Glatiramer

Glatiramer is a prescription medication used to treat symptoms of Relapsing-Remitting Multiple Sclerosis (RRMS). Glatiramer belongs to a group of drugs called immunomodulators, which are thought to work by stopping the immune system from destroying the protective coating around nerve fibers.

This medication comes in an injectable form in a prefilled syringe and is injected just under the skin. Glatiramer can be injected once daily or three times a week. 

Common side effects include redness, pain, or itching at the injection site. 

Glatiramer is a prescription medication used to treat Relapsing-Remitting Multiple Sclerosis (RRMS). 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Glatiramer may be found in some form under the following brand names:

• Copaxone

• Call your doctor right away if you develop any of the following symptoms: hives, skin rash with irritation, dizziness, sweating, chest pain, trouble breathing, or severe pain at the injection site. Do not give yourself any more injections until your doctor tells you to begin again.
• The most common side effects of glatiramer are redness, pain, swelling, itching, or a lump at the injection site. These reactions are usually mild and seldom require medical care.
• Some patients report a short-term reaction right after injecting glatiramer. This reaction can involve flushing (feeling of warmth and/or redness), chest tightness or pain with heart palpitations, anxiety, and trouble breathing. These symptoms generally appear within minutes after an injection, last a few minutes, then go away by themselves without further problems.
• A permanent depression under the skin at the injection site may occur, due to a local destruction of fat tissue.
• If symptoms become severe, call the emergency phone number in your area. Do not give yourself any more injections until your doctor tells you to begin again.

These are not all the possible side effects of glatiramer. For a complete list, ask your doctor or pharmacist. Tell your doctor about any side effects you have while taking glatiramer.

No glatiramer drug interactions have been identified, however, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

• Glatiramer is not recommended for use in pregnancy. So, tell your doctor if you are pregnant or if you plan to become pregnant while taking this medicine.
• Tell your doctor if you are nursing. It is not known if glatiramer is passed through the breast milk to the baby.
• Do not use glatiramer if you are allergic to glatiramer acetate or mannitol.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of glatiramer there are no specific foods that you must exclude from your diet when receiving this medication.

Before receiving glatiramer, tell your doctor:

• if you are allergic to glatiramer or any other medicine.
• if you have kidney disease.
• if you are pregnant.
• if you are breastfeeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Glatiramer falls into category B. There are no well-done studies that have been done in humans with glatiramer. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

It is not known if glatiramer crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using glatiramer.

• Look at the medicine in the pre-filled syringe. If the medicine is cloudy or has particles in it, do not use it. 
• Each pre-filled syringe should be used for only one injection. Do not reuse the pre-filled syringe. After use, throw it away properly.

There are 3 basic steps for injecting glatiramer pre-filled syringes.

Step 1: Gather the materials

• First, place each of the items you will need on a clean, flat surface in a well-lit area:
  • 1 blister pack with glatiramer Pre-Filled Syringe
  • Remove only 1 blister pack from the glatiramer Pre-Filled Syringe carton. Keep all unused syringes in the Pre-Filled Syringe carton and store them in the refrigerator.
  • Alcohol prep (wipe)
  • Dry cotton ball (not supplied)
• Let the blister pack with the syringe inside warm up to room temperature for 20 minutes.
• To prevent infection, wash and dry your hands. Do not touch your hair or skin after washing.
• There may be small air bubbles in the syringe. To avoid loss of medicine when using glatiramer pre-filled syringes, do not expel (or do not attempt to expel) the air bubble from the syringe before injecting the medicine.

Step 2: Choose the injection site

• There are 7 possible injection areas on your body: arms, thighs, hips and lower stomach area (abdomen).
• Each day, pick a different injection area from one of the 7 areas. Do not inject in the same area more than once a week.
• Within each injection area there are multiple injection sites. Have a plan for rotating your injection sites. Keep a record of your injection sites, so you know where you have injected.
• There are some sites in your body that may be hard to reach for self-injection (like the back of your arm), and you may need help.
• Do not inject in sites where skin depression has occurred, because further injections in these sites may make the depression deeper.

Step 3: Give yourself the injection

• Remove the syringe from its protective blister pack by peeling back the paper label. Before use, look at the liquid in the syringe. If it is cloudy or contains any particles, do not use it. If the liquid is clear, place the syringe on the clean, flat surface.
• Choose an injection site on your body. Clean the injection site with a new alcohol prep and let the site air dry to reduce stinging.
• Pick up the syringe as you would a pencil. Remove the needle shield from the needle.
• With your other hand, pinch about a 2-inch fold of skin between your thumb and index finger.
• Insert the needle at a 90-degree angle (straight in), resting the heel of your hand against your body. When the needle is all the way in release the fold of skin.
• To inject the medicine, hold the syringe steady and push down the plunger.
• When you have injected all of the medicine, pull the needle straight out.
• Press a dry cotton ball on the injection site for a few seconds. Do not rub the injection site.
• Throw away the syringe in a safe hard-walled plastic container.

The recommended dose of glatiramer for the treatment of Relapsing-Remitting Multiple Sclerosis is:

• 20 mg once a day injected subcutaneously (in the fatty layer under the skin) OR
• 40 mg three times per week injected subcutaneously (in the fatty layer under the skin) 

If you take too much glatiramer, call your local Poison Control Center or seek emergency medical attention right away.

Keep the glatiramer pre-filled syringe carton in the refrigerator, out of the reach of children.

The glatiramer package should be refrigerated as soon as you get it, at 36-46°F (2-8°C). If you cannot store glatiramer in a refrigerator, you can store it at room temperature, 59-86°F(15-30°C), for up to one month. Do not store glatiramer at room temperature for longer than one month. Do not freeze glatiramer. If a glatiramer pre-filled syringe freezes, throw it away in a proper container.

Glatiramer is light sensitive. Protect it from light when not injecting. Do not use the pre-filled syringe if the solution contains particles or is cloudy.