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Switching MS medications may mean switching routines

By Matt Cavallo

I wrote about switching from an IV-administered multiple sclerosis treatment to an oral medication. I had been on IV administered since 2007, but prior to that, I was on a self-injection MS treatment at home. So, when I made the switch to an oral medication, there was a feeling of breaking free from the highly protocoled IV medications and controlling my own destiny by taking a pill at home. What I didn’t realize is that switching medications meant switching routines. 

I recently had a follow-up visit my neurologist and he started the appointment off by asking why I hadn’t gotten my blood tested. He said I was supposed to get my blood tested 30 days after taking my medication. He further explained that the medication suppressed my immune system and as a part of the protocol of the oral medication, I needed to get my blood test to ensure that my immune system was bouncing back. This information caught me somewhat by surprise because I had missed these instructions when I switched to my new medication. Around the time I switched medications, I was also starting a new job, so I was a bit distracted with all I had to do in life at that time.

My neurologist was so adamant that I get my blood tested that day that he told me to call his office as soon as I got my labs drawn. It had been six months since I had started this medication. My sons had been back at school for the fall semester, and I had caught both COVID and the flu during that time. While with my neurologist, I remembered that my COVID and flu experiences were both more severe than they had been previously. At the time when I was sick, it didn’t dawn on me that my severe illnesses could be related to the immune suppression from my new oral medication. Now, I was connecting the dots that by switching from a heavily protocoled IV treatment to the freedom of an oral medication, I was going to have more responsibility to make sure I follow medical instructions, including getting recommended blood tests.

One of the biggest differences between an IV medication and an oral medication is that the IV medication is infused by a registered nurse. The registered nurse makes sure you adhere to your protocols, and you are authorized to be infused before your next infusion. Whereas you are own your own when taking oral medications at home. 

If you are thinking about switching to a new MS medication, make sure you talk to your neurologist about what changes you will have to make to your routine. Make sure that when you switch medications, you talk to the new pharmaceutical company to get all of your questions answered. Also, you should ask if there are any requirements such as blood tests or imaging you will need to do as a part of the new medication’s protocols. This way neither you, nor your neurologists, will have any surprises at your next visit.