Key takeaways:
There are many injections and infusions available to treat multiple sclerosis (MS). Some examples include Avonex (interferon beta-1a), Briumvi (ublituximab-xiiy), and Tysabri (natalizumab).
You may have the option to give certain injectable MS medications to yourself at home. But others must be given by a healthcare professional in a medical setting, such as an infusion center.
Your care team will discuss your multiple sclerosis treatment options with you. Factors to consider include how often and where you can receive the medication, insurance coverage, and potential side effects.
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Treatment options for multiple sclerosis (MS) have changed dramatically over the past 30 years. In 1993, the FDA approved the first injectable interferon beta treatment for certain types of MS. Since then, multiple injections and intravenous (IV) infusions have become available. MS treatments work to prevent the body’s immune system from attacking nerve cells in the brain and spinal cord. But each medication type does this in unique ways.
When considering MS treatment options, there are several factors you and your healthcare team may consider. For example, you can give yourself many injections at home, while infusions usually require administration in a medical setting. Each treatment also has potential benefits and risks to consider.
So what are the long-term injectable treatment options for MS, and how do you choose the best one for you? Below, we’ll go over eight injectable treatments and how they differ.
1. Interferon beta medications
Interferon beta medications are a type of disease-modifying therapy (DMT) that treat relapsing types of MS. They work by suppressing the immune system. While these medications don’t offer a cure, they can slow down worsening of MS and reduce flare-ups. However, they may not work for everyone.
Common interferon beta side effects include flu-like symptoms and injection site reactions. To lower your risk of side effects, your prescriber will likely start you at a low dose and slowly raise it over time.
Interferon beta medications are injected into the muscle (IM) or subcutaneously (under the skin). Where and how often you inject them can depend on the specific treatment, as detailed below.
Medication | Where to inject | Frequency |
Betaseron, Extavia (interferon beta-1b) | Under the skin | Every other day |
Avonex (interferon beta-1a) | IM | Once weekly |
Rebif (interferon beta-1a) | Under the skin | 3 times per week |
Plegridy (peginterferon beta-1a) | Under the skin or IM | Every 2 weeks |
Avonex, Rebif, and Plegridy are available as injection pens and prefilled syringes. Betaseron and Extavia both come in a vial that needs to be mixed before injecting with a syringe. But you can place the Betaseron syringe inside an autoinjector to make the injection easier.
2. Glatiramer
Glatiramer is unique because it doesn’t weaken the immune system like other MS treatments. Instead, it’s thought to act as a decoy to prevent antibodies from attacking protective proteins on nerve cells.
The most common glatiramer side effects include injection site reactions, fever, and chills. Some people also experience temporary shortness of breath and a fast heartbeat after their dose.
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There are three glatiramer products available for relapsing forms of MS:
Copaxone
Glatopa
Generic glatiramer
All three are injected under the skin either once daily or 3 times a week, depending on your dose. You can inject yourself at home using the prefilled syringe. Your prescriber can also write you a separate prescription for a compatible autoinjector.
Brand-name Copaxone was first approved in 1996. In 2015, the FDA approved Glatopa, the first Copaxone generic. Two years later, another generic version was approved under the name glatiramer. You should expect similar benefits and risks with all three products. But you may be able to save money by choosing a generic version.
3. Kesimpta
Kesimpta (ofatumumab) is an injectable monoclonal antibody. It’s thought to work by targeting B-cells (a type of immune cell). Kesimpta blocks B-cells in the lymph nodes from attacking protective nerve cell coverings. So it’s considered a targeted B-cell therapy.
There are other B-cell therapies available for MS. But Kesimpta was the first self-administered option approved by the FDA. This means you can administer it in the comfort of your own home instead of going to a medical office or clinic.
You’ll inject Kesimpta, which comes as a prefilled syringe and injection pen, under the skin once a week for 3 weeks. Starting at week 4, you’ll inject your dose once a month. Common Kesimpta side effects include upper respiratory tract infections (URTIs), injection-related reactions, and headache.
Since Kesimpta can affect your immune system, serious infections are also a possible side effect.. Because of this, your prescriber will run some tests before, during, and after treatment. If you’re sick, they may have you delay your injections until you’re feeling better.
Good to know: A rare but serious brain infection called progressive multifocal leukoencephalopathy (PML) is possible with Kesimpta. PML hasn’t been reported in people receiving Kesimpta for MS, but it has occurred with higher doses used to treat cancer.
4. Briumvi
Briumvi (ublituximab-xiiy) is another B-cell therapy for relapsing forms of MS. It’s a monoclonal antibody that works in the same way as Kesimpta, but it’s given as an hour-long IV infusion. This means you need to have it administered by a healthcare professional. After the first two infusions, Briumvi is given every 24 weeks.
