Managing Avonex Side Effects

I did some google research on managing Avonex side effects. Avonex is what I think I am injecting IM every week. The side effects are those awful "flu-like" (more like hot/cold, painful hell) symptoms. Since I will be doing the IM injections every week for the foreseeable future, I want to find a way to manage the side effects.

This is what I found:

- Do the injection in the early evening or right before bedtime, depending on when the symptoms tend to hit you.

- Hydration helps tons. One person said to begin the increased hydration the day before and continue through the day after the injection.

- Gatorade the next morning might help.

- Benadryl might help. (I think they mean help you sleep through the worst of it.)

- Take an Ambien. (Several people liked this; some felt it was not good or the side effects were not worth it.)

- Naproxen might help more than ibuprofen.

- You cannot take ibuprofen, naproxen, and aspirin together (not all three, and not even two in any combination).

- You can take acetaminophen with any one of the three pain relievers above.

- The maximum daily dosage of acetaminophen is 4 grams.

-The maximum daily dose of naproxen is 1,500 mg; 1,650 for naproxen sodium.

-The maximum daily dosage of aspirin is 8 grams.

-The maximum daily dosage of ibuprofen is 3,200 mg.

- Take higher doses (not to exceed the maximum daily amount) of pain relievers.

- Taking two pain relievers together helps.

- Start with a heavy dose of a pain reliever (especially ibuprofen or naproxen) half an hour before the injection.

- Continue dosing with pain relievers for 24 hours.

- Start with 1/4 dose of Avonex the first two weeks, 1/2 dose the next two weeks, 3/4 dose the next two weeks, and on the 7th week the full dose.


Whew. That is a lot. Seems like good advice, though. Basically, I need to treat this like a flu that I am bringing on. I can predict the course of it, if it goes similarly to last time.

I had about 1/2 of the Avonex dose on Friday, and I was going to take a full dose this Friday. Now I am going to email the nurse and ask if I can take a half dose again. I need to email her anyway to tell her about the new symptoms I had today.

Since the symptoms began about four hours after the injection and became horrible about six hours after the injection, I will probably do it around 6:00 pm next time. The worst symptoms lasted until 13 hours after the injection, so that would be until 7:00 am. Hm. Maybe I will do the shot at 5:00.

I will drink as much as possible before and after the injection. That cannot hurt anyway. I will consider the Gatorade suggestion. I hate to drink the chemicals and high fructose corn syrup, though. I wonder if there is a more natural alternative.

I think I will try naproxen, since ibuprofen did not help (although I probably did not take enough--I did not expect it to be that bad). I will go with 750 mg of naproxen sodium at 4:30 pm, the shot at 5:00 pm, and 1,000 mg of acetaminophen at 5:30, then another 1,000 mg of acetaminophen at 9:30. In bed by 10:00.

I do not want to use Bendryl, because I have had weird reactions to it before. Sometimes it makes me wired and keeps me awake; sometimes it puts me right to sleep, and once it made my legs twitch uncontrollably for half an hour. I do have a couple of Ambien left from the nutty Dr. Gabby days, but I think I will pass on that.

Maybe I will drink some chicken broth in the evening.

If I wake up during the night, I will take 1,000 mg more of acetaminophen after 1:30 am and  375 or 750 mg of naproxen (depending on how I am feeling) after 4:30 am. I will have the medications on my night stand; last time I did not have anything ready when I woke up sweating and in pain.

And I will try to drink as much as possible! OK, so that is the plan. We will see how it goes on Friday.