Knowing When to Switch MS Medications

Patient Expert

I get a newsletter from the U.S. Food and Drug Administration (FDA) with information about all of the recently approved drugs. It’s exciting to see. We live in a time when we are seeing treatment options advance before our eyes — from new offerings for long-treated condition areas to the first-approved medications in others. What a time to be sick!

If you’re privileged enough to have a condition that has a few available treatment options, when, if ever, do you consider changing to a different medication? I recently decided to change medications for my multiple sclerosis (MS). Here’s how I made that decision.

Determine if your current medication is effective

In my opinion, the first step in considering a medication change is to assess whether your current treatment is doing what you need it to. Depending on your condition, “effective” can mean many different things. With high cholesterol, if you take the medication and it lowers it, that’s an effective medication, but most chronic illnesses do not work like this. For MS, a medication is deemed effective if it elongates the time between your relapses. When it’s really effective, the treatment eliminates them entirely.

I had my first MS relapse in seven years a few months ago. At the time, I had been on my current treatment for two years. My neurologist and I decided together that instead of waiting around to see if I’d have another while on this medication, we’d start considering other options.

Talk to your doctor to understand what remission means in your case, and how your medication can factor into that.

When to consider making a change

Changing medication doesn’t always have to be due to a relapse. I have changed medication in the past due to non-compliance and because some of the newer medication options were much more appealing. When I was first diagnosed with MS, the only medication options available were injections and I didn’t do very well on them. So when an oral medication was first released, I quickly jumped in line to try it. Spoiler alert: That one didn’t work for me.

A medication change can be initiated because of a lifestyle change or even if you’re newly diagnosed with another condition. Depending on your condition, a medication change can be a big deal that requires lots of planning, pre-testing, insurance approvals, and multiple conversations with your doctor; it’s not something to be considered lightly.

When I went to see my neurologist for my relapse, one of the first conversations we had was about my medication, it’s efficacy, and what my options would be if I chose to change. Each person is different and every doctor follows their own version of the guidelines, so it’s important to do your research.

I wasn’t someone who could remember taking two pills a day, so that was not the right move for me and I chose to switch to a medication that was an oral pill once a day, which I had been taking until this last relapse. This time around we’re going with an infusion, to not only help with MS but also with compliance. Lots of medication options means we have a better chance at finding something that works for us and with us.

How to choose a new medication

Choosing a new medication isn’t as easy as switching brands of ibuprofen. Use the tools that are available to you and talk to other patients, read the clinical trial results, and Google articles about your medication’s FDA approval.

Take into consideration that different doctors treat the same condition differently, too. I have a neurologist who tends to treat aggressively in hopes of being proactive as opposed to reactionary. I am a patient who is OK with taking some risks, so this makes us a good match. You should feel confident in your choice to change medications and if you’re not, think about what is holding you back.

If you’re nervous, try talking to other patients. If you’re worried about side effects, read the research. If you’re unsure if you can afford it, call your insurance company and see if the drug company offers a patient-assistance program. I encourage you to gather all your information and digest it all before making your final choice.

Once you have chosen your new medication, your doctor’s office should communicate with you about how to receive it. If it’s as simple as calling in a script over the phone — high five! You’re well on your way to feeling better. But if you need insurance approvals and a specialty pharmacy, the process could take days or even weeks. Be patient but don’t be afraid to ask for status updates.

It may seem like there are a lot of hoops to jump through on the road to feeling better, but if your medication is effective, it will all be worth it and usually once you’ve received it once, it’s much easier when you need refills or treatments.

Choosing a new medication should be a conversation between both you and your doctor but ultimately the choice is up to you. Being confident in your treatment is so important for physical and mental health.

See more helpful articles:

Why I am a “noncompliant” patient

18 Questions to Ask About a New Medication

Meds Compliance: The “Problem”Patient, Meds and Clinician