Table 3

Intravenous therapies

TreatmentDose/administrationFDA ApprovalCommon side effects
300 mg IV once in 28 daysTo reduce frequency of clinical exacerbations by 67% and long-term disability by 42% in RRMS
As a second-line or third-line therapy, although sometimes used as a first-line therapy in very aggressive RRMS
Approved 2006
Pregnancy category C
Headache, fatigue, joint pain, chest discomfort, UTI, lower respiratory tract infection, gastroenteritis, overall increase risk of infections
Occasional increase in LFTs and decreased WCC, although rare
12 mg IV once daily ×5 days, then repeat 12 mg IV once daily ×3 days in 1 yearTo reduce frequency of clinical exacerbations by 49% and reduce long-term disability by 42% in RRMS
As a third-line therapy
Approved 2014
Pregnancy category C
Rash, headache, fever, nasal congestion, nausea, UTI, fatigue, insomnia, URI, herpes viral infections, hives, itching, thyroid gland disorders (common), fungal Infection, pain in joints, extremities and back, diarrhea, vomiting, flushing. Infusion reactions
Elevation of LFTs and decreased WCC
Can cause other autoimmune disorders that can be fatal like Immune thrombocytopenia and increase risk of malignancies like melanoma, thyroid cancer and lymphoproliferative disorders
  • DMT, disease-modifying therapy; FDA, Food and Drug Administration; IV, intravenous; LFTs, liver enzyme tests; RRMS, relapsing-remitting multiple sclerosis; PML, progressive multifocal leukoencephalopathy; URI, upper respiratory infections; UTI, urinary tract infection; WCC, white cell count.