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Real members of MyMSTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Does anyone have advice on medication to help with the "crap gap" between infusions?

A MyMSTeam Member asked a question 💭
Monticello, MN

I take Briumvi every 6 months. The first 4 months are okay and I do quite well with walking and exercising; however, these last 2 months are terrible. As the medication weakens toward the last 6 weeks, I can barely walk and have great pain. Does anyone take medications during this gap? I used to give myself REBIF shots which meant I had the medication continually, but my insurance stopped paying for it because It was self-injected. I could apply for grants from the company, but that took… read more

June 18
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A MyMSTeam Member

Hi there, mine only lasted 8 days-just had the new Ocrevus infusion today. To help reduce the symptoms of crap gap, consider natural supplements and minerals like magnesium glycinate, malate for muscles and bones or if you can afford it, threonate, Neuriva or other cognitive improvement supplements. Maybe do an anti-inflammatory or Paleo diet like I do, it helps me with remembering and reduces tingling in my brain and spine.

June 18
A MyMSTeam Member

Oh thank you! That's what I'm here for-to help others with getting though each day with MS and spread some sunshine and hope along the way.

June 19
A MyMSTeam Member

Thank you for the advice. I will certainly try your advice. I'll talk to my neurologist about switching to Ocrevus.

June 19
MyMSTeam

The crap gap is a real and frustrating experience, and what's being described — worsening walking, pain, and fatigue in those last 6 weeks before the next Briumvi infusion — is something many MyMSTeam members can relate to. It happens as the medication wears off before the next infusion cycle.

The good news is there are Show Full Answer

The crap gap is a real and frustrating experience, and what's being described — worsening walking, pain, and fatigue in those last 6 weeks before the next Briumvi infusion — is something many MyMSTeam members can relate to. It happens as the medication wears off before the next infusion cycle.

The good news is there are options worth discussing with a neurologist. Several prescription medications can help manage specific symptoms during the crap gap, including:

- Pain medications to address the increased discomfort
- Fatigue-targeting treatments to help with energy levels
- Spasticity medications to ease muscle stiffness that may be affecting walking
- Cognitive support options for any brain fog that creeps in It's also worth having a direct conversation with the neurologist about the severity of these last 6 weeks specifically. Some people have had their infusion intervals adjusted based on how their body responds to the medication — this is something a neurologist can evaluate.

The THC lotion helping for 2-3 hours is a start, but given how significantly mobility is being affected, this really deserves a deeper conversation with the neurology team. Don't hesitate to be specific about how bad those last 6 weeks are — the inability to walk is important information for them to have.

June 18

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