How Is ALS Treated? — Page 2

Amyotrophic lateral sclerosis treatments

Treatment for ALS involves a combination of medications and therapy.

Drugs that treat ALS

Medicines approved by the Food and Drug Administration to treat ALS include:

• Riluzole (Rilutek, Tiglutik, Exservan) was the first drug approved for ALS. It can slow the progress of the disease and delay the need for a breathing tube. Rilutek comes in a tablet that you take twice a day. Side effects include dizziness, fatigue, upset stomach, fatigue, muscle aches, and appetite loss.
• Edaravone (Radicava) slows nerve damage, reducing the speed of physical decline from the disease. You take Radicava as an infusion 10 to 14 days in a row, once a month. The most common side effects are bruising and changes in gait (walk).
• A combination of sodium phenylbutyrate and taurursodiol, Relyvrio blocks stress signals to nerve cells to prevent cell death.
• The drug Nuedexta (dextromethorphan HBr and quinidine sulfate) can treat pseudobulbar affect (or PBA), which involves frequent, involuntary episodes of crying or laughing.

Medicines to control ALS symptoms

A few other drugs help relieve amyotrophic lateral sclerosis symptoms (your doctor will work with you to find the right combination that works for you):

• Rigid muscles — baclofen (Lioresal), tizanidine (Zanaflex)
• Pain — NSAIDs, gabapentin, tramadol (Ultram), ketorolac (Toradol), morphine, fentanyl patch
• Drooling — amitriptyline, botulinum toxin type B (Myobloc)
• Thick mucus — guaifenesin (Mucinex, Robitussin)
• Depression — citalopram (Celexa) and other selective serotonin reuptake inhibitors (SSRIs)
• Incontinence — tolderodine (Detrol)

If you’re having trouble breathing, your doctor can surgically insert a tube in the front of your neck. A respirator will be attached to the tube to help you breathe. This is called mechanical ventilation.

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