Avonex vs Copaxone

[woodstock]

I have my follow up appointment with the neuro at the end of the month. Had my first MS event at the end of June at age 48 and from what my pcp has told me, the neuro has dx me as CIS and with a vitamin D deficiency. I have less than five brain lesions (only two measurable) and spinal tap was positive.

From what we discussed at the first visit in August, I believe she's going to recommend not only Vitamin D supplementation, but also a dmd.

Ideally, I believe my neuro will recommend Copaxone, but I have a number of concerns. First and foremost, I am an absolute wuss about injections...am getting lightheaded just reading other's posts about the daily injection and the bee sting like feeling, not to mention the other side effects of bruising and such.

The second choice dmd I believe will be Avonex, which I am considering because of the 1x per week. My concern there is that I work at a school, year round, and will need to be able to continue working full time for at least a few more years (10-12 hopefully). I could do the injections on a Friday and have the weekend to recover, but don't want to spent all my free time 'recovering'.

Can anyone provide pros/cons of either medication especially for someone like me who works full time and has a real fear of needles?

[Waydwnsouth1]

I found myself in the same situation in April. I did all my research and ended up deciding on Avonex. I prefered the once a week injections and fewer side effects IMO. In time I learned the best shot time, what to take to take the edge off of the side effects. The worse being flu like symptoms. I take a 800mg Ibuprofen before my shot and 4 hours after. I stay hydrated by drinking plenty of fluids such as, water or powerade.

The first month or two the flu like sx were geting the best of me. I injected on Saturday afternoons and have switched to night time injections. After 6 months of injections the side effects have mostly faded away.

It really comes down to personal preference. Do your research and don't let the injections sway you they really are not that bad. You make the decision not your doc. Good Luck to you! You came to the right place for advice.

[BigA]

I was 45 in the same position. Here's my opinion.

1) Before you do anything else, you need to look up taking a 1-off mega dose of VitaminD. Nothing is going to do more to help prevent a relapse. Here's the info

You owe it to yourself to read through the whole website. There's a lot to learn.
http://www.overcomingmultiplescleros...esources/FAQs/

2) I can't get Copaxone so I use avonex. The weekly shot is nice 6 days a week, but that 1 day.. that 1 day is massive. You may have forgotten what the flu feels like. Chills, body aches, terrible headaches and feeling terrible. Some people don't get it much, but if you do, be prepared to give up one day of your life until you get used to it.

3) As far as needles, the copaxone is the teeny-tiniest and there is an auto-injector, so you don't have to look at it. The Avonex nail, I mean needle is l o n g and THICK and goes into muscle, over an inch deep.

4) Copaxone has no side effects on your liver or your immune system, exept regarding mylen. With Avonex, you may have a reduced immune system - just slightly lowered. I have a low white blood cell count on Avonex.

5) Copaxone may burn or have site reactions. You have to see how your skin agrees with it or not. Avonex has none.

6) If you do get the Avonex, be sure to get a titrated dose. I think they just have you inject 1/4 1/4 1/2 1/2 1, something like that.

Good Luck!

oh, and EXERCISE a lot. It helps symptomatically and can heal nerves.

[seeuinct]

So helpful

I love coming to this site! This was one of my questions (avonex or copaxone) several days ago.
I was recently dx and have been given those 2 options as they are covered under insurance. I have been researching the meds thoroughly. I am thinking about avonex but I have depression/anxiety which I take meds for. I also have hypothyroidism which I take meds for.
I really only want to do the shot once a week. Do the side effects get better? I am a teacher and was thinking Friday nights the best bet to take the shot but will I be able to cope with that every weekend? It is a lot to consider so thank you both for sharing.

[Kraheera]

There wasn't much of a choice for me. I literally cannot have one day or 3 days a week where I am out for the count, because I'm the only parent int he house with kids the age of 2 and 7.

It just isn't possible right now. I too have that horrid wuss bit when it comes to needles.

Copaxone is a pain in my butt, but if I can manage to catch less than a 2 second glimpse of the needle after the shot, I don't do too bad. And the injector keeps me from seeing the actual needle until after the injection, so that's a plus.

