Pros and Cons of MS Treatments: Injectables vs. Oral vs. Infusions

Multiple sclerosis medications have different schedules, different side effect profiles, and more.

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There are a few very different categories of medications to help you meet your multiple sclerosis (MS) treatment goals. With all these new options, it might feel overwhelming to make the right choice for you.

“It's really important to understand those differences,” says Asaff Harel, MD, Neurologist at Lenox Hill Hospital, Northwell Health. “Each medication comes with different side effect profiles, different risk benefit profiles, and this is really important to discuss with your doctor.”

So let’s get back to the basics and use a tried-and-true method to explore your options: a pros and cons list.

MS Treatments: Injections vs. Oral vs. Infusions

Your doctor will discuss your options based on your MS type and severity. Keep in mind that you may not be eligible for all types of MS medications.

1. Injections 

Pro:  They can be done at home and are less frequent than a daily pill.

At-home injections may be more convenient than needing to visit an infusion center. Some people may also enjoy not having to remember to take a daily pill.

Con: They have to be self-injected, which can be intimidating for some people, and it may be as frequent as every other day.

“The obvious drawback is that… you have to be comfortable with injecting yourself,” says Dr. Harel. The medication also needs to stay refrigerated, which can be difficult to travel with. Plus, frequent injections may be more cumbersome than an infusion a couple times a year. 

2. Oral pills

Pro: They’re easy to do at home, and don’t require needles.

If needles make you queasy, an oral pill may be an attractive option for you.

Con: They can be hard to remember to take,  and many are taken daily.

The reality is that daily pills may be hard to remember. Missing a dose could diminish the treatment’s effectiveness, so you’ll have to be honest with yourself about what you think you’ll realistically stick to. Luckily, there are ways to help you remember, like setting reminders on your phone.

3. Infusions

Pro: They are less frequent, and you don’t have to worry about remembering a pill or injecting yourself.

You may only need to get an infusion a couple of times a year, which may be a perk for some. While this option still involves a needle, it’s done by a healthcare professional, which some people find less intimidating.

Con: They have a stricter schedule and can’t be done at home.

“With infusion medications, you have to be comfortable with having to go to the infusion center regularly,” says Dr. Harel. “Some of the medications require more of a set schedule and have less leniency with regards to delaying an infusion.”

Choosing a treatment that works with — instead of against — your lifestyle

You may need to be patient with the trial-and-error process, and reach out within the community for support, to find the right treatment for you. You don’t want your treatment regimen to be inconvenient, uncomfortable, or a financial burden. 

Here are things you should discuss with your doctor to find the right treatment for your lifestyle:

  1. Which method you’re most comfortable with: self-injections, oral medications, or visiting an infusion center for IV
  2. Which administration schedule you can stick with — from daily to once a year
  3. How often you can visit your doctor for maintenance and/or adjustments: weekly, monthly, every 3 months, or every six months
  4. What you can realistically afford or get covered through insurance

When your treatment plan works for your lifestyle and budget, you’ll be less likely to deviate from the plan. This can help reduce the risk of an MS relapse. Avoiding flares is a crucial step to slowing down the progression of your MS and helping you live a more normal life.