Multiple sclerosis is a condition that brings about great amount of disability and inconvenience. The condition affects the brain and the spinal cord. It arises when the myelin sheath gets attacked by the immune system. This interferes with the communication between the brain and other parts of the body. It could eventually lead to permanent damage and further deterioration of nerves.

Most of the attack from the immune system on the protective sheath occurs in the early stages of the condition. Hence, aggressive treatment with proper medication at the earliest possible stage can be extremely helpful to reduce the relapse rate while also slowing down the formation of any new lesions. The only FDA-approved disease-modifying therapy that is available to treat primary-progressive MS is ocrelizumab (Ocrevus). This treatment slows the progress when compared to patients who have not been treated. However, several disease-modifying therapies are available to treat relapsing-remitting MS.

1. The injectable medications that can be used are:

• Glatiramer acetate
  This would be injected directly under the skin and would function by blocking the attack by the immune system on the protective sheath. However, the injection could cause skin irritation at the site of administration.
• Beta interferons
  These medications are capable of decreasing the frequency and severity of relapses that occur. Similar to the previous medication, this too could be injected right under the skin or it could also be injected into the muscle. These medications have been observed to be one of the most commonly prescribed medications to treat this kind of MS.

2. Oral treatments available for the condition are:

• Dimethyl fumarate
  This medication is used to reduce relapses. It should be consumed twice a day. In some cases, the side effects of nausea, flushing, diarrhea, and a lowered white blood cell count might be observed.
• Fingolimod
  This medication is prescribed to reduce the rate of relapse. The dose should be given once a day. There is a possibility that the heart rate might slow down after the administration. As a result, one would have to measure their heart rate every six hours after taking the medication. High blood pressure, blurred vision, headache, and some rare infections could be side effects.
• Siponimod
  This medication works by slowing down the progression of MS and decreasing the relapse rate. This medication has also been approved for secondary-progressive MS. However, the medication has been found to be harmful to a developing fetus. Women should also take contraceptives along with this medication and should continue the use of contraceptives for 10 days after stopping the medication. The side effects of this medication include headaches, change in heart rate, vision problems, liver problems, and reduction in the white blood cell count.
• Teriflunomide
  Similar to the previous medications, this medication helps decrease the relapse rate. The dose should be given once a day. The medication should not be administered to pregnant women as the medication could prove to be harmful to a developing fetus.