The downside is... the bee sting in certain areas (i.e. the stomach) kicks my butt. I'm hoping I get used to it. My stomach and arms swell a little bit - just like if I had been stung by a bee honestly - but that's usually the worst of it for me so far.

[BigA]

Ask your doctor about your thyroid. Copaxone is really a better medicine and wouldn't think the copaxone shots will be too difficult.

That said, I used to take my shot friday morning with hedaches in the evening. Now I take it Saturday morning and go about taking care of my weekend stuff.

I tried a shot at night but had a terrible headache all night long. Some people do night shots with no problems.

[dpmich]

Really the Avonex needle is not that long or thick. Doing the once a week injection (that I don't even feel) is soooo much better than the every other day or everyday option. I was on Betaseron for 6 years. It helped keep my progression at bay but the injection sores and site re-actions is why I quit it.

The after effects of my Avonex shots is a dull headache the day after. Thats it. The 1st shot no wasn't that way but for every shot after the sypmtoms have lessened. Ultimately it is your choice to make. Don't let people scare you into, or out of, the DMD you feel is the right choice for you. And as you probably know, the one you pick right now is NOT carved in stone. Good luck to you.

Debbie

[chucklebug]

You can also have your doc prescribe the shorter, thinner needles. I'm not sure what the gauge is, but it's definitely more petite than the ones that come with the Avonex. My neuro put those in the prescription without asking me. Bless him.

I'm only in my 3rd week, so I'm no expert by any means, but I can tell you that after chilling the site (the nurse gave me a nifty Avonex-branded velcro wrap that holds a cold pack) helps a LOT. The needle just glides in with no trouble, and very little pain. And no site reactions so far. BTW, the regular needle is just like the one they use for a flu shot.

I am on a titration, that goes 1/4, 1/2, 3/4, full over a month.

Another nice thing about Avonex is that you can shift your shot day by 24 hours week-to-week. I take mine on Friday nights, so I don't feel fluish on a work day. But my birthday is this Saturday, and Friday's a holiday, so I'll take my does this week on Thursday so I'm feeling good for my birthday celebration!

For me, Avonex is clearly the best option in terms of convenience. I just hope it works.

Full disclosure, though: I can be a real baby about a lot of things (I'm terrified of bees, for example) but I have no fear of needles. Probably because I had to get allergy shots every 4 days from age 5 - 14. Plus I used to take insulin, although the intramuscular shot is quite different from subcutaneous.

[Alicious]

My thought is that if you can get used to once a week shots, you will be astounded by how the needles get less and less scary every time you inject. You may find that as the years go on that switching to another med is an option that it may not seem to be right now. Hopefully you won't need to for medical reasons (many people switch at least once), but having options is always a good thing, and your fear of needles is almost certain to diminish.

No matter what , getting a med into your body is critical, and if that means that weekly injections are the way to make it happen, that's what is important. If you cannot face daily injections with Copaxone, then by all means, start with Avonex.

There was a time when I was terrified of needles too. Now, it's nothing big to inject. Really. xoxo

[BigA]

That is true about being able to move the shot. I moved mine from Saturday to Sunday last week because I just didn't feel well.

What I can also say is that the Avonex people (Biogen) generously send me my shots since my insurance doesn't cover it, so they have my gratitude. Copaxone does not have a free medicine program and I know people who lost their insurance who are struggling to continue with their copaxone. If you're taking Avonex and your situation changes, they will help you out.

[WALKINGHORSEWOMAN]

I take my Avonex on a weeknight and make sure that I take Advil Pm along with it.

I always have the sweats/chills with it, even after over a year on the med. But as long as I take the Advil PM I can sleep most of the night, and the next day I am generally a little achy/blah but I usually make it through my work day. Very rarely do I go home early.

I figure 1 day a week of not feeling my best is OK, but it certainly won't be on the weekend!

[Sharonkerry]

I have used Avonex for 5 years. In fact it will be 5 years today. Shot night is Tuesday after I get home from work. I take 2 Alieve gel caps - they last through the night. I have minimal side effects. I don't loose any time. I also use a smaller needle than what come with the kit.

