Glatiramer Acetate (Copaxone)

Occur in ~90% of patients, typically mild and self-resolving. Rotate injection sites to minimize local reactions. Pretreatment with topical anesthetic or ice may reduce discomfort. Reactions usually diminish over time.

Occurs in 10-15% of patients, typically within minutes of injection and resolving within 30 minutes. Usually self-limited but can be distressing. Premedication with antihistamines or short-acting beta-blockers may help. Seek medical evaluation if severe or prolonged.

Localized fat loss or thickening at frequently used injection sites. Prevented by strict site rotation (minimum 1 inch between injections, different body areas each week). May be cosmetically concerning but not medically dangerous.

Mild, asymptomatic enlargement of regional lymph nodes. Reflects immune activation and typically resolves without intervention.

Localized or generalized urticaria reported in <1% of patients. Usually responds to antihistamines. Discontinue if severe or accompanied by angioedema.

Extremely rare (<0.1%) but documented. Presents with rapid onset of dyspnea, hypotension, angioedema, or urticaria. Requires immediate epinephrine and emergency medical evaluation. Contraindication to further use.

Bacterial infection from non-sterile technique. Prevent by using aseptic technique, sterile needles, and alcohol swabs. Treat with topical or systemic antibiotics if infection develops.

Fainting or near-syncope during or immediately after injection, likely related to anxiety or the immediate post-injection reaction. Sit or lie down during injection to prevent injury.