Lemtrada (Alemtuzumab) for Multiple Sclerosis

Members Say Top Tips Side Effects Copay Help FAQs

Lemtrada (alemtuzumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with relapsing forms of multiple sclerosis (MS).

What Members Say

MHT logo These insights are based on 3,723 comments about Lemtrada from MyMSTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Two treatment courses can offer long stretches without regular MS treatment.
This medication offers MRI scan stability and fewer relapses for some.
The second infusion course often feels easier than the first.

Considerations:

Rash, headache, fever, nausea, and flu-like symptoms are common.
Increased infection risk and avoiding others who are sick can add stress after treatment.
Monthly blood and urine testing for years is a major commitment.

How Lemtrada Works and How It’s Taken

Lemtrada works by targeting certain immune cells in the body. This changes how the immune system behaves, and it may reduce immune attacks that can harm the brain and spinal cord. The exact way Lemtrada helps treat multiple sclerosis is not fully known. These effects may help reduce damage linked to relapsing forms of multiple sclerosis in adults.

Doctors may prescribe Lemtrada when someone has relapsing forms of multiple sclerosis. The medication is given as an intravenous infusion, which means it is slowly delivered into a vein. Treatment is given in two courses. The first course is given for five days in a row. The second course is given for three days in a row about 12 months later.

Top Advice From Members on Lemtrada

These insights are based on 3,723 comments about Lemtrada from MyMSTeam members.

Members who use Lemtrada often say it helps to plan for a long treatment process, not just the infusion days. They also frequently mention the importance of monthly monitoring, infection precautions, rest and recovery time, and staying in close touch with their care team about side effects and expectations.

1
Follow through on blood and urine tests when your doctor orders them.
“You need to do what they tell you regarding the blood tests, monthly, and urine tests. They are to head off any side effects that may arise before they can do any permanent damage.”
2
Take simple precautions to avoid infections.
“As you will have been advised, but for the benefit of others interested: After the treatment you are at a greater risk of infection as your white blood cells are temporarily lowered.”
3
Prepare for long infusion days. Stay hydrated and bring things to help pass the time.
“Today went very well! I went prepared with lots of fluid and many things to keep me occupied!”

Connect with others who understand life with multiple sclerosis. Join MyMSTeam for free.

Lemtrada Side Effects

In clinical studies of Lemtrada for relapsing forms of multiple sclerosis in adults, the most common side effects occurred in between 12 percent and 53 percent of people. These side effects were reported more often with those taking Lemtrada than those taking interferon beta-1a. The list below reflects the most common side effects seen in these trials.

Rash
Headache
Fever
Sore throat, sinus infection, and common cold-type symptoms
Nausea or vomiting
Urinary tract infection
Fatigue
Insomnia
Upper respiratory tract infection
Herpes viral infection
Hives and itching
Thyroid gland disorders
Fungal infection
Pain in the back, arms, legs, or joints
Diarrhea
Tingling or “pins and needles” sensations
Dizziness
Abdominal pain
Flushing
Nosebleed

Serious Side Effects and Warnings

Lemtrada can cause serious side effects that require immediate medical attention. These include:

Serious autoimmune problems (when the immune system attacks your own body), including immune thrombocytopenia (low platelets) and kidney disease such as anti-glomerular basement membrane disease
Infusion reactions, including severe allergic reactions (trouble breathing, chest pain, abnormal heart rate, bleeding in the lungs, heart attack, or stroke during or after an infusion)
Stroke and cervicocephalic arterial dissection (stroke or a tear in arteries in the neck that can happen within three days of treatment)
Some types of cancers, including thyroid cancer, melanoma, and lymphoproliferative disorders or lymphoma
Thyroid disorders, including Graves’ disease, hyperthyroidism, and hypothyroidism
Autoimmune cytopenias (low blood cell counts), including hemolytic anemia, neutropenia, or pancytopenia
Autoimmune hepatitis (immune-related liver injury that can lead to liver failure)
Hemophagocytic lymphohistiocytosis (a rare but life-threatening overactivation of the immune system)
Adult-onset Still’s disease (a rare inflammatory condition that can affect multiple organs)
Thrombotic thrombocytopenic purpura (a serious blood-clotting disorder that can damage organs)
Autoimmune encephalitis (immune-related brain inflammation that can cause memory changes, confusion, psychiatric symptoms, or seizures)
Immune-mediated colitis (inflammation of the colon that can cause severe diarrhea or belly pain)
Serious infections, including opportunistic infections and progressive multifocal leukoencephalopathy (a rare brain infection that can lead to severe disability or death)
Acute acalculous cholecystitis (serious gallbladder inflammation without gallstones)
Pneumonitis (lung inflammation that can cause shortness of breath, cough, chest tightness, or coughing up blood)
Acquired hemophilia A (a bleeding disorder caused by antibodies that interfere with blood clotting)

