Download This Article

When you use disease-modifying therapies (DMTs) for multiple sclerosis (MS), you take the control of managing the disease into your own hands—literally. To accomplish their goal of controlling MS relapses and progression, the currently available DMTs must be delivered to the body by injection, either by self-injection or by infusion at a medical facility. Despite the benefits of taking a DMT as directed by a healthcare professional, self-injection may never be your favorite activity. But the more you know about needles and the injection process, the better you’ll be able to self-inject calmly, confidently, and comfortably. 

How DMTs Are Delivered

People with MS self-administer DMTs in 2 different ways: by subcutaneous (SC) injection, in which the needle serves to deposit medication into the fat layer just under the skin; and by intramuscular (IM) injection, in which the medication is delivered into the muscle.

The following DMTs are taken by SC injection: glatiramer acetate (Copaxone^®)—once daily, interferon β-1a (Rebif^®)—3 times weekly, and interferon β-1b (Betaseron^®)—every other day. Interferon β-1a (Avonex^®) is administered by IM injection once weekly.

Two DMTs—natalizumab (Tysabri^®) and mitoxantrone (Novantrone^®)—must be administered by intravenous infusion at the doctor’s office or clinic at 4-week and 3-month intervals, respectively.

The type and timing of injection are important topics to consider as you and your doctor choose the right DMT for you. Whatever the choice, therapy should begin as soon as possible after a diagnosis of MS and continue indefinitely.

Injection-Site Reactions

All injections have the potential to cause injection-site reactions (ISRs) in the skin, which can be a major barrier to commitment to therapy. The most common ISRs associated with DMT injections are pain and skin changes, such as redness and irritation at the injection site. They may develop acutely at the time of injection or as a gradual process. Not everyone using a DMT will experience ISRs. They are more likely to occur with poor injection technique, inadequate preparation of the skin before injection, using the wrong-size needle, or injecting repeatedly in the same area of the body; however, ISRs can still occur even with proper preparation and technique. Women are at greater risk than men, and cigarette smokers are especially susceptible.  

1   2   3