MS LifeLines is always here if you have any questions or concerns about taking Rebif.

MS LifeLines® is always here if you have any questions or concerns about taking Rebif.”

Randall T Schapiro, MD, FAAN President, The Schapiro MS Advisory Group

Before you choose a treatment for relapsing multiple sclerosis, you should be aware of possible side effects. Injection-site reactions and flu-like symptoms (headache, fever, chills, sweating, muscle aches, and tiredness) are 2 of the most common side effects with Rebif, but there are others.

If you are experiencing injection-site reactions and flu-like symptoms, there may be things you can do to help. Read on for some tips. You can also get guidance for managing common symptoms and certain side effects, should they occur, by speaking to an MS LifeLines Nurse at 1-877-447-3243.

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Injection-site reactions

Rebif may cause redness, pain, or swelling at the place where an injection was given. Some patients have developed skin infections or areas of severe skin damage (necrosis), requiring treatment by a doctor. If one of your injection sites becomes swollen and painful or the area looks infected and it doesn't heal within a few days, you should call your doctor. Here are a few tips that may help you with injection-site discomfort*:

  • Bring the syringe to room temperature. Removing the syringe from your refrigerator 1 to 4 hours before injecting may help to reduce irritation. Keep in mind that Rebif syringes should never be warmed in the microwave or placed in boiling water.
  • Clean your injection site beforehand with alcohol swabs. Allow the area to dry before injecting to reduce irritation.
  • Rotate your injection sites! Be sure to rotate your site each time, and don't reuse the same injection spot for at least 7 days. Your treatment journal can help you to keep track of your injections.
  • Applying a cold compress or ice pack to the injection site after injection may help reduce local skin reactions.
  • Monitor your injection site over several days for redness, swelling, or tenderness. If the site worsens over time, contact your doctor.

* These tips have been recommended by some healthcare providers. If you have questions or concerns, call your doctor.

Download your own Treatment Journal

There’s another way to inject Rebif called Rebif® Rebidose®. Hear what many ambassadors like about it and find out why Angela feels that she’s now “calling the shots.”

Watch “Another Way to Inject”

Flu-like symptoms

Flu-like symptoms are a common side effect of Rebif, and for those who get them, these symptoms include headache, fatigue, muscle pain, fever, and chills. It's important to note that flu-like symptoms associated with Rebif are not caused by a viral infection and do not include diarrhea and vomiting. For many people taking Rebif, flu-like symptoms may lessen or go away over time.

If you have questions or your symptoms are concerning, talk to your healthcare provider. Here are some steps you can take that may help you manage flu-like symptoms:

  • Talk to your doctor about whether you should take an over-the-counter medication for pain or fever reduction before or after taking your dose of Rebif.
    • -Taking one of these medications just before an injection may help to reduce flu-like symptoms.
  • Find a time of day that works for you.
    • -Some people inject Rebif before bed, so they can sleep through some of their flu-like symptoms.
    • -Others find that injecting earlier in the day works best for them.
    • -Maintain a consistent injection schedule (3 times a week, at least 48 hours apart) as prescribed by your doctor.

Please see Important Safety Information below and the Rebif Medication Guide and Prescribing Information at the top of this page. Speak with your doctor for more information or about any side effects you may have.

Managing flu-like symptoms

Neurologist Randall T Schapiro, M.D., FAAN, President, The Schapiro MS Advisory Group, discusses ways to help manage one of the common side effects that can occur with treatment for relapsing multiple sclerosis: flu-like symptoms.

Watch “Managing Flu-like Symptoms”

