Understanding your disease-modifying therapy (DMT) options

What are the different ways you can take a DMT?

There are 3 forms of DMTs: injection, oral (taken by mouth), and infusion. A summary of each, including some of their advantages and disadvantages, is below.

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Injection–An option that comes in 2 forms for multiple sclerosis (MS): subcutaneous (administered under the skin) or intramuscular (administered in the muscle).

Subcutaneous injections are used when the medicine can be delivered in small amounts

Intramuscular injections deliver medicine in a way that helps the medicine absorb over time and provides a steady dose

PROSCONS

  • Can be given by a healthcare professional in a healthcare setting, or at home by a care partner or yourself, depending on the DMT
  • Typically taken less frequently than orals, ranging from every other day to once per month (depending on the DMT)
  • Some DMTs that come in this form have well established safety profiles
  • You have to inject yourself with a needle, which may not be ideal for adherence if you have a fear of, or aversion to, needles
  • Those with certain medical conditions may be at a higher risk of getting infections at the injection site
  • Some of the lowest efficacy DMTs come in this form (may apply to some older DMTs)
  • May require refrigeration, which can be a challenge when traveling
oral icon.

Oral–A convenient option for most people living with MS who can swallow pills or tablets and remember to take medicine regularly.

PROSCONS

  • Easy to take and fit into your routine
  • Can be taken anywhere and discreetly
  • Often taken just once or twice a day
  • May forget doses at times
  • May require you to follow a set dosing schedule when you start treatment to get to the daily dose (your healthcare professional can often give you a starter pack for this)
  • May require you to take it with food or have food restrictions
infusion icon.

Infusion–A medicine delivered directly into a vein, used when a fast effect or precise amount of medicine is needed or when the medicine is poorly absorbed in the gut.

PROSCONS

  • Taken the least frequently of any DMT form (as little as 2 times per year)
  • DMTs in this form are known to provide high efficacy
  • Requires you to travel to an infusion center or your healthcare professional’s office
  • DMTs with higher efficacy, including those in this form, are known to have higher associated risks
  • Takes the most time to administer

Your healthcare professional may prescribe a DMT based on the form that’s most appropriate for you and the level of effectiveness it provides. It's important to share with your healthcare professional your thoughts on how you'd like to take your DMT so your medicine works with your life.

Some questions you may want to think about include:

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Does the medicine come as a pill, injection, or infusion? How often do I have to take it (daily, weekly, monthly, or every few months)?

What’s the process of starting the treatment like, and do I think I will be able to continue taking it given my current lifestyle?

What if I need to pause my treatment, for example to plan for a family, to prepare for a surgery, or to receive certain vaccinations?

What do study results show? How well does the medicine manage MS?

How safe is this DMT compared with other options?

How does this DMT compare with other options? What was it studied against?

How does the medication need to be stored? How long does it last?

What other medications am I taking, and what other conditions do I live with?

You're the best judge of what you want and need in an MS treatment. How you take the medicine may be very important to you, so be sure to talk it through with your healthcare professional. Together, you can choose the treatment that works with your life today with an eye toward the future. See more treatment factors to consider here.