Treatment of Multiple Sclerosis – Oral Medications or Tablets
Two oral drugs have been approved and a number of drugs are undergoing clinical trials for the treatment of
The drugs used to modify the course of multiple sclerosis have to be administered via injection. However, newer drugs have been approved that have made treatment easier for patients with multiple sclerosis. These are:
Fingolimod: Fingolimod (Brand name Gilenya) is the first oral treatment approved for multiple sclerosis. It acts by blocking the movement of white blood cells into the brain. It slows the progression of the disease and reduces the number of flare-ups. It is administered in a dose of 0.5 mg once daily.
It can cause side effects such as slow or irregular heart rate, headache, diarrhea, backache, cough and flu – like syndrome. It can also cause serious side effects like liver damage, shortness of breath, swelling in the back portion of the eye and increased chances of infection.
Fampridine: Fampridine is another oral drug used for multiple sclerosis. The FDA has approved the use of dalfampridine (earlier known as fampridine SR) for improving walking in patients with multiple sclerosis. Fampridine blocks potassium channels on the surface of nerve fibers, thus probably improving the conduction of signals. The patient shows an increase in walking speed. It should be taken as 10 mg twice a day.
The side effects observed in clinical trials are back pain, headache, dizziness, insomnia, fatigue, nausea, disturbances in balance, increased falls and urinary tract infection. Other side effects include allergic reactions, throat pain, constipation and indigestion. Rare cases of anxiety and seizures have also been observed. Patients with seizures or moderate to severe kidney disease should not use it.
Other oral treatments being developed include fumaric acid, teriflunomide, laquinimod and cladribine. Fumaric acid probably acts by reducing the number of white blood cells. Teriflunomide is a metabolite of levoflunomide. It acts on cells of the immune system that damage the brain and spinal cord in patients with multiple sclerosis. Cladribine reduces the number of white blood cells. Since its effect lasts for a long time, it may be used for short courses.
Thus oral drugs make the treatment of multiple sclerosis simpler and help the patient adhere better to the treatment.