Other possible Rebif side effects

  • Mental healthSome patients taking interferons have become very depressed and/or anxious. There have been patients taking interferons who have had thoughts about killing themselves. Depression is not uncommon in people with multiple sclerosis. However, if you are feeling noticeably sadder or hopeless, or feel like hurting yourself or others, you should tell a family member or friend right away and call your doctor as soon as possible.
  • Liver problemsYour liver may be affected by taking Rebif and a few people have developed severe liver injury, including liver failure. Your healthcare provider may ask you to have regular blood tests to make sure that your liver is working properly. If you develop symptoms of changes in your liver, including yellowing of the skin and whites of the eyes and easy bruising, you should call your doctor right away.
  • Blood problemsYou may have a drop in the levels of infection-fighting blood cells, red blood cells, or cells that help to form blood clots. If the drop in levels is severe, it can lessen your ability to fight infections, make you feel tired or sluggish, or cause you to bruise or bleed easily.
  • Thyroid problemsYour thyroid function may change. Symptoms of changes in the function of your thyroid include feeling cold or hot all the time, or a change in your weight (gain or loss) without a change in your diet or amount of exercise.
  • Serious allergic and skin reactionsSome people have had hives, rash, skin bumps, or itching while they were taking Rebif. Other people have had more serious allergic reactions, such as difficulty breathing or feeling light-headed. Allergic reactions can happen after your first dose or may not happen until after you have taken Rebif many times. Less severe allergic reactions, such as itching, flushing, or skin bumps, can also happen at any time. You should tell your healthcare provider if you think you are having an allergic reaction.
  • SeizuresSome people have had seizures while taking Rebif.
  • TMACases of thrombotic microangiopathy (TMA) have been reported with Rebif. TMA is a rare but serious medical condition that involves clotting in microscopic blood vessels inside many of the body’s major organs. TMA commonly affects the kidneys and the brain. Cumulative damage from this pathological process can close blood vessels, leading to serious damage to vital organs. TMA may be preceded by other disorders: Thrombotic Thrombocytopenic Purpura (TTP) is a disorder where platelets in the blood adhere to each other too easily, forming clots. Hemolytic Uremic Syndrome (HUS) is a disorder characterized by damaged red blood cells in the kidney, triggering platelets to clot there, which can lead to TMA.

For more information about drug safety and adverse event reporting, visit the Food and Drug Administration website.

Important Safety Information and Indication

Important Safety Information


Before beginning treatment, you should discuss the potential benefits and risks associated with Rebif with your healthcare provider.

Rebif can cause serious side effects. Tell your healthcare provider right away if you have any of the symptoms listed below while taking Rebif.

  • Behavioral health problems, including depression and suicidal thoughts. You may have mood problems including depression (feeling hopeless or feeling bad about yourself), and thoughts of hurting yourself or suicide
  • Liver problems or worsening of liver problems, including liver failure. Symptoms may include nausea, loss of appetite, tiredness, dark colored urine and pale stools, yellowing of your skin or the white part of your eye, bleeding more easily than normal, confusion, and sleepiness. During your treatment with Rebif you will need to see your healthcare provider regularly and have regular blood tests to check for side effects
  • Serious allergic and skin reactions. Symptoms may include itching, swelling of your face, eyes, lips, tongue or throat, trouble breathing, anxiousness, feeling faint, skin rash, hives, sores in your mouth, or skin blisters and peels
  • Injection site problems. Symptoms at the injection site may include redness, pain, swelling, color changes (blue or black), and drainage of fluid
  • Blood problems. Rebif can affect your bone marrow and cause low red and white blood cell and platelet counts. In some people, these blood cell counts may fall to dangerously low levels. If your blood cell counts become very low, you can get infections and problems with bleeding and bruising. Your healthcare provider may ask you to have regular blood tests to check for blood problems
  • Seizures. Some people have had seizures while taking Rebif

Rebif will not cure your MS but may decrease the number of flare-ups of the disease and slow the occurrence of some of the physical disability that is common in people with MS.

Do not take Rebif if you are allergic to interferon beta, human albumin, or any of the ingredients in Rebif.

Before you take Rebif, tell your healthcare provider if you have or have had any of the following conditions:

  • mental illness, including depression and suicidal behavior
  • liver problems, bleeding problems or blood clots, low blood cell counts, seizures (epilepsy), or thyroid problems
  • you drink alcohol
  • you are pregnant or plan to become pregnant. It is not known if Rebif will harm your unborn baby. Tell your healthcare provider if you become pregnant during your treatment with Rebif
  • you are breastfeeding or plan to breastfeed. It is not known if Rebif passes into your breast milk. You and your healthcare provider should decide if you will use Rebif or breastfeed. You should not do both

Tell your healthcare provider about all medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.

The most common side effects of Rebif include:

  • flu-like symptoms. You may have flu-like symptoms when you first start taking Rebif. You may be able to manage these flu-like symptoms by taking over-the-counter pain and fever reducers. For many people, these symptoms lessen or go away over time. Symptoms may include muscle aches, fever, tiredness, and chills
  • stomach pain
  • change in liver blood tests

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Rebif. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects.

Refer to the Instructions for Use that comes with Rebif® Rebidose® (interferon beta-1a) autoinjector.


Rebif® (interferon beta-1a) is used to treat relapsing forms of MS to decrease the frequency of relapses and delay the occurrence of some of the physical disability that is common in people with MS.