Using 'As Needed' Drugs with MS

Patient Expert

People diagnosed with MS use several different types of medication to treat the disease, relapses, and symptoms. They can typically be divided into three categories:

Disease-modifying drugs are approved to be used according to a very specific dosing schedule and should be taken exactly as prescribed (long-term) to maximize benefit and reduce risk. Disease-modifying therapies work in a variety of ways to slow down the disease by reducing relapse frequency, disease activity seen on MRI, and disability progression. Corticosteroids (intravenous and/or oral) and adrenocorticotropic hormone injections are given to reduce the severity and duration of MS relapses or exacerbations. These medications work to more quickly reduce inflammation, thus interfering with an acute attack on the central nervous system. Symptomatic therapies are prescribed to manage the myriad of symptoms which can be caused by MS. Some symptomatic therapies may be prescribed to be taken on a specific routine schedule, such as daily, while others may be prescribed to be taken “as needed.” Many common MS symptoms, such as depression, require medication that is taken regularly for an extended period of time.

What does “as needed” mean?

Medications that are taken “as needed” are used only when necessary to treat a specific situation or symptom, such as pain, the common cold, allergies, constipation, anxiety, or fatigue. Some of these medications might be prescribed for you by a doctor while others can be purchased “over the counter” at your local pharmacy.

“Pro re nata” is a Latin phrase that means in the circumstances or as the circumstance arises. In medicine, pro re nata is abbreviated as p.r.n or PRN and means taken as needed or as the situation arises.

PRN medications are taken every once in a while to treat certain symptoms.

It is important to know what medications can be taken “as needed” and which ones must be taken regardless of how you feel. I take medications for low thyroid function, high cholesterol, and depression, each of which must be taken daily even if I feel great. This is non-negotiable. The list of medications I have on hand to be taken as needed is much longer and help me manage spasticity, nerve pain, anxiety, insomnia, and fatigue.

Can gabapentin or baclofen be taken “as needed”?

When I was first prescribed gabapentin and baclofen, I started them slowly, at a low dose, and titrated up to an effective dose which was taken daily on a regular schedule. Over the years, the amount of these medications I’ve needed to take has varied. At one point, I was taking 600mg of gabapentin three times daily to combat severe nerve pain. But now, I only take an occasional 300mg dose when mild nerve pain reaches the annoying or distracting stage. "As needed."

While I currently take baclofen each evening before bed, I also keep a prescription of diazepam (Valium) on hand for when the spasms get unbearable and when baclofen doesn’t sufficiently reduce the discomfort (ie, when massaging or stretching a knotted muscle causes intense crying).

Take medicines safely.

If you use PRN medications that are taken “only as needed,” it is important that you know exactly how these medications should be used. Discuss with your doctor his/her instructions regarding how frequently the medication can be used and what dosage you should use or not exceed.

Be aware that some of your PRN medications may be used instead of one of your other meds rather than in addition to. And, some medications may have similar ingredients and should not be used together. Ask your pharmacist if you ever have questions regarding medications (prescribed or OTC) to make sure that you take your medicines safely.

See more helpful articles:

10 Lessons I’ve Learned Since Being Diagnosed with MS

Five Ways to Get the Most Out of Your MS Medication

Compliant, Complacent, or Condemned: Which Type of Patient Are You?

MS Signs & Symptoms: What is Pruritus?

9 Things to Know When Your Partner Has MS