Glatiramer Injection (patient information)

# Why this medication is prescribed
Glatiramer is used to reduce episodes of symptoms in patients with relapsing-remitting multiple sclerosis. Glatiramer is in a class of medications called immunomodulators. It works by stopping the body from damaging its own nerve cells (myelin).

# How this medication should be used
Glatiramer comes as a solution to inject in the fatty layer just under the skin (subcutaneously). It is usually injected once a day. To help you remember to inject glatiramer, inject it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use glatiramer exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
You will receive your first dose of glatiramer in your doctor's office. After that, you can inject glatiramer yourself or have a friend or relative perform the injections. Before you use glatiramer yourself the first time, read the written instructions that come with it. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to inject it.
Glatiramer comes in prefilled syringes. Use each syringe only once and inject all the solution in the syringe. Even if there is still some solution left in the syringe after you inject, do not inject again. Dispose of used syringes in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.
You can inject glatiramer into seven parts of your body: right and left arms, thighs, and hips; and lower stomach. There are specific spots on each of these body parts where you can inject glatiramer. Refer to the diagram in the manufacturer's patient information for the exact places you can inject. You should inject in each of the body parts once a week, and you should pick a different place on the body part each time. Keep a list of the places where you have given injections so that you will not inject in these places again until some time has passed.
To inject glatiramer, follow these steps:
- Remove one blister pack from the carton of glatiramer syringes and place it on a clean flat surface. Wait 20 minutes to allow the medication to warm to room temperature.
- Wash your hands thoroughly with soap and water and dry them with a clean towel.
- Peel back the paper label and remove the syringe from the blister pack. Check your pre-filled syringe to be sure it is safe to use. It should be labeled with the correct name of the medication and should contain a clear colorless solution. Do not use the syringe if it is expired, is cloudy, or contains any particles. Small air bubbles in the syringe will not cause any problems and you should not try to remove them.
- Wipe the place on your skin where you will inject glatiramer with a fresh alcohol pad and wait several seconds to allow it to dry.
- Pick up the syringe like a pencil and remove the needle cover.
- Use your other hand to pinch a 2 inch fold of skin between your thumb and index finger.
- Hold the syringe at a 90 degree angle to your body and push the needle straight into your skin. When the needle is all the way in, let go of the pinched fold of skin.
- Hold the syringe steady while slowly pushing down the plunger until the syringe is empty.
- Pull the needle straight out.
- Press a dry cotton ball on the injection site for a few minutes, but do not rub it.
Glatiramer controls multiple sclerosis but does not cure it. Continue to use glatiramer even if you feel well. Do not stop using glatiramer without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before taking glatiramer:
- tell your doctor and pharmacist if you are allergic to glatiramer, mannitol, or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking glatiramer, call your doctor.
- you should know that you may have a reaction immediately after you inject glatiramer. You may experience the following symptoms: flushing, chest pain, pounding heartbeat, anxiety, trouble breathing, closing of the throat, and hives. This reaction is most likely to occur several months into your treatment, but may happen at any time. These symptoms will usually go away without treatment in a short time. Get emergency medical care if these symptoms become severe or last longer than a few minutes. It is important to tell your doctor if this happens.

# Special dietary instructions
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Minor side effects
Glatiramer may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- pain, redness, swelling, itching, or lump in the place where you injected glatiramer
- weakness
- flushing
- depression
- abnormal dreams
- pain in the back, neck, or any other part of the body
- severe headache
- loss of appetite
- diarrhea
- upset stomach
- vomiting
- weight gain
- swelling of the hands, feet, ankles, or lower legs
- purple patches on skin
- joint pain
- confusion
- nervousness
- crossed eyes
- difficulty speaking
- shaking hands that you cannot control
- sweating
- ear pain
- painful or changed menstrual periods
- vaginal itching and discharge
- urgent need to urinate or defecate
- tightness in muscles
- white patches in the mouth

## Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately. In some cases, your doctor may tell you to stop using glatiramer:
- dizziness
- excessive sweating
- chest pain
- sore throat, fever, chills, and other signs of infection
- runny nose
- coughing
- fast heartbeat
- fainting
- skin rash
- hives
- itching
- difficulty breathing or swallowing
- very severe pain at the injection site
Glatiramer affects your immune system, so it may increase your risk of developing cancer or a serious infection. Talk to your doctor about the risks of taking this medication.
Glatiramer may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it in a refrigerator but do not freeze it. If you will not have access to a refrigerator, you can store glatiramer at room temperature for up to 7 days, but do not expose it to bright light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Copaxone

# Other names
- copolymer-1