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First

generation agents
Self-injectables
Drug Interferon-beta 1a Interferon-beta Pegylated Glatiramer acetate
1b Interferon-beta
Brand Avonex , Rebif Betaseron,extavia plegrid Copaxone ,Glatopa
name
MOA Suppresses expression of inflammatory cytokines and increases of Activates T lymphocytes suppress cell
anti-inflammatory cytokines

DOSE IM:30 mcg once/wk SC:0.0625-0.25 SC: 125mcg SC: 20 mg once daily/ 40 mg 3x/wk
SC:125 every other wk mg every other every other wk
day
Indication RFMS
SE depression, flu-like symptoms, leukopenia, injection site reactions. Immediate Post-Injection Reaction
chest tightness, flushing, and dyspnea beginning
Monitor Electrolytes ,CBC, LFTs, thyroid function, depression MRI, tissue necrosis, Post-Injection Reaction
Comment Avoid use in untreated severe depression
IV infusion
Drug mitoxantrone
Brand Novantrone
name
MOA Suppresses proliferation of T cell , B cell, and macrophages
Dose IV:12 mg/m2 q3m to lifetime max of 140mg/m2
Indication SPMS, PRMS and worsening RRMS
SE Bone marrow suppression, neutropenia, cardiotoxicity, AML ,N/V , diarrhea , alopecia
Monitor CBC, ECG, LVEF, LEFs
Comment D/c due to risk of PML

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