glatiramer
Glatiramer (Copaxone) is used to treat relapsing forms of multiple sclerosis (MS). Glatiramer (Copaxone) is injected under the skin, either daily or three times a week, depending on your dose. Injection sites for glatiramer (Copaxone) include the arms, stomach, hips, and thighs. It can cause common side effects such as warmth and pain at the injection site. Glatiramer (Copaxone) comes as prefilled syringes. But your provider can also write you a prescription for autoinjectors, which might be easier to use. Glatiramer is available as both brand-name and generic medications.
What is Glatiramer (Copaxone)?
What is Glatiramer (Copaxone) used for?
Relapsing forms of multiple sclerosis (MS)
How Glatiramer (Copaxone) works
Glatiramer (Copaxone) is a disease-modifying treatment option for multiple sclerosis (MS). The exact way it works to treat MS is unknown. But it's thought to block certain processes of the immune system that can cause this condition.
Drug Facts
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What are the side effects of Glatiramer (Copaxone)?
Common Side Effects
- Warmth at injection site (43%)
- Pain at injection site (40%)
- Infection (30%)
- Itching and swelling at injection site (up to 27%)
- Weakness (22%)
- General body pain (20%)
- Rash (19%)
- Nausea (15%)
- Trouble catching your breath (14%)
- Anxiety (13%)
- Chest pain (13%)
- Back pain (12%)
Other Side Effects
- Pounding heart
- Vomiting
- Swelling from fluids
- Fever
- Runny nose
- Cough
- Cramps, diarrhea, and other symptoms of the stomach bug
Serious Side Effects
- Immediate reactions after injection: throat tightness, difficulty breathing
- Injection site necrosis (skin cell death): blue-black discoloration, swelling, broken skin, dent in skin
- Worsening liver problems or liver failure: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, nausea
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
bleeding, hard lump, hives or welts, itching, pain, redness, or swelling at the injection site
cough or hoarseness
excessive muscle tone
fast, irregular, pounding, or racing heartbeat or pulse
feeling of warmth
fever or chills
joint pain
lower back or side pain
neck pain
painful or difficult urination
redness of the face, neck, arms, and occasionally, upper chest
skin rash
swelling or puffiness of the face
swollen, painful, or tender lymph glands in the neck, armpit, or groin
trouble breathing
Less common
Agitation
bloating or swelling
confusion
difficulty with swallowing
feeling faint, dizzy, or lightheaded
headache, severe and throbbing
itching of the vagina or outside genitals
muscle aches or pain
pain during sexual intercourse
purple spots under the skin
red streaks on the skin
shakiness in the legs, arms, hands, or feet
small lumps under the skin
spasm of the throat
strong urge to urinate
sweating
swelling of the fingers, arms, feet, or legs
thick, white curd-like vaginal discharge without odor or with mild odor
tightness in the chest
tingling of the hands or feet
trembling or shaking of the hands or feet
unusual weight gain or loss
Rare
Blood in the urine
burning or stinging of the skin
continuous, uncontrolled back-and-forth or rolling eye movements
decreased sexual ability
difficulty with moving
ear pain
fast breathing
irritation of the mouth and tongue (thrush)
loss of appetite
menstrual pain or changes
painful cold sores or blisters on the lips, nose, eyes, or genitals
sensation of motion, usually whirling, either of oneself or of one's surroundings
speech problems
vision problems
Incidence not known
Abnormal vaginal bleeding or discharge
back pain, sudden and severe
bleeding gums
blindness
blurred or decreased vision
chest discomfort or heaviness
clear or bloody discharge from the nipple
cloudy urine
coughing up blood
dark urine
decreased urine output
difficult or frequent urination
dilated neck veins
dimpling of the breast skin
drowsiness
extreme tiredness or weakness
gaseous stomach pain
general feeling of discomfort or illness
general tiredness and weakness
headache
increased menstrual flow or vaginal bleeding
indigestion
inverted nipple
joint swelling
large amount of cholesterol in the blood
light-colored stools
lump in the breast or under the arm
lump or swelling in the stomach
muscle weakness, sudden and progressing
nerve pain
nosebleed
pain or discomfort the in arms or jaw
paralysis
persistent crusting or scaling of the nipple
prolonged bleeding from cuts
puffiness or swelling of the eyelids or around the eyes, lips, or tongue
rapid, shallow breathing
recurrent fever
red or black, tarry stools
redness or swelling of the breast
seizures
sore on the skin of the breast that does not heal
stiff neck or back
stomach bloating, burning, cramping, or pain
tearing
tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
unusual tiredness or weakness
upper right abdominal or stomach pain
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Double vision
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Glatiramer (Copaxone)
Pros
Less likely to cause serious side effects compared to some other injectable MS medications, such as Avonex (interferon beta-1a)
Can be stored at room temperature for up to 1 month
Available as lower-cost generics (Glatopa and glatiramer)
Cons
Needs to be injected every day (20 mg/mL) or three times per week (40 mg/mL)
Not well-studied in children or older adults 65 years of age or older
Injection can cause damage to skin, so need to rotate injection sites
Pharmacist tips for Glatiramer (Copaxone)
You should receive training from your provider or pharmacist on how to give yourself glatiramer (Copaxone). Make sure you know how to give yourself glatiramer (Copaxone) to avoid accidentally hurting yourself or wasting the medication. Read the Instructions for Use. Contact your provider or pharmacist if you have any questions on how to use this medication.
