MND Australia
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Medication for MND

People living with motor neurone disease (MND) are often faced with a decision about whether to try a particular medication. You should discuss any proposed medication or therapy with your healthcare team.

Medications for MND may assist in the following ways:

  • by slowing down progression of MND (Riluzole and Radicava)
  • managing symptoms associated with the disease (e.g. pain, drooling). 

What is Riluzole?

Riluzole (also known as Rilutek) can slow progression of amyotrophic lateral sclerosis (ALS) and progressive bulbar palsy (PBP), the most common types of MND. Recent research suggests that taking Riluzole may prolong survival by 6 to 19 months. It is best to start taking Riluzole soon after diagnosis to receive the greatest benefit. 

How does Riluzole work? 

Riluzole blocks the release of a neurotransmitter called glutamate. Glutamate stimulates and excites motor neuron cells, causing them to fire and send their signals. In ALS, it is thought that the motor neurons release too much glutamate. When too much glutamate is released by the neuron sending a signal, it can overstimulate the neuron (called excitotoxicity). It is thought this causes the motor neurone to deteriorate, and eventually die.

How do I get Riluzole? 

In Australia, Riluzole is available through the Pharmaceutical Benefits Scheme (PBS). This means the medication is subsidised for eligible people, making it more affordable. To access Riluzole, you need a special kind of prescription, called an “authority script”, which means the doctor must apply for permission from the government.

Your first authority script for Riluzole must be written by the neurologist who diagnosed you with ALS or PBP. Once the initial prescription has been approved, your GP can issue repeat prescriptions.

What are the side effects of Riluzole?

Most side effects from Riluzole are relatively minor. The most common side effects are fatigue and nausea.

Riluzole can affect liver function. If you have pre-existing problems with your liver, your doctor can advise whether Riluzole is right for you.

LEARN MORE ABOUT RILUZOLE

What is Edaravone?

Edaravone is the active ingredient in a treatment sold under the product name RADICAVA®. It was developed in Japan and originally used to treat stroke patients. In 2015 Edaravone was tested for use in people with ALS. Results suggested it slowed the progression in a small group of people with ALS, with the potential to help these people preserve function longer.  

How does Edaravone work?

Edaravone is thought to have antioxidant properties. These properties protect nerve cells by mopping up damaging “free radicals” in the body. Research suggests Edaravone has most benefit when used early. It is given as an intravenous infusion by a doctor.

How do I get Edaravone?

Edaravone (RADICAVA®) is not yet readily available in Australia.

The Australian Therapeutic Goods Authority (TGA) has approved (edaravone) for the treatment of ALS in Australia. However, RADICAVA® (Edaravone) is not yet available for people to buy through the Pharmaceutical Benefits Scheme (PBS). It is expected to become available in 2025.

Edaravone has been approved for treatment of MND in countries including Japan, Canada and the USA. It is not yet readily available in Australia.

What are the side effects of Edaravone?

Common side effects of Edaravone are bruising, problems with walking and headache. Fatigue has also been reported as a side effect.

In Australia, tofersen is only available to people living with MND who carry mutations in the SOD1 gene. Biogen, the pharmaceutical company that developed the drug, has made it available through their compassionate access program.

Tofersen reduces activity of the SOD1 gene and decreases levels of the protein. It is the first gene-related therapy to be approved for treatment of MND.

To learn more talk to your neurologist.

People living with MND may also use medications to manage symptoms associated with the disease. This might include medications to relieve symptoms such as:

  • drooling
  • cramping
  • pain
  • shortness of breath
  • constipation
  • anxiety
  • depressed mood.

Be honest and open about your symptoms when you talk to your healthcare team. This way, they can help you explore medications that can help keep you more comfortable. 

Scientists around the world continue to do research to learn about MND. Part of this research is to develop medications that may slow, and one day cure, the disease. The research could help find new drugs that make a positive difference to people living with MND.

Generally, clinical trials are a high-quality form of research. The trials follow strict scientific processes. Clinical trials try to find out if the proposed medication works, and is safe.

Figuring out if a medication can safely treat MND is important because it:

  • reduces the risk of side effects, illnesses and other more serious health problems from taking a new kind of medication
  • helps find the right dosage and best way to take a medication
  • finds out if a medication works for broad range of people
  • makes sure research focuses on drug treatments that are more likely to benefit people living with MND.

Finding effective drug treatments for MND takes a lot of time and resources. Advances in research, like platform trials, seek to address this challenge.

New research offers hope. With more flexible approaches to research, the process is quicker. Researchers can now test multiple drug treatments at once, which saves time.

Find out more about research in Australia and around the world

Learn more about clinical trials

People living with MND and their families understandably want to know about treatments that claim to treat or cure MND. Often, people come across these treatments while searching for information about MND on the internet.

Sometimes it can be hard to tell the difference between good quality health information and paid advertising. A good place to learn about alternative treatments is to visit the ALS Untangled website, which helps people find better quality health information online.

ALSUntangled scientifically reviews alternative treatments and posts the outcomes on their website. This information supports people living with MND to make informed decisions about these therapies.

Learn more about ALS Untangled

Check with your doctor or pharmacist before taking any new medication, even over-the-counter remedies. Checking helps make sure any remedy or medication is safe to take with your current medication.

To learn more about off label unproven treatments and right to try, read the International Alliance of ALS/MND Associations Scientific Advisory Council (SAC) briefing notes

You may also like to read this blog post about finding reliable information.


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Treatment for MND