Glatiramer injection is used to treat adults with various forms of multiple sclerosis (MS; a disease in which the nerves do not function properly and people may experience weakness, numbness, loss of muscle coordination, and problems with vision, speech, and bladder control) including:

• clinically isolated syndrome (CIS; nerve symptom episodes that last at least 24 hours),
• relapsing-remitting forms (course of disease where symptoms flare up from time to time), or
• secondary progressive forms (course of disease where relapses occur more often).

Glatiramer is in a class of medications called immunomodulators. It works by stopping the body from damaging its own nerve cells (myelin).

Glatiramer comes as a solution to inject subcutaneously (under the skin). Depending on your dose, it is usually injected either once a day or three days every week (with at least 48 hours between doses, for example every Monday, Wednesday, Friday) . 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: arms, thighs, 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. Choose a different spot each time you inject your medication. Keep a record of the date and spot of each injection. Do not use the same spot two times in a row. Do not inject near your navel (belly button) or waistline or into an area where the skin is sore, red, bruised, scarred, infected, or abnormal in any way.

You may experience a reaction immediately after you inject glatiramer such as flushing, chest pain, pounding heartbeat, anxiety, difficulty breathing, closing of the throat, or hives. This reaction is most likely to occur several months into your treatment, but could happen at any time during your treatment. These symptoms will usually go away without treatment in a short time. However, if these symptoms become severe or last longer than a few minutes, call your doctor and get emergency medical care.

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.

Before using glatiramer,

• tell your doctor and pharmacist if you are allergic to glatiramer, mannitol, or any other medications. Ask your pharmacist for a list of the ingredients.
• 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 breastfeeding. If you become pregnant while using glatiramer, call your doctor.

Inject 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 inject a double dose to make up for a missed one.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

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 1 month, but do not expose it to bright light or higher temperatures.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

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 at the injection site
• weakness
• depression
• abnormal dreams
• pain in the back, neck, or other parts of the body
• severe headache
• loss of appetite
• diarrhea
• nausea
• 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
• muscle tightness
• white patches in the mouth

Some side effects can be serious. If you experience any of these symptoms or those listed in the HOW section, call your doctor immediately or get emergency medical treatment:

• dizziness
• excessive sweating
• sore throat, fever, runny nose, cough, chills, or other signs of infection
• fast heartbeat
• fainting
• rash
• itching
• difficulty swallowing

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 using this medication.

Glatiramer may cause other side effects. Call your doctor if you have any unusual problems while using 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 (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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