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In every dose of Copaxone, there is 40mg. of mannitol and 20mg. glatiramer acetate.
Rebif and Avonex use mannitol as a stabilizer, too.
Mannitol is a diurectic, used in head injury and stroke to reduce edema and improve cerebral blood flow (CBF)`

Mannitol, a 6-carbon sugar, is widely used in head injury management, though it has never been subjected to a randomised control trial against placebo and the methods and timing of administration vary widely. It is an osmotic diuretic and can have significant beneficial effects on Intracranial pressure (ICP), cerebral blood flow and brain metabolism. Mannitol has two main mechanisms of action. Immediately after bolus administration it expands circulating volume, decreases blood viscosity and therefore increases cerebral blood flow and cerebral oxygen delivery.

Acute improvement in exacerbating multiple sclerosis produced by intravenous administration of mannitol.
Seven of 8 patients receiving placebo infusions (2.5% glucose) showed no significant clinical change and 1 exhibited an equivocal improvement. Five of 9 patients receiving mannitol showed definite signs of clinical improvement phase-locked to drug administration, with subsequent gradual reversal to baseline

http://www.ncbi.nlm.nih.gov/pubmed/3000278

In a double-blind, placebo-controlled study, Stefoski et al. (47) demonstrated that a mannitol-induced osmotic diuresis clinically improved critical flicker fusion frequency and visual acuity in patients with exacerbating MS, thereby suggesting that steroids function by reducing edema in acute lesions.

Indications and Usage for Mannitol Injection

Mannitol I.V. (Mannitol Injection, USP) is indicated for the following purposes in adults and pediatric patients.
Promotion of diuresis in the prevention or treatment of the oliguric phase of acute renal failure before irreversible renal failure becomes established.
Reduction of intracranial pressure and brain mass.
Reduction of high intraocular pressure when the pressure cannot be lowered by other means.
Promotion of urinary excretion of toxic materials.

http://www.drugs.com/pro/mannitol-injection.html

I don't know....maybe it's the mannitol injection, not the glatiramer acetate, which has benefitted Jeff. Sure would be a lot less expensive just to inject mannitol....
thoughts?
cheer

Cheer, I used Copaxone for about 3 /1/2 years, after I stopped Avonex for one year. The "C" I stopped using in early 2006. I still was having 2 to 3 relapses from heck a year. My new Neuro wanted me on something so I tried "C" again early 2008. This time I had very bad reactions. Giant hives with edema, huge swellings that went raw, then they collated to the size of dinner plates. Yuck!

I called Share solutions, then their medical management team, and finally they gave me their Pharmacist directly to ask if there was any change in the "C". Well, now it could be left out on the table 30 days without refrigeration she said, was one new thing, and two, they stopped using sugar alcohol from beets and now they used sugar alcohol from corn, which was now coming from China, she said.

Well I am allergic to corn and yet they never changed their insert. I had seen about 6 different doctors for my messed up body, and septic yeast infection it caused. So many meds they all tried. Finally, I had to see an Oncologist, after my allergy/Immunologist gave up.

The Oncologist said it was the Copaxone's Mannitol I was allergic to (the corn). Also, "C" acts like a decoy, so it let an infection into my body, then to multiply, because it got in under it's surveillance system.

I didn't have cancer but was treated with a shotgun, empirical treatment, to rid the body of the infection. I had only had a few injections when this happened. I never had a reaction of any kind until they changed the Mannitol. So I was shooting myself with something I was allergic too.
Long story I know.

Doesn't Mannitol open the BBB? Could let in untoward germs.That may not be a good thing for MS.

Opening is good for brain injury to deliver medication to the injured brain, or drain fluid in case of brain swelling. I'd rather take steroids to reduce the inflammation and the fluid around any active brain lesion. JMO and problem. If you don't have allergies it may not be a problem unless a person has that immediate 20 minute reaction, which I never experienced ever.
CD

Cheerleader wrote:I don't know....maybe it's the mannitol injection, not the glatiramer acetate, which has benefitted Jeff. Sure would be a lot less expensive just to inject mannitol....
thoughts?
cheer

It's likely that the subcutaneous injection of mannitol behaves very differently in the body than mannitol given via IV to help treat head injury or stroke.

NHE

NHE wrote:]
It's likely that the subcutaneous injection of mannitol behaves very differently in the body than mannitol given via IV to help treat head injury or stroke.

NHE

probably, NHE. Just wondering. I know the amount is smaller.
Interesting on the beets to corn change, CD. Thanks for sharing that. You might want to submit a post on this on the Copaxone thread, for others with corn allerigies who may not know....
cheer

Cheer, I thought of doing that many times, on many forums, but since I am on LDN since
11-2008, I thought Copaxone users would just think that I was being negative against Copaxone. I am not.

After having Avonex flu for almost a week after each shot, with a needle the size of a paper clip, "C" was a piece of cake. It just stopped working for me, then when I tried to try again, it changed.
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*Also, I have a theory about Copaxone. Let me run it by you Cheer and NHE. Besides the Mannitol, Copaxone has the four amino acids G, L, A and T. but in a random chain of over 150, so basically each pre-filled syringe, in the 30 pack box, must be varied in its contents. I thought that was why some people had that immediate bad reaction, but not with every shot. Any thoughts on this?
Just a thought I had years ago while researching the drug prior to use.
CD

Yes, mannitol is a sugar alcohol (some others are sorbitol, xylitol, erythritol). These are "sweeter" than sugar and the body responds by producing even more insulin.