Active substance: GLATIRAMER ACETATE

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• If the solution contains particles, do not use it. Use a new syringe.


The first time you use Copaxone 20 mg/ml you will be given full instructions and will be
supervised by a doctor or nurse. They will be with you while you give yourself the injection
and for half an hour afterwards, just to make sure you do not have any problems.

Package leaflet: Information for the user

20 mg/ml

solution for injection, pre-filled syringe
glatiramer acetate

Read all of this leaflet carefully before you start using this medicine because it
contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may
harm them, even if their signs of illness are the same as yours.
• If you get any of the side effects, talk to your doctor or pharmacist. This includes
any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Copaxone 20 mg/ml is and what it is used for
2. What you need to know before you use Copaxone 20 mg/ml
3. How to use Copaxone 20 mg/ml
4. Possible side effects
5. How to store Copaxone 20 mg/ml
6. Contents of the pack and other information
1. What Copaxone 20 mg/ml is and what it is used for
Copaxone 20 mg/ml is a medicinal product which modifies the way in which your
body’s immune system works (it is classed as an immunomodulating agent). The
symptoms of multiple sclerosis (MS) are thought to be caused by a defect in the
body’s immune system. This produces patches of inflammation in the brain and spinal
Copaxone 20 mg/ml is used to reduce the number of times you suffer attacks of MS
(relapses). It has not been demonstrated to help if you have any form of MS which
does not have relapses, or hardly any relapses. Copaxone 20 mg/ml may not have
any effect on the length of time an MS attack lasts, or how badly you suffer during an

Instructions for Use
Read these instructions carefully before using Copaxone 20 mg/ml.
Before the injection, make sure you have everything you need:
• One blister with one Copaxone 20 mg/ml pre-filled syringe
• Disposal unit for used needles and syringes.
• For each injection, take only one blister with one pre-filled syringe from the package.
Keep all remaining syringes in the box.
• If your syringe has been stored in the refrigerator, take the blister containing the syringe
out at least 20 minutes before you will inject the medicine so that it warms up to room
Wash your hands thoroughly with soap and water.
If you wish to use the autoject2 to make your injection, please refer to the instructions for
use provided together with the autoject2.
Choose the injection site, using the diagrams in Figure 1.
There are seven possible areas on your body for injection: arms, thighs, hips and stomach
(belly). Within each injection area there are several injection sites. Choose a different site
for the injection every day. This will reduce the likeliness of any irritation or pain at the site
of the injection. Rotate the injection sites within an area. Do not use the same site each
Please note: do not inject in any area that is painful or discoloured or where you feel firm
knots or lumps.
You should consider having a planned schedule for rotating injection sites and making a
note of it in a diary. There are some sites on your body that may be difficult for
self-injection (like the back of your arm). If you want to use these, you may require
Area 1
Avoid about 5 cm
around the navel

Area 4
Left Arm
Fleshy part of
upper back portion

Area 5
Right Arm
Fleshy part of
upper back portion

It is used to treat patients who are able to walk without help.
Copaxone may also be used in patients who have experienced symptoms for the first
time which indicate a high risk of developing MS. Your doctor will rule out any other
reasons which could explain these symptoms before you are treated.
2. What you need to know before you use Copaxone 20 mg/ml
Do not use Copaxone 20 mg/ml
• if you are allergic to glatiramer acetate or any of the other ingredients of this
medicine (listed in section 6).
• if you are pregnant.
Warnings and precautions
Talk to your doctor or pharmacist before using Copaxone 20 mg/ml
• if you have any kidney or heart problems as you may need to have regular tests
and check-ups.



Copaxone is not to be used in children below the age of 12 years.
Copaxone has not been specifically studied in the elderly. Please ask your doctor for


Other medicines and Copaxone 20 mg/ml
Tell your doctor or pharmacist if you are taking, have recently taken or might take any
other medicines.
Pregnancy and breast-feeding
Do not use Copaxone 20 mg/ml if you are pregnant. Tell your doctor if you become
pregnant while you are using this medicine or if you plan to become pregnant.
You should use effective birth-control (e.g. the ‘pill’ or condoms) to avoid pregnancy
during the treatment with Copaxone.
In case you would like to breast-feed while using Copaxone, please discuss this first
with your doctor.
Driving and using machines
Copaxone 20 mg/ml is not known to influence the ability to drive or operate

