Copaxone side effect??

A board to discuss the Multiple Sclerosis modifying drug Copaxone

Copaxone side effect??

Postby Cfuller00 » Wed Jul 13, 2016 4:32 pm

I was diagnosed with MS in April 2015. I have been taking 20mg Copaxone daily ever since. I have never had an issue with my teeth. I receive regular cleanings and check ups. I have never had a cavity. My diet is actually better now than ever. I have eliminated all caffeine from my diet long before I was diagnosed. I only drink water. I went 4 months ago for my regular cleaning appointment and was told I now have 10 cavities and that my enamel is deteriorating quickly. Could this be a result of the Copaxone?
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Re: Copaxone side effect??

Postby ElliotB » Wed Jul 13, 2016 5:18 pm

Doubtful, but your best bet may be to contact Shared Solutions.
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Re: Copaxone side effect??

Postby NHE » Wed Jul 13, 2016 11:04 pm

Cfuller00 wrote:I was diagnosed with MS in April 2015. I have been taking 20mg Copaxone daily ever since. I have never had an issue with my teeth. I receive regular cleanings and check ups. I have never had a cavity. My diet is actually better now than ever. I have eliminated all caffeine from my diet long before I was diagnosed. I only drink water. I went 4 months ago for my regular cleaning appointment and was told I now have 10 cavities and that my enamel is deteriorating quickly. Could this be a result of the Copaxone?

Tooth caries are listed in Copaxone's Prescribing Information as a frequent gastrointestinal side effect.

https://www.copaxone.com/InteractivePI/ ... -reactions

Considering your situation, it may be best to talk to your neurologist about switching to a different medication.
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Re: Copaxone side effect??

Postby ElliotB » Sat Jul 16, 2016 12:43 pm

As I am on Copaxone, this topic is of great interest to me and I have been doing some research. Just curious... Do you have "dry mouth"?

You may find this info from the UK MS society of interest:

https://www.mssociety.org.uk/sites/defa ... Aug-12.pdf
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Re: Copaxone side effect??

Postby Cfuller00 » Sat Jul 16, 2016 2:18 pm

I don't currently have dry mouth. My only symptom other people than the cavities is sensitivity which I am sure is at least in part related to my enamel disappearing.
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Re: Copaxone side effect??

Postby lyndacarol » Sat Jul 16, 2016 4:10 pm

Cfuller00 wrote:I don't currently have dry mouth. My only symptom other people than the cavities is sensitivity which I am sure is at least in part related to my enamel disappearing.
Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. (2013)
http://www.ncbi.nlm.nih.gov/pubmed/23356636


Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation (2005)
https://www.ncbi.nlm.nih.gov/pubmed/16155270


Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population
https://www.ncbi.nlm.nih.gov/pubmed/15213036
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Re: Copaxone side effect??

Postby aetex » Sun Jan 08, 2017 10:46 am

I haven't been on the forum for a long time, but came to ask about this and here is a thread from last summer!!
I have always had healthy teeth and have obsessively brushed my teeth since I was a kid. After two years on copaxone, I have gone from needing one crown a year ago (which I didn't do--- oops), to now needing 3 root canals and 3 crowns. My teeth are falling apart!! MY dentist (he is a new dentist for me, but very experienced) was puzzled, he even commented that he can tell I care for my teeth and it doesn't make sense why my teeth are so bad, although completely asymptomatic.
My neurologist has not heard of people having this issue, so I am wondering if it is actually the copaxone, or if it is just crappy teeth as I get older. I'm 36 so its not like I'm elderly or anything. I am so frustrated, but at the same time copaxone has been a godsend for my MS so I am afraid to stop it.
I guess at this point I'm choosing porcelain teeth over progression of disease. Ugh. Can't win with this stuff :(

Oh- and I take 10000 IU vitamin D daily so that is not the issue.
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Re: Copaxone side effect??

Postby NHE » Sun Jan 08, 2017 11:10 pm

aetex wrote:I haven't been on the forum for a long time, but came to ask about this and here is a thread from last summer!!
I have always had healthy teeth and have obsessively brushed my teeth since I was a kid. After two years on copaxone, I have gone from needing one crown a year ago (which I didn't do--- oops), to now needing 3 root canals and 3 crowns. My teeth are falling apart!! MY dentist (he is a new dentist for me, but very experienced) was puzzled, he even commented that he can tell I care for my teeth and it doesn't make sense why my teeth are so bad, although completely asymptomatic.
My neurologist has not heard of people having this issue, so I am wondering if it is actually the copaxone, or if it is just crappy teeth as I get older. I'm 36 so its not like I'm elderly or anything. I am so frustrated, but at the same time copaxone has been a godsend for my MS so I am afraid to stop it.
I guess at this point I'm choosing porcelain teeth over progression of disease. Ugh. Can't win with this stuff :(

Oh- and I take 10000 IU vitamin D daily so that is not the issue.


