Treatment for multiple sclerosis has improved over the past decade, and there are now multiple medications approved by the U.S. Food and Drug Administration (FDA) to slow disease progression, reduce the rate of exacerbations (relapses), and prevent new lesions. Depending on the MS medication prescribed, you may be taking them orally, as injections under the skin, or intravenously as infusions.

Infusion treatments are medications delivered directly into your bloodstream through an IV, inserted in either your hand or your arm. Read on to get the most important facts about MS infusion medications.

1. Infusion Treatments Can Manage MS Long Term

MS infusion treatments are considered long-term DMTs and are used to manage relapsing forms of MS, including relapsing-remitting multiple sclerosis (RRMS), clinically isolated syndrome (CIS), and active secondary-progressive multiple sclerosis (SPMS). In some cases, they’re used for treating primary progressive MS (PPMS).

Researchers have found that early treatment of MS can help slow and stabilize disease progression and reduce relapses.

2. MS Infusion Medications Are Highly Effective

For people with active MS, DMT infusion therapy is considered highly effective in slowing disease progression and preventing flare-ups and symptoms. DMTs interfere with immune cell attacks on the myelin — the fatty coating that protects the nervous system.

MS infusion therapy can relieve symptoms for longer periods of time than some other medications, and it can reduce the severity and length of relapse episodes. DMT infusion therapy can also slow the development of brain lesions found on an MRI scan.

3. Infusion Medications Have Risks

Although infusion therapies for treating MS are promising, they aren’t right for everyone. Infusion medication can put some people at a higher risk for infection, a compromised immune system, or severe infusion reactions.

Risks associated with infusion medications for MS may include:

• Progressive multifocal leukoencephalopathy (PML), a serious brain condition
• Immunosuppression, which increases the risk of various infections and illness
• Herpes virus infection
• Infusion reactions
• Hepatitis-B virus reactivation
• Potential harm to an unborn baby
• Heart disease
• Leukemia

Read about tips for managing MS infusion side effects.

4. There Are 5 Infusion Drugs Available for Treating MS

There are currently five infusion therapy drugs approved by the FDA for treating MS as disease-modifying agents. Each medication comes with its own benefits and side effects, and each medication is given on a different schedule.

Alemtuzumab

Alemtuzumab, sold as Lemtrada, is approved to treat RRMS and active SPMS. Alemtuzumab is given over a course of five days, followed by another three-day round a year later.

Side effects of alemtuzumab can include:

• Allergic reaction
• Increased risk of infection
• Other autoimmune diseases

Because of its risks, alemtuzumab is available only through a restricted distribution program. The program helps ensure the safety and monitoring of people taking the drug.

Natalizumab

Natalizumab, sold under the brand name Tysabri, is administered every four weeks for relapsing forms of MS. It was taken off the market for a period of time because it was associated with a serious risk of developing PML. Natalizumab was re-approved after researchers identified exposure to the John Cunningham (JC) virus as a key risk factor for developing PML. Doctors now screen for the JC virus prior to prescribing the medication.

Side effects of natalizumab can include:

• Allergic reaction
• PML
• Headache
• Fatigue
• Urinary tract infection
• Respiratory infection

Ocrelizumab

Ocrelizumab, branded as Ocrevus, is given every six months. It was the first medication approved to treat PPMS as well as relapsing forms of MS.

Side effects of ocrelizumab can include:

• Allergic reactions
• Increased infections
• PML
• Potential increases in risk for some types of cancer

Ublituximab

Ublituximab, sold under the brand name Briumvi, is the most recent FDA-approved infusion drug for treating relapsing forms of MS. Ublituximab is infused once every 24 weeks.

Common side effects of ublituximab can include:

• Infusion reactions
• Upper respiratory tract infections
• Other infections

Mitoxantrone

Mitoxantrone, sold as Novantrone, was the first long-term drug to treat RRMS and SPMS. Now, however, it is prescribed less often for treating MS because it can increase one’s risk of developing cardiac (heart) disease and leukemia. It is given once every three months.

Side effects of mitoxantrone can include:

• Heart disease
• Secondary leukemia
• Allergic reaction

5. You’ll Undergo Testing Before Infusion Treatment

Before an infusion is administered, you will likely undergo a series of lab tests to ensure the medication is safe for you. Depending on the medication prescribed, these baseline tests may include:

• Screening for vaccinations against varicella zoster (shingles) and hepatitis A, B, and C
• COVID-19 test
• Measure of JC virus titer to check your risk for developing PML
• Tests for tuberculosis
• Blood pressure test
• Complete blood cell count (or CBC) to check white blood cell levels
• Liver function test
• Urinalysis (kidney function test)
• Heart function test

6. MS Infusions Are Given at an Infusion Center

Many people being treated for MS with infusion medications go to infusion centers to receive their medication. An infusion center can be located in a hospital, clinic, doctor’s office, or pharmacy.

Since infusion treatments can take several hours, the licensed staff will typically try to make you as comfortable as possible by providing blankets, pillows, beverages, and other amenities, such as Wi-Fi. The infusion can be paused if you need to use the restroom.

Read about ways to find an infusion center near you.

How To Prepare for an Infusion

To prepare for your time at an infusion center, consider bringing items that can help you pass the time comfortably. You may want to:

• Wear comfortable clothes.
• Clear your schedule.
• Bring a book.
• Bring a loved one to keep you company.
• Bring food or snacks.
• Bring a tablet or other electronic device to watch videos, listen to a podcast or music, or play games.

The goal of infusion therapy is to make you feel better, slow disease progression, and reduce symptoms and flare-ups, but you may leave the center feeling tired and weak. It’s important that you take the time to rest in a relaxing environment after your treatment to let your body recover.

7. Some People Experience a ‘Crap Gap’ Between Infusions

Some people taking infused DMTs for MS experience what’s known as the “crap gap” between IV infusions of MS medications. This may be the time before your next infusion when the drug is wearing off, or it can be right after your most recent trip to the infusion center, before the drug begins to work. During this time, MS symptoms may feel worse, and you may feel generally “off.”

Read What Is the ‘Crap Gap’ Between MS Infusions?

8. You May Be Eligible for Help With MS Infusion Costs

Manufacturers of infused MS medications often offer copay assistance that can make DMTs more affordable for those taking them. Some also offer help covering the costs associated with receiving the infusion. It’s worth checking to find out whether you’re eligible for these programs — you might save some money.

Read Copay Assistance and Help With MS Infusion Cost: Are You Eligible?

Talk With Others Who Understand

MyMSTeam is the social network for people living with MS and their loved ones. By joining, you gain a community of over 196,000 people who come together to ask questions, give advice, and share their experience living with MS.

Have you received infusion therapy to treat your MS? Share your experience in the comments below or on MyMSTeam. Your story may help others learn more about what to expect from visiting an infusion center.