Area 2
Right Thigh
(about 5 cm above
knee and 5 cm
below groin)

Area 3
Left Thigh
(about 5 cm above
knee and 5 cm
below groin)

Area 6
Left Hip
Fleshy area of
upper hip, always
below the waist

Figure 1

Area 7
Right Hip
Fleshy area of
upper hip, always
below the waist

How to inject:
• Remove the syringe from its protective blister by peeling back the paper label.
• Remove the shield from the needle.
• Gently pinch up the skin with the thumb and forefinger of the free hand (Figure 2).
• Push the needle into the skin as shown in Figure 3.
• Inject the medicine by steadily pushing the plunger all the way down until the syringe is
• Pull the syringe and needle straight out.
• Discard the syringe in a safe disposal container. Do not put used syringes into the
household waste but dispose of them carefully in a puncture-proof container as
recommended by your doctor or nurse.

3. How to use Copaxone 20 mg/ml
Always use this medicine exactly as your doctor has told you. Check with your doctor
or pharmacist if you are not sure.
The daily dose in adults and adolescents aged 12 years and over is one pre-filled
syringe (20 mg of glatiramer acetate), administered under the skin (subcutaneously).
It is very important to inject Copaxone 20 mg/ml properly:
• Into the tissue under the skin (subcutaneous tissue) only (see “Instructions for Use”
• At the dose instructed by your doctor. Take only the dose prescribed by your doctor.
• Never use the same syringe more than once. Any unused product or waste must be
• Do not mix or co-administer the content of Copaxone 20 mg/ml pre-filled syringes
with any product.

Figure 2

Figure 3

If you have the impression that the effect of Copaxone 20 mg/ml is too strong or too weak,
talk to your doctor.
If you use more than one syringe of Copaxone 20 mg/ml a day then you should
Talk to your doctor immediately.
If you forget to use Copaxone 20 mg/ml
Use it as soon as you remember but do not use a double dose to make up for forgotten

If you stop using Copaxone 20 mg/ml
Do not stop using Copaxone 20 mg/ml without consulting your doctor.
If you have any further questions on the use of this medicine, ask your doctor or
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets
Allergic reactions (hypersensitivity)
You may rarely develop a serious allergic reaction to this medicine.
Stop using Copaxone 20 mg/ml and contact your doctor immediately or go to the
nearest hospital casualty department, if you notice any sign of these side effects:
• rash (red spots or nettle rash),
• swelling of the eyelids, face or lips,
• sudden shortness of breath,
• convulsions (fits),
• fainting.
Other reactions following injection (Immediate Post-Injection)
Some people may get one or more of the following symptoms within minutes after
injecting Copaxone 20 mg/ml. They normally do not cause any problems and usually
disappear within half an hour.
However, if the following symptoms last longer than 30 minutes, tell your doctor
immediately or go to the casualty department at your nearest hospital:
• flushing of the chest or face,
• a feeling of tightness in the chest,
• shortness of breath,
• rapid and pounding heartbeat (palpitations).
The following side effects have been reported with Copaxone:
Very common (may affect more than 1 in 10 people)
• Skin reactions at the injection site. They included: reddening of skin, pain, formation of
wheals, itching, tissue swelling, inflammation and hypersensitivity at the injection site.
These injection site reactions are not unusual and normally decrease over time.

• abortion
• strange dreams, confusion, abnormally happy or active, seeing or hearing things
that are not there, aggressiveness, personality change, suicide attempt

• blood in the urine or other problem in the urinary system, kidney stones
• swollen breasts, sustained erections, difficulties getting an erection, prolapse,

problems with the vagina, prostate or testes, vaginal bleed, abnormal smear test

• problems with the lungs, tight feeling in the throat, inability to breath, abnormally
fast or deep breathing (hyperventilation), nose bleeds

• swelling of the capillaries, skin contact rash, skin lumps, painful red skin lumps
• varicose veins
Rare (may affect up to 1 in 1,000 people) and very rare (may affect up to 1 in
10,000 people)
• Severe allergic reaction
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. You can also report side effects directly
Yellow Card Scheme
Tel: Freephone 0808 100 3352

By reporting side effects you can help provide more information on the safety of this
5. How to store Copaxone 20 mg/ml
Keep this medicine out of the sight and reach of children.
Store in a refrigerator (2°C – 8°C).
Copaxone 20 mg/ml pre-filled syringes can be kept for up to one month outside the
refrigerator at room temperature. You can do this only once. After one month any
Copaxone 20 mg/ml prefilled syringes that have not been used and are still in their
original packaging must be returned to the refrigerator.
Do not freeze.
Keep the pre-filled syringes in the outer carton in order to protect from light.

