Understanding MS Relapse

Multiple sclerosis (MS) is a chronic, or long-term, condition. It has acute, or short and severe, stages called relapses. Some people call these flares, exacerbations, or attacks. MS relapses are indications of active disease. Just like MS itself, MS relapses are different for different people—and each relapse you have may be different too. You might find walking difficult or have problems with your vision. Others might have numbness in their limbs.

MS damages the protective covering around the nerve cells, and ultimately the nerve cells in your brain, optic nerves, or spinal cord. MS relapses are unpredictable, yet common, signs of the inflammation that causes that damage.

Most likely, your doctor has prescribed a disease-modifying therapy (DMT) as an important, central part of your MS treatment. The use of DMTs may reduce the rate of MS relapses—the number you might experience over time. DMTs may not treat or totally prevent relapses, and the relapses themselves should be identified and treated rapidly.

How to Tell if You're Having a Real Relapse

It can sometimes be challenging to tell whether you’re having symptoms of MS attack or whether you’re just not feeling well due to other causes. Yet it’s important to get treatment for a relapse as soon as possible once it starts.


You have new MS symptoms or your existing MS symptoms suddenly become worse

These symptoms last for at least 24 hours (they may go on for days or weeks)

Your symptoms occur at least 30 days after your last relapse

You don’t have a fever, illness, or similar condition when the symptoms start

Download the Symptom Journal or the My MS Manager™ app from the Multiple Sclerosis Association of America to help you keep track of your symptoms regularly and identify relapses early.

Multiple Sclerosis Relapse and Acthar

Make A Plan To Treat MS Relapse

Whether you are currently experiencing a relapse or you’re monitoring the progression of your MS, make a plan with your doctor to recognize and treat your MS relapse symptoms. The goals of treating an MS relapse are to reduce inflammation, speed recovery, and minimize disability.

Just like with your ongoing MS treatment, it may take a few tries to find the relapse treatment that works for you. As you and your doctor make your treatment plan, it’s important to also plan check-ins to monitor your progress toward your treatment goals. Tell your doctor if your treatment is not working, difficult to tolerate, or inconvenient to administer. You may want to investigate an alternate treatment option or connect at a live event near you with other people who have relapsing MS.

Hear From Yosafa—Diagnosed With MS in 2003

DO NOT take Acthar until you have talked to your doctor if you have any of the following conditions:

  • A skin condition called scleroderma
  • Bone density loss or osteoporosis
  • Any infections, including fungal, bacterial, or viral
  • Eye infections, such as ocular herpes simplex
  • Had recent surgery
  • Stomach ulcers or a history of ulcers
  • Heart failure
  • Uncontrolled high blood pressure
  • Allergies to pig-derived proteins
  • Have been given or are about to receive a live or live attenuated vaccine
  • Suspected congenital infections (in children under 2 years of age)
  • If you have been told that you have Cushing’s syndrome or Addison’s disease

Tell your doctor about any other health problems that you have. Give your doctor a complete list of medicines you are taking. Include all nonprescription medicines, vitamins, and herbal supplements that you are taking.

What is the most important information I should know about Acthar?

  • Never inject Acthar directly into a vein
  • Always inject Acthar beneath the skin or into the muscle
  • Follow your doctor’s instructions for injecting Acthar
  • Never stop treatment suddenly unless your doctor tells you to do so
  • Try not to miss any scheduled doctor’s appointments. It is important for the doctor to monitor you while taking Acthar

Acthar and corticosteroids have similar side effects.

  • You may be more likely to get new infections. Also, old infections may become active. Tell your doctor if you see any signs of an infection. Contact your doctor at the first sign of an infection or fever. Signs of infection are fever, cough, vomiting, or diarrhea. Other signs may be flu or any open cuts or sores
  • When taking Acthar long term, your adrenal gland may produce too much of a hormone called cortisol. This can result in symptoms of Cushing’s syndrome. This may cause increased upper body fat, a rounded “moon” face, bruising easily, or muscle weakness
  • Sometimes when you stop taking Acthar long term, your body may not produce enough natural cortisol. This is called “adrenal insufficiency.” Your doctor may prescribe a steroid medicine to protect you until the adrenal gland recovers
  • You might develop high blood pressure, or retain too much fluid. As a result of this, your doctor may recommend some changes to your diet, such as eating less salt and taking certain supplements
  • Vaccines may not work well when you are on Acthar. Talk to your doctor about which vaccines are safe to use when you are taking Acthar
  • Acthar may hide symptoms of other diseases. This can make it more difficult for your doctor to make a diagnosis if something else is going on
  • Stomach or intestinal problems. Acthar may increase the risk of bleeding stomach ulcers. Tell your doctor if you have stomach pains, bloody vomit, bloody or black stools, excessive tiredness, increased thirst, difficulty breathing, or increased heart rate
  • Taking Acthar can make you feel irritable or depressed. You may also have mood swings or trouble sleeping
  • If you have other conditions, such as diabetes or muscle weakness, you may find they get worse
  • You might develop certain eye conditions, such as cataracts, glaucoma, or optic nerve damage
  • Your body may develop allergies to Acthar. Signs of allergic reaction are:
    • Skin rash and itching
    • Swelling of the face, tongue, lips, or throat
    • Trouble breathing
  • Long-term Acthar use can affect growth and physical development in children This can be reversed when Acthar is no longer needed
  • Acthar may cause osteoporosis (weak bones)
  • Acthar might harm an unborn baby. Therefore, tell your doctor if you are pregnant or plan on becoming pregnant

What are the most common side effects of Acthar?

The most common side effects of Acthar are similar to those of steroids. They include:

  • Fluid retention
  • High blood sugar
  • High blood pressure
  • Behavior and mood changes
  • Changes in appetite and weight

Specific side effects in children under 2 years of age include:

  • Increased risk of infections
  • High blood pressure
  • Irritability
  • Symptoms of Cushing’s syndrome
  • Thickening of the heart muscle (cardiac hypertrophy)
  • Weight gain

The above side effects may also be seen in adults and children over 2 years of age.

These are not all of the possible side effects of Acthar.

Tell your doctor about any side effect that bothers you, or that does not go away. Call your doctor or pharmacist for medical advice about side effects. You may report side effects to the FDA. Call 1-800-FDA-1088 or visit www.fda.gov/medwatch. You may also report side effects by calling 1-800-778-7898.

Please see full Prescribing Information.

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