Similar to Kesimpta, common Briumvi side effects include infusion reactions and URTIs. During your first two infusions and for an hour afterward, you’ll be monitored for infusion reactions. That way, if a serious reaction occurs, medical staff will be able to provide treatment right away.
Briumvi can also increase the risk of serious infections. So, it’s important to let your care team know if you’re sick before arriving for your infusion. They’ll also run some tests before, during, and after treatment. PML hasn’t been reported with Briumvi, but it’s still considered a possible side effect.
5. Lemtrada
Lemtrada (alemtuzumab) is another monoclonal antibody infusion for relapsing forms of MS. Lemtrada targets several types of immune cells, including T-cells, B-cells, and natural killer cells.
You’ll receive Lemtrada as a 4-hour infusion in a medical setting, in at least 2 courses of treatment:
First course: Once daily for 5 days in a row
Second course: Once daily for 3 days in a row, 12 months after the first course
Additional 3-day courses: Given as needed, at least 12 months after the previous course
Lemtrada has a boxed warning (the FDA’s strictest warning) for serious side effects such as an increased risk of cancer, stroke, and other autoimmune conditions. Because of this, it’s only available through a special safety program. Due to these risks, Lemtrada is typically only used after at least two other MS medications haven’t worked for you.
6. Mitoxantrone
Mitoxantrone (formerly sold as the brand name Novantrone) is a cancer treatment that’s also used for relapsing forms of MS. It’s thought to work by targeting different immune system cells, proteins, and chemicals that promote inflammation.
You’ll receive mitoxantrone as a 5- to 15-minute IV infusion. It’s administered by a healthcare professional every 3 months. The most common side effects include nausea, hair thinning, and menstrual cycle changes. URTIs and urinary tract infections are also possible.
Like Lemtrada, mitoxantrone has a boxed warning. That’s because it has an increased risk of heart failure (during or even years after stopping treatment) and certain types of cancer. Experts say that since safer options are now available, mitoxantrone shouldn’t be prescribed unless the potential benefits greatly outweigh the risks.
7. Ocrevus
Ocrevus (ocrelizumab) is a B-cell therapy for relapsing forms of MS. Unlike Kesimpta and Briumvi, it’s also approved for primary progressive MS.
After the first two infusions, Ocrevus is given every 6 months. Each infusion takes 2 to 4 hours, and you can typically receive them at home, at your prescriber’s office, or at an infusion center.
There’s also a version of this medication, Ocrevus Zunovo (ocrelizumab / hyaluronidase), that’s injected under the skin by a healthcare professional. Each injection takes about 10 minutes and you’ll receive it once every 6 months.
Like other B-cell therapies, common Ocrevus side effects include URTIs and infusion reactions. Due to the risk of infusion reactions, you'll be watched for at least 1 hour after each infusion (15 minutes for Ocrevus Zunovo). But keep in mind that reactions can happen for up to 24 hours after your dose.
Ocrevus may increase the risk of cancer, including breast cancer. While rare, there have been cases of PML and immune-related colitis (colon inflammation) with Ocrevus. Let your care team know right away if you develop new or persistent diarrhea, one-sided body weakness, or vision changes during treatment.
8. Tysabri
Tysabri (natalizumab) is an IV infusion that’s given once per month by a healthcare professional. Each infusion takes about 1 hour. Tysabri works by keeping B-cells and T-cells away from your central nervous system (CNS). This prevents them from damaging nerve cells.
Common Tysabri side effects include headache, fatigue, and joint pain. Tysabri has also been associated with PML. For this reason, it’s only available through a restricted program called the Tysabri Touch Prescribing Program.
In August 2023, the FDA approved Tyruko (natalizumab-sztn) — the first biosimilar for an MS medication. It became commercially available in November 2025. Biosimilars can typically help you save money on your prescription. Tyruko has the same dosage form and regimen as Tysabri, and will also only be available through a special safety program.
How to decide between treatment options
Having many treatment options to choose from can feel overwhelming. Keep in mind that there are also oral medications for MS in addition to the injectable options covered here. When determining the best option for you, there are several things your prescriber may consider, including:
Where you’ll be getting your treatment: Some options allow you to administer the medication yourself at home. Others require you to go to your prescriber’s office or an infusion center.
How often you’ll receive your dose: Dose frequency can vary from every day to twice a year. It’s important that you can commit to staying on schedule before starting treatment. Otherwise, it may not work as well.
Potential side effects: Side effects can vary among the different MS medications. Your care team should discuss the potential benefits versus the risks with you.
Cost: If you have insurance, your plan may only cover certain treatment options. You can also check to see if the manufacturer provides a copay savings card or patient assistance program that can help reduce the cost of the medication.
The bottom line
Infusions and injections for MS can offer flexible dosing schedules and prevent relapses over the long term. However, they differ in terms of side effects, administration time, and whether you can receive the medication at home. When choosing a treatment option for MS, your healthcare team can help you weigh the risks and potential benefits to find the best option for your needs.
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