Further very common side effects included:
• nausea
• feeling weak, chest pain, non-specific pain
• infections, flu
• pain in the joints or back
• headache
• anxiety, depression
• skin rash

Do not use this medicine after the expiry date which is stated on the label and carton
(EXP). The expiry date refers to the last day of that month.

Common (may affect up to 1 in 10 people)
• swollen lymph nodes
• rapid heart beats, rapid and throbbing heartbeat (palpitations)
• ear problems
• eye problems, double vision
• problems with your bottom, constipation, tooth fillings, indigestion, difficulty swallowing,
bowel incontinence, vomiting
• chills, local reactions, accumulation of fluid, swollen ankles, swollen face, high
temperature, loss of tissue under the skin at injection site
• allergic reactions
• infection of the respiratory track, stomach, ear, runny nose, cold sores, tooth abscess,
vaginal thrush
• abnormal liver function test
• weight gain, loss of appetite
• pain in your neck
• skin growths, tissue growth
• altered taste, abnormal tension of arteries or muscles, migraine, problems with speech,
fainting, tremor
• nervousness
• inability to empty your bladder, need to empty your bladder quickly, frequent urination
• cough, hayfever
• bruising, excessive sweating, itching, nettle rash and other skin problems

What Copaxone 20 mg/ml contains
• The active substance is glatiramer acetate. 1 ml solution for injection (the contents
of one pre-filled syringe) contains 20 mg glatiramer acetate.
• The other ingredients are mannitol and water for injections.

Uncommon (may affect up to 1 in 100 people)
• change in number or form of white cells, less platelets, big spleen
• extra heart beats, slow or fast heart beats
• enlarged or overactive thyroid
• cataract, scratch on the eyeball, dry eye, a bleed on the eye, droopy eyelid, widening of
the pupil, abnormal vision or loss of vision
• bowel inflammation, polyps in the colon, burping, ulcer in the gullet, inflammation of the
gums, rectal bleed, enlarged salivary glands
• cyst, hangover, body temperature lower than normal (hypothermia), non-specific
inflammation, destruction of tissues at the injection site, problems with mucous
• abscess, boils, infection of skin or kidney, shingles
• tiredness after vaccination
• gallstones, enlarged liver
• low alcohol tolerance, gout, too much fat (lipids) in the blood, changes in the blood
(increased sodium, decreased (ferritin)
• swollen joints (arthritis or osteoarthritis), decrease in the mass of muscles
• skin cancer
• hand numbness and pain, mental disorders, fits (convulsion), writing and reading
disabilities, muscle spasm, impaired muscle tone, nerve inflammation, muscle
weakness, paralysis, eye flickers, foot drop, unconscious state (stupor), visual blind

Dispose of any syringes that contain particles.
Do not throw away any medicine via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures will
help protect the environment.
6. Contents of the pack and other information

What Copaxone 20 mg/ml looks like and contents of the pack
Copaxone 20 mg/ml solution for injection in pre-filled syringe is a sterile, clear
solution, free of visible particles.
If the solution contains particles, throw it away and start again. Use a new syringe.
Copaxone is available in packs containing 7, 28 or 30 pre-filled syringes of 1 ml
solution for injection or in a multipack comprising 3 cartons, each containing 30
pre-filled syringes of 1 ml solution for injection.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Teva Pharmaceuticals Ltd.
Ridings Point, Whistler Drive
Castleford, West Yorkshire
WF10 5HX
Tel:+44 (0)207 540 7117
Fax:+44 (0)207 540 7349
Teva Pharmaceuticals Europe B.V.
P.O. Box 43011
This medicinal product is authorised in the Member States of the EEA under the
name COPAXONE 20 mg/ml in:
Austria, Belgium, Czech Republic, Cyprus, Denmark, Estonia, Finland, Germany,
Greece, Hungary, Ireland, Island, Italy, Latvia, Lithuania, Luxembourg, Malta, Norway,
Poland, Portugal, Spain, Sweden, Slovakia, Slovenia, The Netherlands, United
This leaflet was last revised in 04/2013.


individual doses. Use the next dose 24 hours later.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.