Medication	Dosage and route	Selected adverse effects	Cost*
Alemtuzumab (Lemtrada)	12 mg per day for five days, IV; 12 months later, 12 mg once per day for three days, IV	Infusion reaction, increased risk of infection, thyroid problems, blood clots, immune thrombocytopenia, kidney problems	— (only available at specialty pharmacy)
Cladribine (Mavenclad)	1.75 mg per kg twice yearly, orally	Increased risk of infection, headache, tuberculosis, malignancy, PML	— (only available at specialty pharmacy)
Dimethyl fumarate	240 mg twice per day, orally	Flushing, gastrointestinal symptoms, PML	$130 (—)
Diroximel fumarate (Vumerity)	231 mg twice per day, orally	Flushing, gastrointestinal symptoms, PML	— (only available at specialty pharmacy)
Fingolimod (Gilenya)	0.5 mg once per day, orally	Arrhythmia, hepatic dysfunction, increased risk of infection, PML	— ($10,000)
Glatiramer (Copaxone, Glatopa)	20 mg per mL once per day, subcutaneously 40 mg per mL three times per week, subcutaneously	Injection site reactions	20 mg: $4,700 ($26,600, $4,700) 40 mg: $6,000 ($22,000, $5,000)
Interferon beta-1a (Avonex, Rebif)	30 mcg once per week, intramuscularly 22 mcg or 44 mcg three times per week, subcutaneously	Influenza-like symptoms, injection site reactions, rare liver toxicity	30 mcg: — ($7,200) 22 mcg or 44 mcg: — ($35,000)
Interferon beta-1b (Betaseron, Extavia)	0.25 mg once every other day, subcutaneously	Influenza-like symptoms, injection site reactions, rare liver toxicity	— ($125,300, $6,500)
Mitoxantrone	12 mg per m2 every three months, IV	Heart failure, increased risk of infection, leukemia	Only available at specialty pharmacy (—)
Monomethyl fumarate (Bafiertam)	190 mg twice per day, orally	Flushing, gastrointestinal symptoms, PML	— (only available at specialty pharmacy)
Natalizumab (Tysabri)	300 mg every four weeks, IV	Dizziness, nausea, rash, increased risk of infection, PML	— (only available at specialty pharmacy
Ocrelizumab (Ocrevus)	600 mg every six months, IV	Infusion reactions, herpes, increased risk of malignancy	— (only available at specialty pharmacy)
Ofatumumab (Kesimpta)	20 mg at weeks 0, 1, and 2, then 20 mg per month starting at week 4, subcutaneously	Liver injury, PML, increased risk of infections	— (only available at specialty pharmacy)
Ozanimod (Zeposia)	0.92 mg once per day, orally	Arrhythmia, increased risk of infection, hepatic dysfunction, PML	— (only available at specialty pharmacy)
Peginterferon beta-1a (Plegridy)	125 mcg every two weeks, subcutaneously	Influenza-like symptoms, injection site reactions, rare liver toxicity	— (only available at specialty pharmacy)
Ponesimod (Ponvory)	20 mg once per day, orally	Arrhythmia, increased risk of infection, hepatic dysfunction, PML	— ($8,300)
Siponimod (Mayzent)	2 mg once per day, orally	Arrhythmia, increased risk of infection, hepatic dysfunction, PML	— ($8,900)
Teriflunomide (Aubagio)	7 mg or 14 mg once per day, orally	Nausea, diarrhea, rash, teratogenic	— (only available at specialty pharmacy)