Glatiramer acetate is a synthetic compound that resembles myelin basic protein, a component of the protective myelin sheath around nerve fibres. It is thought to work by diverting the immune system's attack away from myelin, reducing the inflammation and damage that causes MS relapses. The exact mechanism is not fully understood, but Copaxone has been shown to reduce relapse rates and slow disability progression.

Unlike many other MS medicines, Copaxone does not broadly suppress the immune system. This makes it a well-established option for people who want a medicine with a long safety record.

Your dose:

There are two formulations of Copaxone. Your neurologist will advise which is right for you: 20mg injected once daily, or 40mg injected three times a week (at least 48 hours apart). Always follow your doctor's instructions.

How to take it:

• Inject under the skin (subcutaneously). Common sites include the thigh, abdomen, upper arm, and buttock
• Rotate injection sites with every injection to reduce the risk of skin reactions
• Allow the prefilled syringe to come to room temperature for 20 minutes before use
• Do not use if the solution is cloudy or contains particles

Before you start:

• Tell your doctor about all medicines, vitamins, and supplements you take
• Let your doctor know if you are pregnant or planning to become pregnant
• Your MS nurse will train you on how to inject safely before you begin

For the daily formulation:

• Take the missed dose as soon as you remember, then resume your daily schedule
• Do not take two injections on the same day
  

For the three times weekly formulation:

• Take the missed dose as soon as you remember, provided at least 48 hours have passed since your last injection
• Then continue on your usual schedule
  

If you are unsure what to do, contact your MS nurse or pharmacist.

If you think you have injected more than prescribed, contact your doctor or go to your nearest emergency department. Bring your medicine packaging.

• Store in the fridge at 2°C to 8°C
• Do not freeze. If frozen, discard and do not use
• Keep in the original packaging to protect from light
• If refrigeration is unavailable for a short period (such as during travel), Copaxone can be kept at room temperature up to 28°C for up to one month
• Keep out of reach of children and pets

Copaxone is generally well tolerated.

The most common side effects include:

• Injection site reactions: Redness, pain, swelling, and lumps under the skin are very common. Rotating sites and using correct technique reduces these. If a lump develops that doesn't go away, or if the skin changes colour significantly, tell your doctor or MS nurse
• Immediate post-injection reaction: A small number of people experience flushing, chest tightness, palpitations, anxiety, and shortness of breath shortly after injection. This usually passes within 15 to 30 minutes and is not dangerous, but can be alarming. Tell your doctor if this happens
• Lipoatrophy: Over time, repeated injections in the same site can cause local fat loss under the skin, leaving a depression. Rotating sites prevents this
• Fatigue: Some people report feeling more tired during treatment

Contact your doctor or MS nurse if any side effect concerns you.

Copaxone has few significant drug interactions because it does not broadly suppress the immune system and is not processed by the liver in the same way as many other medicines.

However:

• Tell your doctor about all medicines, vitamins, and supplements you take
• Live vaccines: Discuss any vaccinations with your doctor before receiving them

Never start, stop, or change any medicine without speaking to your doctor first.

Does Copaxone have serious side effects like some other MS medicines?

Copaxone has one of the longest and most established safety records of all MS disease-modifying therapies. It does not suppress the immune system broadly, so serious infections and immune-related complications are not a primary concern. The main side effects are injection site reactions, which are common but manageable.

Will I always need to inject daily?

The three times weekly formulation (40mg) was developed to reduce the injection burden while maintaining effectiveness. If you are finding daily injections difficult, speak to your neurologist about whether the three times weekly option might be suitable for you.

How do I manage injection site lumps?

Lumps or hardening under the skin (lipoatrophy) usually result from injecting too frequently in the same spot. Use a structured rotation schedule covering all available sites, allow each site adequate recovery time, and ask your MS nurse for a rotation map if needed.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.