Copaxone & Post Injection Reaction

I had my second reaction after giving my Copaxone shot last night.  I had some trouble breathing and my heart was racing.  I layed down on the bed and after a few minutes I was fine.  The first time I had a reaction, my face flushed and felt really warm.  Both times it wasn't near as bad as what the literature had said about the reactions (I didn't feel like I was going to die or anything like that).  However, it's something that baffles me.  What exactly causes this?  My neuro told me that it's because I probably injected into a blood vessel the first time.  However, I started injecting at an angle, like he suggested, and still had a reaction.  Has anyone had these and/or know what causes it or have any suggestions to avoid it?  

[Quixotic1]

Your neruo should have known about the Immediate Post-Injection Reaction.  Both of those episodes sound like it, especially the one last night.  I don't think they are always very severe, but the trouble breathing and the heart racing are right out of the book.

Honestly, I have no clue what the cause of the Post-Inection reaction could be.  It is weird.  How long again since you started the Copaxone?  It is not at all characteristic of an allergy.  (though the reaction resembles the beginning of anaphylaxis).  Major allergic reactions don't come and go and come and go with exposure.

Weird.  Maybe it's just me, but I think the manufacturer really downplays this reaction.

Quix

[cjacks]

Hi Deb

My neuro said his theory on the Imm.Post Injection Reaction is that a bit of the med gets into some ? pathway that  it wasn't meant to and  gets to the heart , you have a reaction until it dissipates ... a couple of min..  

I haven't had your reaction but I have had wheezing a couple of times in the beginning , nothing now.

It sounds like your handling it well . It is not suppose to be dangerous.  You could try seeing what Shared Solutions has to say , don't expect to much from them  but you never know.

When injecting I also angle syringe , and I look for vessels 'trying' to stay away from them. I know when a nurse gives an injection , she will insert the needle and them draw back on the plunger a little to see if blood come back up in the syringe..   SS does not teach this ..  maybe because they are subcutaneous.  Elaine could speak to this..

You don't need to put the needle in all the way making it  shallower , have you seen how small the auto injector is ...  TINY  ..  They need to give the manual syringes smaller needles.  

There's a way to transfer meds to a smaller needle syringe. My SS nurse was not thrilled at this but did show me how . She says the sterile procedure is questionable , she kept frowning . Oh well


Good luck with this and your journey , if you get any other info I be grateful to hear about it .

Jo

[Deb61]

Quix,
It is really weird!  I've been on Copaxone about 5 and a half months, now.  For a long time I didn't have any problems.  The manufacturer should at least give some possible reasons as to why this may occur, how to prevent it (if possible), how often a typical person gets it, etc.  I guess they just want you on their medicine . . .  

Last night I had some anxiety during the shot--my guess is that I was anticipating what had happened the night before and my head was spinning.  It went away as soon as I stretched out on the bed, so tonight, I suspect it will be better (take deep breaths, memditate, do tai chi, etc. hehe).  

Jo,
I had mentioned to SS about the first reaction, but didn't hear anything that would help me, other than contacting my neuro, blah, blah, blah.  

I have not heard about the needle depth.  So you don't have to put the needle in all the way?  Do you have to put it in another syringe to do that or can you (when you manually inject) make sure the needle doesn't go in all the way?  

The reactions, do not seem dangerous when I'm having them, that's why I think I'm handling them.  Actually, when I took Imitrex for migraines (I've since stopped), I felt stranger when the medicine kicked in (heart pounding, chest tightness, darkening vision, etc.).  

Thank you all for the suggestions and info.

Deb

[Heather3418]

I have been on Copaxone for almost 8 months.  To date, I have had nothing but injection site reactions.  None of the dreaded breathlessness or heart palpitations.  I too, have heard that if Copaxone gets into the blood stream accidental, it may cause the more severe reaction.  Only lasting a few minutes.

I have recently found that using the alcohol prep before injection, makes the injection site reaction worse.  I will now soap and rinse the injection site if I haven't just taken a shower and the little lumps and redness are almost a thing of the past.  Usually I take the injection soon after a shower, knowing that my skin is clean.