If you have trouble using the glatiramer (Copaxone) pre-filled syringes, talk with your provider. They can write you a prescription for the autoinjector that goes with your product, which might make it easier for you to give the injection. Keep in mind that the autoinjector from one manufacturer might not work with glatiramer products from another, so double check that the prescription is for the appropriate autoinjector.
Keep the blister packs containing the prefilled syringes in the original package to protect them from light and place it in the refrigerator. Before injecting yourself, take a blister pack out of the refrigerator and lay it on a flat surface to warm up. This will take about 20 minutes. Don't try to warm up the syringe any other way.
If you're traveling and don't have access to a refrigerator, the prefilled syringes can be kept at room temperature for up to 30 days. Read the travel guide for more tips on how to travel with glatiramer (Copaxone).
Always check the medication solution to make sure it's clear and colorless to yellow before using it. If it's cloudy, discolored, or has particles, don't use it and contact your pharmacist.
Keep the injection site guide with you to help you remember where you can inject glatiramer (Copaxone). Use a different place each time you give yourself the medication. Don't inject into the same exact place more than once a week. This will help prevent bruising or irritation on your skin. Don't inject into skin with scars or dents to avoid making your skin worse.
After giving yourself the medication, throw the needle and syringe away in a sharps container or something made of heavy-duty plastic, such as an empty milk carton or laundry detergent bottle, to lower the risk of needle-stick injuries. Don't throw away needles or syringes in your trash can.
The prefilled syringes are single-use only and should be thrown away after injecting yourself. Don't save any leftover medication that might still be inside the syringe and don't reuse a syringe. Don't share your prefilled syringes with another person. This will help prevent spreading of infections.
Frequently asked questions about Glatiramer (Copaxone)
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What are the risks and warnings for Glatiramer (Copaxone)?
Glatiramer (Copaxone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Reactions after injection
Glatiramer (Copaxone) can cause reactions (flushing, chest pain, feeling of a pounding chest, high heart rate, anxiety, shortness of breath, throat tightness, or hives) within seconds to minutes after injection. In general, these reactions can start several months after starting treatment with glatiramer (Copaxone) and you might experience one or many episodes of these reactions. These reactions usually get better over time and typically don't require treatment.
Chest pain
Glatiramer (Copaxone) can cause chest pain, which can be either an immediate reaction after the injection or as a side effect. The chest pain will usually go away over time and is not associated with other symptoms, so it's not a medical emergency. If you have chest pain with other symptoms such as difficulty breathing, feeling weak, or light-headed, call 911 right away because this can mean you might be having a heart attack.
Loss of fat tissue and injection site necrosis
Glatiramer (Copaxone) can cause loss of fat tissue (lipoatrophy) in the sites where you inject the medication. It can occur at various times after you begin treatment with Glatiramer (Copaxone) and is thought to be permanent. In addition, although rare, glatiramer (Copaxone) can cause necrosis (cell death) in the skin at the site of injection. To prevent these issues, make sure you rotate the injection sites with each injection.
Liver damage
Although rare, glatiramer (Copaxone) can cause serious liver problems that can lead to liver failure or death. Seek medical attention right away if you notice swelling of your stomach, yellowing of your skin or the whites of your eyes, stool changes (black, tarry, or bloody stools), coughing or vomiting up blood, confusion, slurred speech, mood swings, or changes in personality. You might need to stop using glatiramer (Copaxone) to prevent further liver damage.
Glatiramer (Copaxone) dosage forms
Typical dosing for Glatiramer (Copaxone)
The dose of glatiramer (Copaxone) depends on the product strength your provider prescribes. The strengths are not interchangeable.
The 20 mg/mL syringe is injected under the skin once per day.
The 40 mg/mL syringe is injected under the skin three times per week, each dose at least 48 hours apart.
Interactions between Glatiramer (Copaxone) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Tofacitinib
How much does Glatiramer (Copaxone) cost?
Glatiramer (Copaxone) contraindications
Allergy to mannitol
What are alternatives to Glatiramer (Copaxone)?
Relapsing forms of multiple sclerosis (MS)
Relapsing forms of multiple sclerosis (MS)
Relapsing forms of multiple sclerosis (MS)
What is the latest news about Glatiramer (Copaxone)?
Glatiramer (Copaxone) images
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References
Best studies we foundKhan, O., et al. (2013). Three times weekly glatiramer acetate in relapsing–remitting multiple sclerosis. Annals of Neurology.
Teva Neuroscience, Inc. (2023). Copaxone- glatiramer acetate injection, solution [package insert]. DailyMed.
Teva Neuroscience, Inc. (2023). Injection guide.
Teva Neuroscience, Inc. (2023). Travel planning guide.
U.S. Food and Drug Administration. (2022). FDA alerts patients, caregivers, and health care providers of cross-compatibility issues with autoinjector devices that are optional for use with glatiramer acetate injection.
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