When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to glatiramer or mannitol.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have an infection.
• Some patients may have a reaction a few minutes after receiving a shot. This reaction may include flushing, a fast or pounding heartbeat, chest pain, shortness of breath, anxiety, a tight feeling in the throat, or hives. The reaction usually lasts a few minutes and goes away without treatment. If the reaction gets severe or does not go away, call your doctor right away. This reaction can happen even if you have used the medicine regularly for several months. Also, chest pain can occur by itself, but should not last more than a few minutes.
• This medicine may cause a permanent depression under the skin at the injection site. Contact your doctor right away if you notice any of these side effects at the injection site: depressed or indented skin; blue-green to black skin discoloration; or pain, redness, or sloughing (peeling) of the skin.
• Avoid people who are sick or have infections.
• Do not stop using this medicine without first checking with your doctor.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety.
• Chest pain, shortness of breath, or trouble with breathing.
• Fast, pounding, or uneven heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Severe pain, redness, swelling, itching, or lump where the shot is given.
• Sores or ulcers in the mouth or lips.
• Swelling in your face, hands, ankles, or feet.
• Swollen, painful, or tender lymph glands in the neck, armpit, or groin.
• Trouble with swallowing.
• Unusual bleeding, bruising, or weakness.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice these less serious side effects, talk with your doctor:

• Back pain.
• Discoloration of the skin.
• Double vision or changes in vision.
• Joint or muscle pain.
• Mild pain, redness, swelling, itching, or lump where the shot is given.
• Nausea or vomiting.
• Rash or itching.
• Stuffy or runny nose.
• Sweating.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088