I am told by a nurse that an alcohol prep is always used before injections, due to the risk of a staff infection.  This can be found in doctor's offices and hospital settings, rarely in your own home.  

So as long as I am not having any signs of infections, I continue to use the non-alcohol wipe approach.  After 7 months with large, hot welts, I finally enjoy a tiny bump with no redness and burning.  It works for me.  Something I am sure Shared Solutions would have a "cow" over.  I have not found them very helpful anyway.  Nice, but not informative.  

Make sure you pinch up some fat or skin before injection, so you are less near any blood vessels, especially if you are on the thin side.  After losing over 100 pounds, I have plenty of loose skin left to inject. The only good thing about once being overweight.

Deb61 - Keep in touch with your doctor, if you continue to have these less than pleasant reactions.  They may want to send a nurse out to your home to make sure that the injections are going into skin and fat only.

Are you using the self-inject method or the auto-injector?  Check the 'depth' of the injection on the auto-injector.  Going BACK two numbers or one, may get the medication in you without the chance of hitting any blood vessels.  I have my auto-injector on 6 and it works just fine.  The key to successful injecting is always making sure that you do not use the exact same spot for at least 10-14 days..Rotation' is a huge key to success.

Copaxone lists the severe possible side effects as soon as you sign onto their web site.  They are listening to the complaints.  I am scared of that one side effect, but have had little to no problems from the Copaxone that this is one drug that I know I can stick with.  The Avonex was just putting me flat on my back for 3-4 days after injection.  I got tired of feelings achy and flu-like most of the week, then only to have to inject again on the 7 th day.  I was one of those that had side-effects throughout my three years on the drug.  It's a great drug and very effective at reducing relapses, so I can't totally rule it out.  It does what they claim.

So until a pill form comes along that we injectors can take, I will endure the possible if not rare side effects of the racing heart, flushness and possible breathlessness.  Especially since it normally goes away within 15 minutes.  I always keep some Benadryl beside where I inject, just in case.  It's a Heather thing...not one that I have heard is recommended by Copaxone.  I feel better knowing that Benadryl is there.  Yeah, one might call me quirky... I just feel safer.

Best of luck to you and sorry this post turned into a short novel.

Best Wishes,
Heather

[Heather3418]

Forgive the typos and spelling...I did mean staph infection not staff

[Deb61]

I would rather deal with an occasional reaction afterwards than to be sick for a longer period of time after the shot.  This reaction goes away pretty quickly and there's no lasting effect.  

My husband has been giving me the shots (manually) and he hates it when this is happening (feeling like it's his fault somehow), but it's not as bad as I anticipated it when I read about the reaction in the literature.  Maybe I didn't have the full-blown reaction that the the Shared Solution people mention.  I'm going to see how this shot goes, if I have more anxiety or a reaction, I'll will be calling my doctor's office.  I will definitely tell him about it when I see him in October.

My first MRI after beginning treatment is also scheduled for October.  It will have been 7 months by then.  Did you see improvements in your MRIs since starting Copaxone?

Tonight, I'm going to give the shower method a shot! (hehe).

Thank you,
Deb

    

[monotreme]

The Copaxone flyer we received from Shared Solutions states that they have no idea why this type of reaction occurs and there is no pattern to predict when it will happen.

I did ask the Shared Solutions nurse about pulling back before injection to make sure there is no blood in the syringe.  Of course the SS nurse said that they can't recommend it because it was not presented to the FDA when the drug was getting approval.  What a wimpy response.

I think that Heather is right about skipping the alcohol wipes.  We have done that all week with Craig and it does lessen the burning.  I think that the chance of a staph infection is much less when in your own home.    We are in the process of trying to get half inch needles.  I think I have a source.  In the meantime we are injecting at a 45 degree angle and I don't always put the entire syringe in.  We do it manually.

Good Luck everyone!!
Elaine