Immunomodulator Pregnancy: Use may be considered during pregnancy if necessary; a moderate amount of data indicates no malformative or feto/neonatal toxicity. Can be used during breast-feeding.

Glatiramer acetate

Brand names: Copaxone, Brabio

Glatiramer acetate is an injectable disease-modifying therapy for relapsing forms of multiple sclerosis.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 20 mg (one pre-filled syringe)

Route: Subcutaneous injection

Frequency: Once daily

Recommended dosage in adults for multiple sclerosis. Initiation should be supervised by a neurologist or physician experienced in the treatment of MS. Duration of treatment is not defined; long-term treatment decisions are made on an individual basis. A different injection site should be chosen each time (abdomen, arms, hips, thighs). SC use only — do NOT give intravenously or intramuscularly. Note: US labelling (Glatopa) also describes a 40 mg/mL strength given three times per week; the 20 mg/mL and 40 mg/mL products are not interchangeable — verify the product strength.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to glatiramer acetate or to any of the excipients

Side effects

Injection-site reactions (erythema, pain, mass, pruritus, oedema, inflammation) — very common
Immediate post-injection reaction (flushing, chest pain, dyspnoea, palpitations/tachycardia)
Infection, influenza
Hypersensitivity; anaphylactic reactions (rare, can be fatal)
Rare cases of severe liver injury (hepatitis with jaundice, liver failure)

Interactions

No significant interactions identified with therapies commonly used in MS patients (per US label); concurrent corticosteroids for up to 28 days did not show significant interaction
Not formally evaluated in combination with interferon beta

Clinical monograph

How it works

It is a mixture of synthetic polypeptides that is thought to modify immune responses, shifting T-cell activity towards a regulatory, anti-inflammatory profile and reducing autoimmune attack on myelin.

Prescribing in practice

A transient immediate post-injection reaction with flushing, chest tightness, palpitations and breathlessness can occur and, although self-limiting, should be explained so it is not mistaken for a cardiac event.
Injection-site reactions and rare localised lipoatrophy are common, so site rotation is important.
It is generally well tolerated and not associated with the routine blood-count or liver monitoring needs of some other disease-modifying therapies.

Monitoring

No specific routine laboratory monitoring is mandated, but injection sites should be reviewed and relapse activity assessed clinically.

Counselling the patient

Rotate your injection sites to reduce skin reactions and dimpling.
A short-lived flushing or chest-tightness reaction can occur just after injecting and usually passes on its own, but seek help if it persists.
You can be trained to self-inject safely.

Evidence & guidelines

Glatiramer acetate reduces relapse rate in relapsing-remitting multiple sclerosis in randomised controlled trials and is an established first-line disease-modifying option.

Reference: NICE NG220; ABN MS guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways