Multiple Sclerosis Society of Canada

Symptom Management

Symptom Management Medication Name

Bladder Dysfunction

Urinary antispasmodic

Botulinum toxin (Botox*)
Flavoxate (Urispas*)
Imipramine (Tofranil*)
Mirabegron (Myrbetriq*)
Oxybutynin (Ditropan*)
Solifenacin succinate (Vesicare*)
Tolterodine (Detrol*)

Promote the flow of urine

Tamsulosin (Flomax*)
Prazosin (Minipress*)
Darefenasin (Enablex*)

Suppression and Treatment of Urinary tract infections

Ciprofloxacin (Cipro*)
Nitrofurantoin (Macrodantin*)
Sulfamethoxazole (Bactrim*, Septra*)

Urinary suppressant

Desmopressin (DDAVP*)

Intermittent self-catheterization or indwelling catheter

Discuss with your physician

Bowel Dysfunction

Stool softener

Docusate oral (Colace*)
Docusate enema (Enemeez Mini Enema*)

Constipation

Bisacodyl (Dulcolax*)
Sodium phosphate (Fleet Enema*)
Psyllium hydrophilic mucilloid (Metamucil*)
Magnesium hydroxide (Phillips’ Milk of Magnesia*)

Depression

Tricyclic antidepressant

Amitriptyline (Elavil*)
Nortriptyline (Aventyl*, Pamelor*)

SSRI

Citalopram (Celexa*)
Fluoxetine (Prozac*)
Paroxetine (Paxil*)
Sertraline (Zoloft*)

SNRI

Mirtazapine (Remeron*_)
Venlaflxine (Effexor*)
Desvenlaflaxine(Pristiq*)

Fatigue

CNS stimulant

Amantadine (Symmetrel*)
Methylphenidate (Ritalin*)
Modafinil (Alertec*)

Numbness

-

Corticosteroids (in very severe cases). Prednisone, methylprednisone (Solumedrol *)

Pain

Neuropathic pain and paresthesias

Amitriptyline (Elavil*)
Nortriptyline (Aventyl*)
Gabapentin (Neurontin*)
Pregabalin (Lyrica*)
Carbamazepine (Tegretol*)
Phenytoin (Dilantin*)
Cannabis sativa L. extract (Sativex*)
Cyclobenzaprine (Flexeril*)
Narcotic analgesics-acetaminophen-oxycodone (Percocet*)

Muscle relaxant

Methocarbamol (Robaxin*)
Baclofen (Lioresal*)
Lorazepam (Ativan)

Analgesics and anti-inflammatory agents

Acetaminophen (Tylenol*)
Ibuprofen (Advil*)

MS Relapse

Reduce inflammation that occurs in the CNS during an MS relapse

Prednisone (Deltasone*)
Methylprednisone intravenous (Solu-Medrol*)

Sexual Dysfunction

Erectile dysfunction

Alprostadil (Caverject*, Muse*, Prostin VR*)
Papaverine
Sildenafil (Viagra*)
Tadalafil (Cialis*)
Vardenafil (Levitra*)

Decreased vaginal lubrication

Water soluble lubricants (KY Jelly*)

Relief of dysesthesias (pain)

Carbamazepine (Tegretol*)
Phenytoin (Dilantin*)

Spasticity (muscle stiffness)

Muscle relaxant

Baclofen, injection (Intrathecal Baclofen - ITB Therapy)
Baclofen, oral (Lioresal*)
Cannabis sativa L. extract (Sativex*)
Diazepam (Valium*)
Lorazepam (Ativan*)
Tizanidine (Zanaflex*)

Speech and swallowing difficulties

Medication may be used to dry a mouth that is over-secreting

Anticholinergics (Ditropan*)

Tremor

Anticonvulsant

Gabapentin (Neurontin*)
Levetiracetam (Keppra*)
Primidone (Mysoline*)
Topiramate (Topamax*)

Antibiotic

Isoniazid (Isoniazid*)

Beta Blocker

Propranolol (Inderal*)

Vertigo/Dizziness

Antiemetic (anti-nausea)

Dimenhydrinate (Gravol*)
Ondansetron (Zofran*)
Meclizine (Bonamine*)
Prochlorperazine (Compazine*, Stemetil*)

Vision problems

Corticosteroids

Methylprednisone Solu-Medrol (IV)
Prednisone Deltasone (oral)

Walking

Potassium channel blocker

Fampridine SR (Fampyra*)