All DMDs need to be injected. The reason for this is that they are proteins, and as such they would be broken down in the stomach if they were taken orally. This has practical implications for you and your lifestyle. Some of the things which you could think about are:
All of the DMDs come with the option of an automatic injecting device (an autoinjector). You can see how these work in the 'See the process' page. Some people find that autoinjectors make injecting easier - particularly in hard to reach places. With most types of autoinjector, it also means that you don't need to see the needle going in, which can be a help if you are not keen on needles.
Three of the DMDs (Avonex®, Rebif® and Copaxone®) come in a premixed form - this means that there is no need to mix the drug together before injecting it. Betaferon®, Extavia® and the BIO-SET version of Avonex® all have to be mixed before injection, which adds a minute or two to the time you need, but this does avoid the need for them to be stored in a fridge.
Four of the DMDs are injected under the skin (sub-cutaneous), and one (Avonex®) is injected into the muscle (intramuscular). Subcutaneous injections use a shorter and thinner needle. However, sub-cutaneous injections do lead to more skin-site reactions (as explained in the earlier Side-Effects section).
There is a lot of help and support available while you are on treatment, but these factors still need to be carefully considered.
If, like many people, you are concerned about injecting yourself, you might want to pay particular attention to Moira and Carol when you come to the "Listen to Others" section, who talk about what it's really like to inject yourself and how they managed to overcome their early fears and phobias.
|Injection frequency||Where injected||Pre-mixed syringe available?||Storage|
|Interferon beta 1a: Avonex®||Once a week||Into the muscle||Two versions are available: a premixed version (PFS) which comes ready to inject, and a version which must be mixed before use (BIO- SET).||Premixed version: Fridge 2-8 °C, but a single vial can be kept at room temperature for up to a week. The BIO-SET version can be kept at room temperature for up to 2 years.|
|Interferon beta 1a: Rebif®||3 times a week||Under the skin|| Three premixed versions are available: Prefilled syringes (for manual injection
or use with the Rebiject II device), Multidose cartridges (for use with the RebiSmart autoinjector
device) and the RebiDose prefilled pen.
||All versions: In a fridge at 2-8°C. If they cannot be stored in a fridge,
they can be stored at room temperature (below 25°C), once for up to 14 days.
|Interferon beta 1b: Betaferon®||Alternate days||Under the skin||No||At room temperature up to 2 years.|
|Interferon beta 1b: Extavia®||Alternate days||Under the skin||No||At room temperature up to 2 years.|
|Glatiramer acetate: Copaxone®||Every day||Under the skin||Yes|| In a fridge, at 2-8 °C.
If they cannot be stored in a fridge, they can be stored at room temperature (15°C to 25°C), once for up to one month.