Copaxone and nausea/indigestion

[Alicious]

Has anyone else had a nausea or indigestion reaction while taking Copaxone? Did anything help?

I started Copaxone on November 12. About 5 days later, I got really nauseated one morning for about 5 minutes. Two days later, I almost vomited in the morning, but felt fine the rest of the day. The past three days, within about 1-3 hours of injecting in the morning, I get what I call "pre-nausea," which is that feeling you get when you haven't eaten for far too long, or when you know something is wrong and it could lead to nausea. I'm not pregnant.

This now lasts all day long. I also have a feeling of indigestion, and am burping more than I would expect, and it relieves pressure, just as it would if I were actually eating something that was making me feel ill.

I called Shared Solutions (the drug maker) and spoke with a nurse and a pharmacist/medical researcher, and they confirmed what the full prescribing info said--that 11% of people on the placebo and 15% on Copaxone experienced nausea in the clinical trials. The pharmacist was able to tell me that while it is really rare that the few people they studied with this issue has it resolve within six months. The nurse kept asking me about site reactions.

Six months. UGH. I'm going to start taking my shots at night and see if that helps, and will discuss it with the neuro in December 2 to get his take on it, but this is immensely annoying. I wake up feeling fine, but the feeling lasts and is even worse by bedtime, some 14 hours after injection. I only have so much faith that dosing at night will help. Antacids, etc. don't help either. I'm wiling to suck this up for awhile, but long term this just isn't doable if there are other options...and there are.

[Alicious]

Dr. Google (ok, drugs.com) tells me that nausea is a common side effect of mannitol, the diluent in Copaxone. At least that's a potential answer.

[MrsBones]

I had nausea for maybe the first month or so of Copaxone. It eventually went away on its own.

Until it did, I talked to the doc and he gave me an rx for Tigan. Problem solved.

I don't know if it has anything to do with anything, but there's 40 mg of mannitol in Copaxone compared to much larger doses in those described on drugs.com for mannitol use as a drug.

Do you have any issues with sugar free gum, low calorie/ sugar free foods, some toothpastes or mouthwashes? Mannitol is very commonly used in many food and hygiene products. Take a look at those products. If they make you nauseous as well, mannitol may be the culprit. More likely it's a generic Copaxone side effect.

[Alicious]

I am relived to hear it went away in a month or so. On the phone with Shared Solutions, I swear they were looking at the receiver as though I had two heads and then tried to change the topic back to site reactions. I guess we're rare birds! (OK, the pharmacist was great. The nurse didn't know what to do with my complaint.)

I have never had a problem with gum, etc., so perhaps it really is the Copaxone. As long as it goes away eventually, it's OK. I (pathetically) don't want to ask the neuro for a script--I had hyperemesis in pregnancy (as well as in home IV service, a Zofran pump, Tigan, Phenergan, Reglan, you name it for the every 45 minute vomiting) and the mere idea of those meds makes me want to puke even more.

Thank you so much for your answer, and again, I'm glad for your sake that the nausea was short lived!

[MrsBones]

I am relived to hear it went away in a month or so. On the phone with Shared Solutions, I swear they were looking at the receiver as though I had two heads and then tried to change the topic back to site reactions. I guess we're rare birds! (OK, the pharmacist was great. The nurse didn't know what to do with my complaint.)

I think they hear about site reactions so often, they're flummoxed by some other side effect. They have to flip pages in their answer manual. It's by far the most common side effect, so they're kinda lost when you have something else.

It did go away eventually. I just took the Tigan less and less until I realized one day that I hadn't taken it in a week. My drug of choice would have been Compazine, but I had a bizarre reaction to that, so no more Compazine for me. But that stuff if you can take it...wonderful.

I do have to say after taking Copaxone,Rebif and Tysabri, the Copaxone has been by far the easiest to take, with the least side effects overall. I hope it does as well for you as it has for me.

