REVIEW YOUR MS RELAPSE TREATMENT OPTIONS WITH YOUR DOCTOR TODAY

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1 DISCUSSION GUIDE DISCUSSION GUIDE REVIEW YOUR MS RELAPSE TREATMENT OPTIONS WITH YOUR DOCTOR TODAY Please see the Important Safety Information on pages 4 6 and the accompanying full Prescribing Information.

2 When considering options for the treatment of your MS relapses, it s important to take note of where you are in your MS experience and what you may be looking for in an alternative treatment. Your notes can help you get ready for your next visit so you and your healthcare provider can work together to find the best treatment for your needs. TAKE A MOMENT TO ANSWER THESE QUESTIONS: Did you know that there are MS relapse treatment options? Yes No Are you interested in treating your next MS relapse? Yes No Are you interested in an MS relapse treatment option that is self-injected, allowing you flexibility to inject at home or wherever is best for you? Yes No If you answered Yes to any of the questions above, complete this Acthar discussion guide and bring it to your next visit with your healthcare provider. Together, you can review your current MS relapse treatment and decide if Acthar might be right for you. Please see the Important Safety Information on pages 4 6 and the accompanying full Prescribing Information. 2

3 Patient name: Date of visit: SUGGESTED TOPICS FOR YOU AND YOUR HEALTHCARE PROVIDER TO DISCUSS: 1 Let s review my MS relapse symptoms in my Symptom Journal. 2 Let s discuss my MS relapse treatment options. 3 Let s talk about Acthar as a treatment option for my next MS relapse. Acthar is what I would like for my next MS relapse. Instructions for healthcare provider: Please keep this Acthar guide in your patient s file as a reminder of your discussion about the treatment of his/her MS relapses. Using electronic records? Add a note to the patient s file: Patient requested more information about Acthar for his/her next MS relapse. Visit ActharMSrelapse.com/info_kit to learn more about Acthar. 3

4 WHAT IS ACTHAR? H.P. Acthar Gel (repository corticotropin injection) is a prescription medication used for the treatment of acute exacerbations of multiple sclerosis in adults. Controlled clinical trials have shown Acthar to be effective in speeding the resolution of acute relapses of multiple sclerosis. However, there is no evidence that it affects the ultimate outcome or natural history of the disease. IMPORTANT SAFETY INFORMATION You should not take Acthar if you have: A skin condition called scleroderma Bone density loss Any infections Eye problems, such as ocular herpes simplex Had recent surgery Stomach ulcers or a history of ulcers Heart problems igh blood pressure H Allergies to pig-derived proteins Been recently given a vaccine or are about to take one A condition where your adrenal glands produce either too much of certain hormones (as with Cushing s syndrome), or not enough (adrenal insufficiency) Never inject Acthar directly into a vein, and always take Acthar as prescribed by your doctor. Never stop treatment suddenly unless your doctor tells you to. Try not to miss any scheduled doctor s appointments, as it is important for the doctor to monitor you while taking Acthar. 4

5 Acthar can cause side effects similar to those with steroid treatments. Tell your doctor if you have any of the symptoms listed here. Increased risk of infections. You may be more likely to get new infections. Also, old infections may become active. Signs of infection are fever, cough, vomiting, or diarrhea. Other signs may be flu or any open cuts or sores Adrenal gland changes. Taking Acthar long term may cause symptoms of Cushing s syndrome, such as upper body fat, rounded moon face, bruising easily, or muscle weakness Increased blood pressure, body salt, and fluid. Your doctor may recommend changes to your diet Unpredictable response to vaccines. Talk to your doctor about which vaccines are safe to use when taking Acthar Masking other conditions. Tell your doctor if you have any infections, changes in weight, excessive tiredness, increased thirst, fast heart rate, or difficulty breathing Stomach or intestinal problems. Acthar may put you at increased risk for bleeding from the stomach or getting stomach ulcers. Tell your doctor if you have any pain in the stomach area, vomiting, or bloody or black stools Changes in mood or behavior. You may be irritable, have mood swings, be depressed, or have trouble sleeping Worsening of other medical conditions, including diabetes Eye problems, such as cataracts, glaucoma, or optic nerve damage 5

6 IMPORTANT SAFETY INFORMATION (CONTINUED) Allergic reactions. Tell your doctor if you have a skin rash, swelling, or trouble breathing Bone density loss. Acthar may cause osteoporosis at any age Potential harm to unborn baby. Tell your doctor if you are pregnant or plan on becoming pregnant The most common side effects are similar to those of steroids. They include: Fluid retention Behavior and mood changes Changes in blood sugar Changes in appetite and weight Increased blood pressure Specific side effects in children under 2 years of age include: Increased risk of infections Symptoms of Cushing s syndrome Increased blood pressure Cardiac hypertrophy (thickening of the heart muscle) Irritability Weight gain The above side effects may also be seen in adults and children over 2 years of age. These are not all of the possible side effects of Acthar. Tell your doctor about any side effect that bothers you, or that does not go away. You may report side effects to the FDA. Call FDA-1088 or visit You may also report side effects by calling Please see accompanying full Prescribing Information. 6

7 NOTES 7

8 Having candid discussions with my neurologist has truly made us partners in my treatment. Maby, Temecula, CA Visit ActharMSrelapse.com/info_kit to learn more about Acthar Mallinckrodt, the M brand mark and the Mallinckrodt Pharmaceuticals logo are trademarks of a Mallinckrodt company. Other brands are trademarks of a Mallinckrodt company or their respective owners Mallinckrodt. PM (1)c 08/15 Printed in USA. DISCUSSION GUIDE Paul (front cover), Christine, Maby, and Katrina (at right) Acthar Ambassadors

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