Copaxone is a disease modifying agent in the form of a glatiramer acetate injection. It was first approved in 1996 for treating relapsing-remitting form of multiple sclerosis (RRMS). Clinical trials showed that treatment with Copaxone contributed to a reduction of relapses and reduction in new lesions. Copaxone has been available as a 20mg daily injection since 1996, and additionally as a 40mg three-times-weekly injection, since 2014.
How Copaxone works
As an autoimmune disease, MS can cause the immune system to attack itself. In MS, T-cells that are supposed to fight infections can do damage to myelin. Healthy myelin protects axons in the central nervous system, and axons are responsible for transmitting signals from the brain to the body. When myelin sheath is damaged, signals from the brain are blocked or confused, resulting in MS symptoms.
Glatiramer acetate is a synthetic protein that simulates the base protein of myelin. It serves to block T-cells from doing further damage to myelin, and in turn, prevents further progression of the disease. It is also thought to modify immune processes that are negatively affected by MS, by activating immune cells that help reduce inflammation of lesions upon reaction with the synthetic protein.
Glatiramer acetate is rapidly hydrolyzed (broken down and absorbed) upon injection. A trial of oral glatiramer acetate showed little to no benefit, and so injection is the only method used now.
Copaxone is administered via subcutaneous injection (fat layer under the skin above the muscles), daily with 20mg dosage or three-times a week with 40mg dosage. The medication is pre-filled into disposable syringes, which must be stored in the refrigerator, and then used at room temperature.
Injection site should be cleaned with an alcohol wipe or swab before and after injection. The areas of the body that can be injected are: back of upper arms, front side of thighs, upper buttocks, and abdomen. Ice packs can be used to prep the skin and/or to soothe after injection.
Used syringes must be disposed of properly into a medical sharps container. Needle cutters, which clip and store up to 1,500 needle tips, can also be purchased. Copaxone also offers a product called Autoject 2, which is an automatic injection device to help make injections more comfortable and to access hard-to-reach areas on the body.
Common adverse reactions to watch out for are: injection site reactions (redness, swelling, irritation), vasodilatation (widening of blood vessels), rash, shortness of breath, and chest pain. These presented in 5% of patients in clinical trials. Be sure to ask your doctor about other possible side effects and drug interactions.
Copaxone is not typically available at the local pharmacy, but is ordered through and delivered by special pharmacies. There is currently no generic form of Copaxone, however, there are available programs that can provide assistance. Shared Solutions is a program network provided by Copaxone to assist with injection training, peer & nurse support, and financial & insurance assistance.
My experience with Copaxone
With my history of adverse reactions to other medications, Copaxone was the first and only MS medication prescribed to me. The neurologist explained it to me as the mildest drug on the market. No blood testing was required before I started, and none are required for maintenance.
I started with 20mg of Copaxone in 2012 and, when it became available, I tried 40mg for the convenience of injecting only three times per week. However, due to my hypersensitivity, the 40mg solution burned under my skin, and due to my “MS brain,” I kept forgetting my injection schedule. I went back on 20mg as it definitely proved to be milder, and injecting myself daily was easier to remember.
There is the nagging reality that there is no cure for MS, which makes the injections feel like empty promises. They also hurt and I don’t feel any immediate results. But then I turn myself around and practice gratitude for the other realities. That just a few decades ago there were few to zero treatment options for people living with MS– and now, I have one of many to choose from. It doesn’t hurt as much when I think about that.
Have you taken Copaxone?
Shortly after earning her MSW degree from Columbia University and starting a career in psychiatric social work, KM was diagnosed with multiple sclerosis. She stopped working in 2013 and became active in the MS community. She joined team Park Pedalers for Bike MS: Coast the Coast in 2014 and she will be riding with them again this year. She lives in New Jersey with her husband, two children, and her nursemaids—cat, Mali, and dog, Moby.