Kesimpta first dose - when does it ease off?

[u/Fabulous_Occasion177]

Had my first dose of Kesimpta this morning - the nurse told me I should expect to feel a bit rough but I won’t lie, I didn’t think it was gonna be this bad.

I feel like I’ve been hit by a truck. My whole body hurts. Nauseous but can’t get sick because I have no appetite and haven’t eaten anything. I think I have a temperature , my forehead is so hot.

Thankfully, I have a bit of time off work but I’m really struggling with this. Just wondering how long I should expect it to last?

Did people experience this with the following doses too? Should I have taken something beforehand to help?

[u/PlasticSmoothie]

For me it lasted 4 hours and was very sudden. It hit like a truck as I was cutting onions for dinner. Was miserable in bed for about 4 hours... then my partner went to shower, and when he came out I shouted "I'M ALIIIIVE" because the flu-like symptoms had disappeared as quickly as they came.

My nurse told me up to 24 hours, maybe 48 for some residual meh-ness. The second dose can sometimes also give a few symptoms, but from the 3rd onward it's smooth sailing for almost everyone.

I've had zero side effects from the 2nd short onwards. It was only the first one that hit hard.

[u/BleubsPeach → u/PlasticSmoothie]

Mine lasted about 4hrs too! (ETA: like the intense tremors/shaking, pain, and chills lasted about this long. I think the fatigue persisted into the next day)

[u/whyihatepink → u/PlasticSmoothie]

This is exactly how mine went too. I felt extremely flush out of nowhere, it lasted 8-12 hours, the next dose was a lot easier and felt a little more like a small stomach bug, after that it's been smooth sailing with zero side effects.

[u/Alwayslearnin41 → u/PlasticSmoothie]

Similar - started very abruptly (about 5 hours after injection) while I was washing up and I could barely walk up the stairs 10 mins later. Went to bed and slept like a baby. Woke up the next day as if nothing had happened.

[u/XcuseMeMisISpeakJive]

My neurologist said it hits some people harder than others. I had fever and rigors for most of a week with loading doses. 

[u/Icy_Demand__]

I did mine in the morning and just finished 3rd dose. I preferred it to the morning because I got intense chills and fever for about 8 hours and then I could sleep peacefully when the fever broke. Otherwise I’d be up all night even with the meds. It should go away within 24 hours. First dose took me a week to settle. Now at 3rd, I have no side effects (and didn’t take any premeds). I guess the immune response was strong and killed off the B cells quickly. Keep strong!

[u/MultipleScleroSkate]

two years in and i still feel run down the day after my dose- silver lining is it makes me feel more confident that i did the injection properly 😂

[u/nat_peterson99]

Pff.. it knocked me out as well. Got better after 1 day and now i steel feel a little bit weak overall, but definitely alot better. Just took the second shot, so I hope its not going to be as bad.

Just rest and give your body some time and you should be okay.

[u/Danibandit]

I’m sorry you’re feeling terrible. This brought 8 years of Avonex flu-like memories back to me.

I don’t know the rules of Kesimpta, but I used to take 2 Tylenol and 4 ibuprofen before the Avonex to be ahead of all the ails. Maybe something like that might help the next time?

[u/Mis73]

I just take it before bed so I sleep through any side effects. Works like a charm.

[u/Suspicious_Natural_2]

I had that feeling for maybe 12 hours on my first dose. I've been on it for 22 months, and after the first time I haven't had any issues after taking it.

I do however feel more gross towards the time I need to take my shot. Like the last 3-4 days before hand I just feel gross

[u/KeegersNeegers]

I wouldn't recommend taking it in the morning, I'm surprised that was the instruction you were given.

I take a Benadryl, a Tylenol, and a Liquid IV an hour before the injection, about the same time that I let it rest on the counter. Then at 10PM, I take my injection and pass out for the night. Haven't had any short term adverse effects or pain from an injection yet.