Get medical help right away if you think you are having a serious reaction.

How To Save on Lemtrada

Sanofi, the manufacturer of Lemtrada, offers the Lemtrada Co-Pay Program. Eligible people with commercial insurance may pay as little as $0 out-of-pocket cost for Lemtrada and up to $100 per day for charges related to the administration of a Lemtrada infusion.

The Lemtrada Co-Pay Program also offers support through a case manager who can explain program benefits and provide information on financial support. To learn more, visit the Lemtrada website or call 855-676-6326.

What To Know Before Taking Lemtrada

Before starting Lemtrada, your doctor may order several tests. These include:

A complete blood count with differential
Serum creatinine level tests
A urinalysis with urine cell counts
Thyroid function tests
Liver blood tests
A tuberculosis screening

They will also ask whether you have had the varicella-zoster vaccine or any other live vaccines. You should get any needed live vaccines at least six weeks before starting Lemtrada. If you get the chickenpox vaccine, treatment should be delayed for six weeks.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Also let your doctor know if you have had recent infections or have had cancer or nervous system problems in the past.

Do not take Lemtrada if you have HIV or an active infection, or if you have had a serious allergic reaction to alemtuzumab or any of the ingredients in Lemtrada.

If you are pregnant, planning to become pregnant, or breastfeeding, talk with your doctor about the risks and benefits before starting Lemtrada. Lemtrada may cause fetal harm. If you are able to become pregnant, use effective birth control while taking Lemtrada and for at least four months after a treatment course.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Lemtrada?
In two studies of adults with relapsing-remitting multiple sclerosis, Lemtrada lowered relapse rates more than interferon beta-1a over two years. In one study, the annualized relapse rate (the number of relapses study participants had in a year) was 0.26 with Lemtrada and 0.52 with interferon beta-1a. This was a 49 percent relative reduction.

Also, 65 percent of people taking Lemtrada were relapse-free after two years, compared with 47 percent of people taking interferon beta-1a.

In the second study, the annualized relapse rate was 0.18 with Lemtrada and 0.39 with interferon beta-1a. This was a 55 percent relative reduction. In that study, 78 percent of people taking Lemtrada were relapse-free at two years, compared with 59 percent of people taking interferon beta-1a.

How often is Lemtrada taken for multiple sclerosis?
Lemtrada is given by IV infusion in two treatment courses. The first course is given daily for five days in a row. The second course is given 12 months later for three days in a row. If needed, additional three-day courses may be given at least 12 months after the last treatment course.

What tests are needed before and during Lemtrada treatment for multiple sclerosis?
Before treatment, testing includes a complete blood count with differential, serum creatinine level tests, a urinalysis with urine cell counts, thyroid testing, liver blood tests, and tuberculosis screening. After treatment starts, blood and urine tests continue every month until 48 months after the last treatment course. Thyroid testing continues every three months until 48 months after the last treatment course.

Should I take Lemtrada if I have an infection or want vaccines?
Do not take Lemtrada if you have an active infection. Live viral vaccines should not be taken after a course of Lemtrada. Any needed immunizations should be completed at least six weeks before treatment starts. If you have not had the chickenpox or varicella-zoster vaccine, you may need testing and vaccination before treatment.