Tooth caries are listed as a "gastrointestinal" adverse reaction in the Prescribing Information.

https://www.copaxone.com/Resources/pdfs ... mation.pdf

Teva Neuroscience wrote:Gastrointestinal:
Frequent:Bowel urgency, oral moniliasis, salivary gland enlargement, tooth caries,
and ulcerative stomatitis.


aetex wrote:My neurologist has not heard of people having this issue, so I am wondering if it is actually the copaxone, or if it is just crappy teeth as I get older.

Perhaps your neurologist hasn't read the Prescribing Information in some time? This would not be surprising.
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Re: Copaxone side effect??

Postby aetex » Mon Jan 09, 2017 8:37 am

When I say he has not heard of it, I mean that in his clinic (large university based MS center with research), this is not a side effect that he has heard of patients complaining. I work in medicine, and it is not unheard of for there to be side effects listed that showed up in research but do not actually arise in actual use. Yes, he has seen the prescribing information.
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Re: Copaxone side effect??

Postby NHE » Tue Jan 10, 2017 12:38 am

aetex wrote:When I say he has not heard of it, I mean that in his clinic (large university based MS center with research), this is not a side effect that he has heard of patients complaining. I work in medicine, and it is not unheard of for there to be side effects listed that showed up in research but do not actually arise in actual use. Yes, he has seen the prescribing information.

I did not mean to say anything negative about your neurologist. The reason I said what I did is because of my own experience. When I was diagnosed in 1999, I was given glossy brochures for each of the 3 medications that were available at the time. When I took them home I discovered an almost hidden pocket in each which held copies of the prescribing information. I studied each with the proverbial fine-toothed comb and a medical dictionary. When I went back to the follow-up appointment with my neurologist he recommended Copaxone. I quickly replied that I wasn't comfortable with Copaxone due to its tendency to be clastogenic (causing breaks in DNA). He asked with a tone of disbelief where I had heard that. I told him that it was in the prescribing information sheets he had given me. That was the end of the discussion. In the end, as a result of carefully studying the prescribing information documents, I essentially knew more about the drugs than my neurologist did.

Looking back, it makes sense that Copaxone is indeed clastogenic. The lipoatrophy problem that many patients experience has been linked to apoptosis. In effect, if enough DNA damage occurs, the cell will commit suicide via apoptosis rather than go on with overwhelming damage that could potentially lead to abnormal regulation of growth. It's likely that subdermal fat layers that die off in lipoatrophy may be more sensitive to Copaxone's clastogenic activity than other tissues.
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Re: Copaxone side effect??

Postby aetex » Wed Jan 11, 2017 6:01 pm

NHE wrote:
aetex wrote: When I went back to the follow-up appointment with my neurologist he recommended Copaxone. I quickly replied that I wasn't comfortable with Copaxone due to its tendency to be clastogenic


I am curious what you thought was a better treatment option.
If it matters at all to you, the clastogenic effects have never been recreated in vivo, only in vitro. Insulin injections also can cause lipoatrophy, I think it has more to do with a foreign protein being injected into a fat cell than it has to do with disruption of DNA replication.
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Re: Copaxone side effect??

Postby NHE » Wed Jan 11, 2017 10:50 pm

aetex wrote:I am curious what you thought was a better treatment option.

Of the three ABC drugs available at the time, I wound up choosing Avonex. It seemed like the lessor evil of the three (Betaseron listed "injection site tissue necrosis" as a side effect). I took Avonex for 10 years. I had lots of side effects. Indeed, my first injection incapacitated me with a high fever and sweats for 24 hours. I later found that ibuprofen was helpful in counteracting the side effects.
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Re: Copaxone side effect??

Postby disneylover » Sat Jan 28, 2017 3:22 pm

Well, I started taking Copaxone November 2016 and started getting lesions, pimples on my scalp, losing hair and itchy scalp beyond belief! Worst part is losing hair!! When I called Neuro's office and Shared Solutions, they stated that it was not listed as a side effect in the clinical studies, but after looking for a minute, they both stated, yes, we have had some patients complaining about hair loss. Neuro's office then said to go to my Primary care physician about it because my hormones were probably off and my hormones were the reason for the hair loss. Well, I took Copaxone for 6 weeks and then stopped and what do you know?! My scalp no longer itches and I am not losing hair. Hmmmmm.......interesting that they never blame the drugs!!!!! It's always something else that must be causing the problem, yet you never had the problem until you started taking the drug!!! Come on now.......how stupid do these dr.'s think we are?!?!? BTW, there is an MS forum that talks about all of their hair loss stories. So sad....... and then on top of it, the dr.'s don't even relate the drugs to your symptoms.
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Re: Copaxone side effect??

Postby aetex » Mon Jan 30, 2017 7:29 pm

Disneylover- If you don't trust your provider, please find a new one. Trust is of the utmost importance in a patient-provider relationship. This disease is too much of a beast to be facing it with someone that you don't feel has your back.
In all honesty, it sounds like your doctor addressed appropriately. With common things being common, it would be silly of him to blame a drug that could potentially help you a lot without ruling out the more obvious things that typically cause hair loss like hormone imbalance. That doesn't sound like he was dismissing your concerns at all. And at the end of the day- if copaxone works for me, I really wouldn't care that much if my hair was thin.
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