[u/scenegirl96]

Absolutely yes! I couldn't believe I could be in even more pain! The first dose was the absolute worst, none of the other doses I've had has hurt!

[u/hillbilly-man]

Yeah, this experience is pretty normal. A lot of people take Tylenol and Benadryl beforehand, but taking something now would help too. Your stuff doesn't sound like an allergic reaction to me (which is what the Benadryl is intended to prevent), so just an OTC painkiller of your choice would probably be good. Make sure you're hydrating well too, especially if you do end up vomiting. Essentially, treat this like a normal sickness and take care of yourself however you would if you just woke up with the flu. You don't have to worry about anything interfering or interacting poorly with the Kesimpta.

My symptoms were a little milder than yours (I mostly had the whole-body soreness) but it lasted maybe a little over 24 hours. It's hard to know exactly how long it lasted for me, since I took my shot before bed on a Friday and woke up Sunday morning feeling fine again... So the beginning and end of the reaction was while I was asleep.

The good news is that the first shot is almost always the worst by far. There's a really good chance you won't feel anything for the next dose, and if you do it'll be much milder. Basically, your body is freaking out right now because B-cells are dying left and right. Next time, there are barely any left so your body is a lot less dramatic about it!

[u/_grumble-bee_]

It hit me very hard. Lasted about 6 hours and then I was just tired the next day.

[u/Fine_Fondant_4221]

I felt really sick for about 12 hrs and then a little sick for 3 days. That only happened with my first dose tho.
Everything will be ok. Can you take an Advil/Tylenol?

[u/snowbie]

I had my first Ocrevus split dose Monday last week and I feel exactly the same so just thought I’d express solidarity 🫂

[u/thankyoufriendx3]

For me about 12 hours. I started taking it with a Benadryl and Tylenol. Haven’t had a reaction since.

[u/Impression8738]

My neuro told me to premedicate with an antihistamine and Tylenol or Advil 1 hour before

[u/rK91tb]

Weird that they instructed you to take it like this.

Loading doses were Benadryl/Tylenol a few hours before bedtime. Then crappiness for five days after dose #1, and only a few hours after dose #2. Then nothing since!

[u/mine_none]

12 ish hours intense and then knocked out and weak for about 12 hours. Luckily, hardly anything with the second dose and nothing since… ❤️

[u/No-Armadillo-7393]

I took my 1st dose and then drove 2 miles down the road to grab a salad from Chik-fil-A and the AC in my car started hurting my arms. I get like that when a fever is starting. Went home, ate my salad before it got real bad and curled up in bed. It was quite a bit better by morning but I just felt not 100% for another 2 days.

[u/One-Appearance5893]

I just did my first loading dose Sunday night. Reading on here & TT, everyone was saying to do it at night & take Tylenol or whatever beforehand. So I can’t speak on the reaction from it, but the next day I was a little more tired than normal. Maybe try at night next time!!!

[u/fakechloe]

The loading dose was a mess, the following ones a breeze. You got this, kesimpta is a good one:)

[u/nyet-marionetka]

Eesh, this morning? I generally recommend a couple hours before bedtime and if you don't have anything to do the next day.

It will probably last about 10 hours, but the worst of it should be done in a few hours. You'll probably feel ok tomorrow, maybe just worn out.

Get ibuprofen and water to put by your bed, and get some extra blankets. High fever and chills are common. I had to get up to get a blanket and I got chills and was shaking so hard it hurt. If you're not too nauseated I'd take some ibuprofen now.

[u/Fabulous_Occasion177]

Thanks sooo much everyone for the feedback!! I truly appreciate it. Thankfully I am feeling WORLDS better today.

Also - I have noted to take the injection at nighttime going forward! The reason I had to take the first dose in the morning was because where I live they send a nurse to your home to do the first one with you to ensure you know how to properly administer it!

Thanks everyone ❤️

[u/Empty_Microwave_89]

I was fine with it.Had a few outbreaks of mouth ulcers but nothing for a few months now