If I ever use Copaxone I would perform my shots manually and not use an auto injector. It's less damaging to the skin.

Over the years I've moved from doing my shot in the morning to night. I used to work out about an hour after my shot. I found that helped me get through the side effects in the beginning. As time has gone by the side effects have become minimal.

All the best!
Sharon

[Tracelyn]

I have taken Copaxone and I am currently on Avonex.
Here is my comparison of them.

Copaxone has a thin needle that is a SubQ (into the fat) shot. It can cause injection site reactions, raised bumps and welts. There were no flu symptoms for me, and the autojector is awesome. I will say that the medicine stung pretty smartly. I eventually found myself purposely avoiding taking the shot daily and asked to be switched to another med.

I was placed on Avonex. For me the avonex shot is great. I have no site reactions from the injection. It does not burn or sting. The typical kiit comes with a pretty big looking needle, but your doctor and request a smaller/thinner needle, like mine did. It also does not have a autojector at this time (atleast in the US), but I have gotten myself into the groove of where to "stab" my self and not flinching. I do tend to get a the flu like symptoms. Hydration and Aleve are my best friends. I take mine are saturday nights so if I need to rest more on Sunday to get over the feelings I can.

For me Avonex has been a godsend. I do not avoid my shot nights, I just move it a day forward or behind if Sunday is really needed for something else.

Some people are concerned with the possibility of depression on the the meds. I personally had depression before I was dx'ed with MS, and my Neuro increased my dosage of AD's as MS itself has been known cause depression.

[jonsanders]

Copaxone vs Avonex

Hi there, I've just joined this site as I was looking for answers on this subject.
I have just switched to Copaxone from Avonex which I hope will be better for me.
Avonex was ok once I got used the the injections, this was before the auto pen. The injector looked like a torture device and the needles are quite long so as to get deep enough into the muscle.
After many years I had got to the point that the side effects were only just wearing off before I had to inject again! The tiredness and depression had become too invasive and I felt as if I was set in concrete most of the time too.
I have high hopes for the Copaxone, it seems to feel a little like a bee sting but I worry about the fat loss around the injection sites as it is irreversible.
Has anyone out there had Copaxone for a while that can put my mind at rest?

[woodstock]

I'm the original poster of this thread. After much consideration, I decided to go with Copaxone and have now been on it for more than a year. I admit that I postponed starting it from Nov 11 until the end of March 12. My repeat MRI in June 12 did show one small new lesion which I can't help but wonder if it developed as a result of my delay.

The first 3 months or so on Copaxone were a challenge. I started out doing the shots at night because they would hurt for over an hour, sometimes longer and I couldn't imagine doing the shots in the morning and then wearing dress clothes for work over the sites. I did the heating of the skin, then injecting, then ice at first. Now, I do my shots in the morning and don't heat or ice the locations.

My first nurse who came out suggested I use a depth of 4 at every site location and I feel that much of the pain I experienced was probably due to the shots not being deep enough. I would have redness, pain, and swelling (like the medication was just below the surface of my skin which at that depth it probably was). I am now up to an 8 in most of my sites. I am anal about recording where I take each shot and rotate religiously to avoid necrosis. I also avoid spots where I have stretch marks or any marks on my skin.

I discovered that once I had a second nurse come out to go over the injection training again, that I did much better and had fewer site reactions. I changed to am shots when the sites weren't hurting much within a few minutes after injection. In the morning, I have to be out the door to work by a certain time, so it forced me to get the shots done and overwith. When I was injecting in the evenings, I started out doing them at 7 pm and found myself sometimes staying up until midnight or later because I was trying to avoid the injections.

The good news...since being on Copaxone full time, no new lesions and a shrinking of the few lesions I had. Just got recent blood test results back and have my highest Vitamin D levels yet. I was at a 29 at the end of last summer and now am at a 47! I'm hopeful that it bodes well for the future.

Still, I do find myself getting tired of the injections from time to time and I'm going to discuss the possibility of switching to BG-12 in the future. Just concerned that it seems like Copaxone is working and don't want to switch and then all of a sudden find that I should have stuck with it. Hope this helps!