Multiple sclerosis, Treatment

Hit me with your best shot: Comparing Betaseron and Copaxone

Switching MS treatments has been more of an adjustment than I thought.

I figured a shot was a shot was a shot, right?


In a layman’s way, I get how Betaseron and Copaxone are different — the former is an interferon that works by reducing the ability of inflammatory cells of the immune system to enter the central nervous system, while the latter is a polypeptide mixture and induces the immune system cells to behave as anti-inflammatory cells.

OK, so I just ripped those from smarter-sounding sites. But I know they fight MS in different ways.

What I didn’t expect was just how dramatically different the shots themselves would be. Both are subQ, meaning they go under the skin and not any deeper. Both come with a handy-dandy auto injector, the magic wand of shot delivery. Both have strict rotation-site schedules. Both warn of long-term injection site problems (necrosis in one, lipoatrophy in the other). Both have about the same success rate (30 percent) in reducing MS flare-ups.

And neither is as fun as being on a trampoline to be sure. But then, what is?

With Betaseron, it was such a big production, like putting on Les Mis every other night in our dining room: The ritualistic mixing, the preparation (mental and physical), the deep pain that came and went in a matter of moments. The biggest side effects are flu-like symptoms, which I got a small dose of during my time on it. But I always made sure to take it right before bed so that I could sleep off the icky stuff.

There’s also the depression side effect, which is something I never gave much thought except in retrospect (as in, right this second). Am I happier now than two months ago? Maybe? I guess I thought my sadness was the result of my circumstances, but the argument can be made that my inability to cope or “get over it” pointed to a larger underlying issue. (It’s 2:30 in the morning — who doesn’t ruminate if they are up at this hour?)

But I digress.

Copaxone is an every-night shot. There is no 58-step preparation. This one is pretty much lock and load and go. Oh, but there is the whole problem of getting the right depth setting for the needle that comes down to how much skin you can pinch in the injection site area.

The side effects with Copaxone are definitely more immediate — a bee sting sensation at the injection site that can last anywhere from 5 to 20 minutes, tenderness, bruising. And those are the “good” shots. The not-so-good ones, which I’ve only had the once, cause flushing, chest tightness and symptoms similar to a heart attack.

Apparently, I hit a vein in my leg, which caused tinnitus and my vision to go into Fear and Loathing mode. I got really flushed and almost passed out. Thankfully, I didn’t have the other side effects and the episode lasted for about 10 minutes, tops.

Still, that was enough to make me want to walk run away from Copaxone for a good long time. But I won’t. I’ve since taken several shots with no problems, and I was given pointers on how (and where) to do the leg.

Another big difference? With Betaseron you rub the medicine in, which was a good feeling for someone like me who can’t leave well enough alone. Copaxone, you can’t touch the injection site, no matter how much you want to scratch or rub.

I’ll dutifully continue treatment, but I long for the day that I take a pill and be done with it. (Gilenya won FDA approval a year ago, but this is one case in which I won’t be an early adopter.)




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