and serious eye problems are also possible side effects.

More common side effects include:

  • Headache
  • Influenza
  • Diarrhea
  • Back pain
  • Cough
Other Immunosuppressive Drugs

Common names include:

  • Azathioprine
  • Cyclophosphamide
  • Mitoxantrone
  • Methotrexate
  • Natalizumab
  • Cladribine

These immunosuppressive drugs may be given to try to prevent a relapse or progression of MS. These drugs may produce serious side effects. Some of these are prescribed by doctors who specialize in treating MS, but the medications may not be approved by the Food and Drug Administration (FDA) for treating MS.

Possible side effects include:

  • Nausea and vomiting
  • Diarrhea
  • Increased risk of infection
  • Kidney and liver damage
  • Progressive multifocal leukoencephalopathy (a potentially fatal viral infection of the brain)—Natalizumab
Anticonvulsant Medications

Common names include:

  • Gabapentin
  • Carbamazepine

Anticonvulsants are used to control tremors and seizure activity. They also may be ordered to treat nerve pain. In addition, gabapentin may be given to treat spasticity, as well as unusual sensations.

Possible side effects include:

  • Drowsiness
  • Nausea
Muscle Relaxers
GABA-B Agonists

Common name: Baclofen

A GABA-B agonist is used to control muscle spasticity. This drug may be taken by mouth or injected into the spinal canal. The benefits are usually short lived. Do not stop taking this medication without consulting your doctor.

Possible side effects include:

  • Drowsiness
  • Lightheadedness
  • Weakness
Noradrenergic Alpha-2 Agonists

Common names include:

  • Tizanidine
  • Clonidine

These medications affect nerve pathways and are used to treat spasticity. Clonidine may also help with insomnia . Your doctor may order regular lab tests to check liver function.

Possible side effects include:

  • Drowsiness
  • Dry mouth
  • Low blood pressure

Common brand name: Dantrium

Dantrolene is used to control muscle cramps and spasms in patients who cannot walk. It tends to worsen muscle weakness. It is given at bedtime and may be increased to include doses during the day.

Possible side effects include:

  • Diarrhea
  • Nausea
  • Loss of appetite

Common names include:

  • Diazepam
  • Clonazepam

Benzodiazepines relax the muscles and are used to control nighttime muscle spasms and spasticity in patients who cannot tolerate other drugs used to treat this symptom. Clonazepam can also help control tremors.

Possible side effects include:

  • Drowsiness
  • Lightheadedness
Botulinum Toxin

Common brand name: Botox

Botulinum toxin is made from a type of bacteria. Given as an injection, botox is injected into certain muscle groups that are causing painful contractions. The injection works by temporarily blocking the signal from the nerves to the muscles.

Side effects may include:

  • Nausea
  • Fatigue
  • Flu-like symptoms
  • Headache
Bladder Control Medications
Anticholinergic Drugs

Common names include:

  • Oxybutynin
  • Propantheline

Anticholinergic drugs may be ordered to control urinary urgency, frequency, and incontinence. These drugs increase bladder capacity and provide some relief of urinary urgency.

Possible side effects include:


Common brand name: Stimate

Desmopressin helps relieve frequent urination during the night that has not responded to other treatment. It produces more concentrated urine. It can decrease sodium levels, so blood tests may be ordered. This drug is a nasal spray used at bedtime.

Possible side effects include:

  • Headache
  • Nasal congestion
Medications Used to Treat Fatigue

Common brand name: Symmetrel

Amantadine is an antiviral drug used to treat fatigue. It is usually taken twice daily.

Possible side effects include:

  • Nausea
  • Dizziness
  • Insomnia

Common brand name: Provigil

Modafinil is used to treat fatigue. It is a wakefulness agent, taken in the morning. Possible side effects include headache.


Common names include:

  • Amitriptylin
  • Trazodone
  • Fluoxetine

Antidepressants may be ordered to combat depression associated with MS. Some antidepressant drugs are also given to people with chronic pain for pain-relieving abilities. They may improve your pain threshold and help you to sleep. Antidepressants are not addictive.

Do not stop taking these drugs without checking with your doctor. Do not take an antidepressant if you have taken a MAO inhibitor in recent weeks.

Possible side effects include:

  • Blurred vision
  • Dry mouth
  • Weight loss or weight gain
  • Lightheadedness when standing up
Other Medications Used to Treat MS

Common brand name: Ampyra

Ampyra blocks potassium channels in neurons. This helps demyelinated axons (nerves that have lost or damaged myelin sheaths) transmit their signals better. In studies, Ampyra has improved walking in people with MS.

Common side effects include:

Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Naproxen sodium
  • Ibuprofen
  • Aspirin

These drugs work to reduce inflammation and pain. Possible side effects include:

  • Gastrointestinal bleeding
  • Stomach upset
Pain Relievers

Common brand name: Tylenol (acetaminophen)

Acetaminophen relieves minor pain. It does not prevent future headaches or treat the cause of the headache. It can cause liver problems if taken with alcohol. Do not drink alcohol while taking this drug. Do not take more than the recommended dose. Acetaminophen is unlikely to cause side effects (stomach upset, bleeding ulcers) associated with other pain medications.

Special Considerations

It is important to take all of the antibiotics as prescribed, even when you are feeling well.

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

When to Call Your Doctor

Call your doctor if your symptoms worsen or if new symptoms develop.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 09/2015 -
  • Update Date: 09/17/2014 -
  • Ampyra. Ampyra website. Available at: Accessed September 29, 2015.

  • Multiple sclerosis (MS). EBSCO DynaMed website. Available at: Updated May 6, 2015. Accessed September 29, 2015.

  • NINDS multiple sclerosis information page. National Institute of Neurological Disorders and Stroke website. Available at: Updated July 17, 2015. Accessed September 29, 2015.

  • Plasmapheresis. Johns Hopkins Medicine website. Available at: Accessed September 29, 2015.

  • What is MS? National Multiple Sclerosis Society website. Available at: Accessed September 29, 2015.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.