[Maple25]

I had nausea on and off for about 6 months now. I gained about 20 pounds trying to keep my stomach contents in with carbs and chocolate. I am not pregnant either, first they said it was a relapse that came on as a vertigo and nausea often accompanies vertigo. Now I know what to do about it.
Have you tried ginger? Ginger helps with nausea and motionsickness. I drink ginger ale or if you can get some sushi ginger, without the sushi of course and eat it like that, it will do wonders. Also coke is helpful. Have some crackers.
I hope this will help

[Alicious]

I forgot about compazine! So far the nausea has been low grade enough that I don't think I need anti-nausea meds, but maybe I should ask for a small script just to have on hand.

Maple25, I will try ginger. So far what I have in my stomach doesn't seem to make much of a difference, although yesterday steamed peas worked better than chocolate. I like peas and all, but that was unexpected. I will do my shot tonight instead of this morning, and hopefully I can sleep through some of it.

Thank you both so much!

[Maple25]

Super, great idea to change the time you give your shots. I do mine in the evening after a long shower and ice them after then just go to sleep. Usually all the pain/discomfort is gone by the morning. I still have the silly nausea sometimes though(( and I am not pregnant either.

possible copaxone issues too

Still seem to be having issues with the copaxone.

I get a dry mouth and nausea and then an "off" feeling in my head.

Comes and goes. Seems if I eat I feel a bit better.

Guessing the mannitol is causing problem with blood sugar.

My site reactions are getting worse too.

Don't want to switch to another med, hoping I get used to these reactions or that they stop all together.

Just my two cents.

[MrsBones]

Still seem to be having issues with the copaxone.

I get a dry mouth and nausea and then an "off" feeling in my head.

Comes and goes. Seems if I eat I feel a bit better.

Guessing the mannitol is causing problem with blood sugar.

My site reactions are getting worse too.

Don't want to switch to another med, hoping I get used to these reactions or that they stop all together.

Just my two cents.

Mannitol is used in products for diabetics because it has little to no impact on blood glucose levels. It's a sugar alcohol which ,while sweet, isn't sugar as you would you normally think of sugar. Otherwise, it could not be used in products that claim to be sugar free, or meant to be used by those who need to control their blood glucose levels.

If you feel better eating, it could indicate that you blood glucose levels are too low. Have you spoken to your doctor about that particular detail? It may indicate a completely unrelated issue that needs to be addressed.

It wouldn't be unusual to experience worsening reactions, unfortunately. They tend to diminish greatly with time for the majority of users or even stop completely. However, lots of folks have a "Copaxone honeymoon" where the site reactions are relatively minor during the initial few weeks to a month and then really kick in with worsening reactions before settling down. It happens.

Discuss all of this with your doctor, including how eating helps the issues you're having. They may be a side effect of the Copaxone, but could very well be something else. Especially since eating makes a difference. Any time eating quickly and directly changes how you feel, it should be investigated.

Going to do a glucose tollerance test and allergy testing with the copaxone injection. Going to do the glucose first to rule it out as the allergy testing might then not be needed.

Glad the neuro is willing to listen. The symptoms I am having can happen according to Shared Solutions though not typical.

Will keep you update.

[Alicious]

My nausea is almost completely gone! Switching to nighttime injections really helped, but I was still queasy in the morning up until about 11/26, when it was just awful, and now nothing. ??? (Thank goodness!)

The weird thing is that it really seemed to affect my digestion--not just my perception of it. I was nauseated, but also burping a lot, and it felt for all the world (still does sometimes) like my gastric system was emptying sooner than it usually does, sort of like when I was on Reglan for nausea in pregnancy. (Reglan works by speeding digestion.) It's less intense now, but always within about 2 hours of when I inject. I'm asking the doc tomorrow how/if it can affect my digestion because I'm curious. As is, I would totally stay on Copaxone now, site reactions and all.

Wobbler, good luck with the testing and site reactions. Please keep us posted!

Was supposed to have the glucose tollerance test on Friday but doc's office failed to fax the order to I will do it next Friday if needed.

On Tuesday (if they do the referral) I will have allergy testing with the Copaxone.

I will let you know.

Still having dry mouth with nausea and "off" feeling in my head. So over this!!!!!

[Alicious]

I am so sorry to hear your nausea and dry mouth are still going. That's no fun at all. Hopefully the testing orders will go through so you can get on with things!

Allergy testing in the a.m. will let you know what I find out.