
Glatiramer acetate (Copaxone and Brabio)
Glatiramer acetate is a disease modifying therapy (DMT) for relapsing MS. Its brand name is Copaxone and you take it as an injection. Since 2018 a new brand of this drug, Brabio, has also been available.
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- Who can take glatiramer acetate (Copaxone or Brabio)?
- How does glatiramer acetate (Copaxone or Brabio) work?
- How well does glatiramer acetate (Copaxone or Brabio) work?
- What are the side effects of glatiramer acetate (Copaxone or Brabio)?
- Glatiramer acetate (Copaxone or Brabio) and pregnancy, breastfeeding and contraception
Who can take glatiramer acetate (Copaxone or Brabio)?
In Scotland, Wales and Northern Ireland you can have glatiramer acetate (its brand names are Copaxone and Brabio) if:
- you have relapsing MS and you’ve had a recent relapse and/or MRI scans show new signs that your MS is active (you have new lesions)
In England you can have this drug if:
- you’ve had two relapses in the last two years
- you’ve had one relapse in the last two years and MRI scans show new signs your MS is active (you have new lesions)
Across the UK you can have this drug if:
- you have a clinically isolated syndrome or CIS (a first attack of MS-like symptoms) and a brain scan shows you’re likely to go on to get MS.
The makers of Copaxone, one brand of glatiramer acetate, say their drug can be taken by women during pregnancy, including when they're breastfeeding.
How does glatiramer acetate (Copaxone or Brabio) work?
It's not clear how glatiramer acetate (Copaxone or Brabio) works. It seems to kill the immune cells that attack the coating (myelin) around nerves in your brain and spinal cord.
You inject it under your skin once a day or, at a higher dose, three times a week.
How well does glatiramer acetate (Copaxone or Brabio) work?
MS drugs can be put into three groups based on how well they control it. The effectiveness of glatiramer acetate (Copaxone or Brabio) is classed as 'moderate', the least effective of the three groups. This is based on how much it reduces relapses and slows down how fast your disability gets worse.
Long term evidence, from people on glatiramer acetate for years, shows its effect is much bigger than 'modest' if you start it early on in your MS.
Relapses dropped by: 34%
This means that in a trial, on average, people saw a 34% drop in the number of relapses they had. This was compared to people who took a placebo, a dummy treatment with no drug in it.
Disability getting worse was slowed down by: a modest amount
This means that in a trial, on average, people saw a modest drop in the risk of their disability getting worse. This was compared to people who took a placebo.
What are the side effects of glatiramer acetate (Copaxone or Brabio)?
Compared to other DMTs the risk of side effects, especially serious ones, is among the lowest. After their injection some people go red in the face (flushing), feel breathless or get a pounding heart for a short time. Most people find that where they inject into their skin it bruises, becomes itchy or goes red or hard. You could also get dents in your skin where you inject.
More than one in 10 people also get one or more of these:
- headaches
- rash
- flu-like symptoms
- feeling anxious or depressed
- joint or back pain
- feeling weak or sick.
A serious allergic reaction can happen with glatiramer acetate called anaphylaxis. It’s uncommon but can be life-threatening. If this happens, it’s usually within an hour of injecting the drug. It’s most likely when people first start taking the drug. But it can also happen months or years into the treatment. Between one in every 100 people and one in every 1,000 people on glatiramer acetate has this reaction.
Symptoms of this reaction include wheezing, difficulty breathing, swollen lips, throat or face, and hives (a skin rash). This reaction can quickly become life-threatening, so immediate emergency medical help is needed. These symptoms can be similar to common injection reactions that come with this drug. So your health care team should tell you what to look out for, and what to do if you notice signs of the more dangerous (but uncommon) allergic reaction.
Glatiramer acetate (Copaxone or Brabio) and pregnancy, breastfeeding and contraception
Pregnancy
There’s no evidence glatiramer acetate harms unborn babies. This drug is available under two brand names: Copaxone and Brabio. There’s been a lot of research into Copaxone and pregnancy but not into Brabio.
You can take Copaxone while you're pregnant if your neurologist thinks you need to.
If you prefer, you can stop taking this drug up to a month before you try to get pregnant. One month (or less) is the ‘washout period’. That’s how long it takes for levels of the drug in your body to reach a level where it’s totally safe to get pregnant.
If you can become pregnant, ask your neurologist for advice if you want to take either brand of glatiramer acetate.
If you and your partner want to have a child, discuss this with your neurologist. If you think you’ve become pregnant, let your medical team know at once. Never stop your DMT without first getting their advice.
Breastfeeding
You can take Copaxone while breastfeeding. If you want to breastfeed, ask your neurologist for advice about feeding this way while taking glatiramer acetate (and for a month after you stop taking it).
Contraception
There are no special recommendations about contraception while taking glatiramer acetate (Copaxone or Brabio).