Guide to Copaxone/Glatopa
(Glatiramer Acetate)

Multiple Sclerosis (1)

Copaxone is a prescribed medication used to treat relapsing forms of multiple sclerosis (MS). This includes clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults.

In 2015, the FDA approved the first generic, Glatopa. Then in 2018, the second generic, Glatiramer Acetate, was approved.

Use this guide as a reference for vital information to know while taking this medication. Always consult with a healthcare professional or your health care provider to decide if this drug is right for you. (For the sake of simplicity, we will use Copaxone as the drug name throughout this article)

What is Multiple Sclerosis (MS)?

Multiple Sclerosis (MS) is a chronic, disabling condition that damages the central nervous system (CNS). The CNS includes the brain and spinal cord.

With MS, a person’s immune system attacks the protective sheath (myelin) that covers nerve fibers. This attack causes communication problems between your brain and the rest of your body, leading to permanent damage or deterioration of the nerves.

Relapsing-remitting MS is MS in which patients have relapses of MS and periods of stability in between relapses. Relapses are episodes of new or worsening symptoms not caused by fever or infection, lasting more than 48 hours.

Secondary-progressive multiple sclerosis (SPMS) is MS that develops from relapsing-remitting multiple sclerosis (RRMS). Because the course of MS varies, not all people who have RRMS will develop SPMS. There is currently no way to know who will eventually develop SPMS. However, those who have frequent severe relapses seem to be at higher risk.

Causes of MS

The cause of MS is still unknown. Scientists believe a combination of factors may trigger MS. According to The National Multiple Sclerosis Society, research is ongoing in the areas of:

  • Immunology (the study of the body’s immune system)
  • Epidemiology (the study of disease patterns in large groups of people)
  • Genetics (understanding the genes that may not be functioning correctly in people who develop MS)
  • Infectious agents (such as viruses)

Having a better understanding of what causes MS may help facilitate the development of more effective ways to treat, cure, and even prevent the disease.

Complications and Symptoms of MS

MS symptoms aren’t predictable, vary from person to person, and each person’s symptoms can alternate over time. A person might only experience one or two symptoms, while another person experiences many of them.

While there is no known cure for MS, medication, rehabilitation, and other management strategies can help control the symptoms effectively. Working with an interdisciplinary team of healthcare professionals is one of the most critical components of overall MS care.

Common Symptoms of MS

  • Numbness or weakness in limbs and trunk of the body
  • Lhermitte sign– Electric-shock sensations that occur with specific neck movements
  • Tremors, lack of coordination, unsteady gait
  • Vision problems such as partial or complete loss of vision, prolonged double vision, or blurry vision
  • Slurred speech
  • Fatigue
  • Dizziness
  • Tingling or pain in parts of your body
  • Issues with sexual, bowel, and bladder function
  • Depression
  • Cognitive and emotional changes
  • Swallowing problems

The primary symptoms are the direct result of damage to the myelin and nerve fibers in the central nervous system (CNS). However, secondary symptoms can occur from complications of primary symptoms.

Some examples are:

  • Bladder dysfunction from repeated urinary tract infections.
  • Loss of muscle tone, weakness, poor posture, decreased bone density, increased risk of fracture, and shallow, inefficient breathing from inactivity.
  • Immobility can cause pressure sores

While secondary symptoms are treatable, the goal is to avoid them by managing primary symptoms.

What is Copaxone and How Does it Work to Treat Multiple Sclerosis?

Copaxone is a disease-modifying agent used to treat progressive Multiple Sclerosis (MS). It uses a synthetic protein that simulates myelin basic protein, which is used to insulate nerve fibers in the spinal cord and brain. The medication also helps to block myelin-damaging T-cells through a mechanism that is still not completely understood.

Copaxone is an injectable medication that combines four amino acids used to treat relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS with relapses).

In 2014, the FDA approved a higher dose of Copaxone to 40mg, three times per week, taken at least 48 hours apart. This higher dose doubled the standard once daily 20mg dose. However, it did require the medication to be administered subcutaneously, not intravenously. Patients and their physicians could now choose between the two dosage regimens.

Glatopa, the first generic version of Copaxone, was approved in 2015 at the original 20-mg daily dose. In February 2018, Glatiramer Acetate was also approved at the newer, 40-mg three-times-weekly injected dose.

How Long Does it Take for Copaxone to Start Working?

The medication starts taking effect in the body right after your first injection. However, its effects might not be evident for several months, so it is important to continue taking the medication as instructed by your doctor. Your physician will perform MRIs to determine if any relapses have occurred each year. Copaxone is a long-term treatment and should be administered for as long as the rug is tolerated or remains effective.

How Effective is Copaxone in Treating Multiple Sclerosis?

Copaxone has been shown to reduce relapses in people with MS by 34-56% after two years of use. It took an average 287-700 days for a relapse to occur for those taking Copaxone, compared to 150-198 days for those on the placebo. A trial has shown a significant reduction in brain lesions for those taking Copaxone, which will continue to be studied.

What are Possible Side Effects of Copaxone?

Taking Copaxone does have potential side effects. Although not all of these side effects may occur, they may need medical attention if they do occur.

Alert your doctor immediately if you experience any of the following side effects:

Most Common Side Effects

  • Injection site reactions (swelling, soreness, redness, pain)
  • Shortly after injection- Shortness of breath, anxiety, fast heartbeat, itching, and flushing may occur.

Least Common, but Serious Side Effects 

  • Dizziness/fainting
  • Chest pain
  • Persistent Nausea and Vomiting
  • Loss of appetite
  • Stomach/Abdominal Pain
  • Dark Urine
  • Yellowing eyes/skin
  • Signs of infection (such as fever, persistent sore throat)
  • Depression or other mental/mood changes
  • Tremors
  • Swelling of legs and feet
  • Vision problems

Other side effects not listed may occur in some patients, and some usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Please consult with your doctor with any potential side effects, as they might be able to tell you ways to prevent or reduce some of them.

Interactions

Drug interactions can change how Copaxone works and cause serious side effects if contraindication occurs. It is vital to keep a list of your updated prescriptions, supplements, and any over-the-counter  you take and share with your doctor and pharmacist, who can determine if a drug interaction may occur.

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