Ocrevus is a brand-name prescription medication that’s FDA-approved to treat certain types of multiple sclerosis (MS) in adults.

With MS, your immune system mistakenly attacks the nerves in your brain and spinal cord. MS can cause symptoms such as muscle weakness, inflammation (swelling), numbness, tingling, and trouble walking.

Ocrevus is FDA-approved to treat the following conditions in adults:

  • Clinically isolated syndrome (CIS). CIS happens when someone who hasn’t been diagnosed with MS experiences MS-like symptoms. This is a one-time episode that lasts at least 24 hours. People with CIS don’t necessarily have MS, but it’s often the first sign of MS.
  • Relapsing-remitting MS. With this type of MS, your disease typically relapses (gets worse) and then goes into remission (a period when you have no symptoms).
  • Active secondary progressive MS. With this condition, you may have started with relapsing-remitting MS, but now your MS symptoms get gradually worse all the time.
  • Primary progressive MS (PPMS). With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to get worse since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.

Ocrevus is given as an infusion (an injection into your vein that’s slowly dripped in over time). It’s always given by a healthcare professional.

Ocrevus belongs to a class of drugs called monoclonal antibodies. (A drug class is a group of medications that work in a similar way.) Ocrevus works by decreasing the number of certain cells in your immune system called B cells. These B cells make your MS symptoms worse.

FDA approval

The Food and Drug Administration (FDA) approved Ocrevus in March 2017.

Effectiveness

To learn about the effectiveness of Ocrevus, see the “Ocrevus for MS” section.

Ocrevus is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Ocrevus contains the active drug ocrelizumab.

Ocrevus can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Ocrevus. These lists do not include all possible side effects.

For more information on the possible side effects of Ocrevus, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they’ve approved. If you would like to report to the FDA a side effect you’ve had with Ocrevus, you can do so through MedWatch.

Mild side effects

The most common* mild side effects for people taking Ocrevus can include:

  • upper or lower respiratory infection, such as a cold or pneumonia
  • herpes infections such as shingles or cold sores
  • depression (in people with relapsing-remitting MS)
  • pain in your back, arms, or legs (in people with relapsing-remitting MS)
  • skin infections –– in people with primary progressive MS (PPMS)
  • cough (in people with PPMS)
  • diarrhea (in people with PPMS)
  • swelling of your arms or legs (in people with PPMS)

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* To learn about less common mild side effects, visit the drug’s Medication Guide or talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ocrevus aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Cancer, such as breast cancer. Symptoms of breast cancer can include:
    • a lump in your breast
    • pain in the breast or nipple
    • discharge from the nipple

Other serious side effects are explained below in “Side effect details.” These include:

Side effect details

You may wonder how often certain side effects occur with this drug or whether certain side effects pertain to it. Here’s some detail on some of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Ocrevus. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

It’s not known how many people had allergic reactions from taking Ocrevus in clinical trials. Call your doctor right away if you have a severe allergic reaction to Ocrevus. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Fatigue

Some people may experience fatigue (lack of energy) while taking Ocrevus. In most cases, fatigue is an infusion side effect. For more information, see the “Infusion side effects” section below.

Infusion side effects

Certain side effects are possible after an Ocrevus infusion. These infusion side effects can happen up to 24 hours after getting a dose of Ocrevus.

Examples of infusion side effects include:

  • skin itching or redness
  • trouble breathing
  • mouth pain or swelling
  • fatigue
  • headache
  • increased heart rate

Your doctor or nurse will monitor you for at least 1 hour after your dose of Ocrevus. This is to make sure you don’t have any symptoms of serious side effects from the infusion. Infusion reactions are possible for up to 24 hours after you get your infusion.

If you notice any infusion side effects during or after getting your dose of Ocrevus, talk with your doctor right away. Sometimes these side effects may be serious and even life threatening.

If you do experience infusion reactions while getting your dose of Ocrevus, there are a few things your doctor may do:

  • They may stop or slow down your dose of Ocrevus. This can help relieve the side effects that you’re experiencing.
  • They may also give you medication before you get your dose of Ocrevus to help prevent side effects from the Ocrevus infusion. These medications include a corticosteroid such as methylprednisolone (Medrol), an antihistamine such as diphenhydramine (Benadryl), and acetaminophen (Tylenol). These medications can help prevent infusion side effects such as swelling or pain.

If you have any symptoms of infusion side effects, talk with your doctor as soon as you notice them. These side effects can become very severe and may require treatment right away.

Infusion side effects in clinical trials

In clinical trials, 34% to 40% of people taking Ocrevus experienced an infusion reaction. In comparison, 26% of people taking a placebo and 10% of those taking interferon beta-1a (Rebif) experienced an infusion reaction.

Of the people taking Ocrevus who had infusion side effects, 0.3% of the cases were considered severe. It wasn’t reported how many people taking either a placebo or Rebif had infusion side effects that were considered severe.

In clinical trials, it was more common for people to experience infusion side effects with their first dose of Ocrevus than with later doses.

Diarrhea

Some people may experience diarrhea while taking Ocrevus. In clinical trials, diarrhea was not reported as a common side effect in people taking Ocrevus for relapsing forms of MS.

However, in people taking Ocrevus for PPMS, about 6% experienced diarrhea. In comparison, 5% of people taking a placebo had diarrhea.

If you experience diarrhea that’s severe or bothersome to you, talk with your doctor about ways to relieve this side effect.

Back pain

Back pain can be a side effect of Ocrevus. In clinical trials, back pain was not a common side effect in people taking Ocrevus for PPMS. However, back pain was a common side effect in people taking Ocrevus for relapsing forms of MS (RMS).

Back pain occurred in 6% of people taking Ocrevus for RMS. In comparison, back pain occurred in 5% of people taking interferon beta-1a (Rebif).

If you experience back pain that gets worse or is bothersome, talk with your doctor. They may be able to recommend ways to relieve this side effect.

Weight gain and weight loss (not side effects)

Changes in weight were not seen in clinical trials of people taking Ocrevus. However, changes in weight may be symptoms of MS itself. You may gain weight if you’re having trouble moving around or exercising.

On the other hand, if you can’t move for a long time, you may lose weight. This could happen because you may lose muscles if you can’t use them.

Although Ocrevus shouldn’t cause changes in your weight, talk with your doctor if you experience weight changes during your treatment. Your doctor can help you determine what may be causing the changes and how to manage your weight.

PML (not a side effect)

Progressive multifocal leukoencephalopathy (PML) is a rare but serious brain infection. In clinical trials, PML did not occur in anyone taking Ocrevus.

PML can be very serious and may even cause death. Symptoms of PML can include changes in memory, confusion, weakness, problems using your arms and legs, vision changes, and changes in personality.

In rare cases, other medications used to treat MS, such as natalizumab (Tysarbi), may cause PML. However, this condition has not yet been reported in anyone taking Ocrevus.

If you have concerns about PML, talk with your doctor before starting Ocrevus.

Hair loss (not a side effect)

Hair loss is not a side effect of Ocrevus and was not seen during clinical trials. However, some other medications used to treat MS, such as methotrexate (Trexall) or azathioprine (Imuran), may cause hair loss. Stress can also contribute to hair loss.

If you experience hair loss while taking Ocrevus, talk with your doctor. They may be able to help determine the cause and how to further prevent it.

The Food and Drug Administration (FDA) approves prescription drugs such as Ocrevus to treat certain conditions.

Ocrevus is approved to treat certain types of multiple sclerosis (MS). With MS, your immune system mistakenly attacks the nerves in your brain and spinal cord. This makes it hard for your brain to communicate with the rest of your body.

MS can cause symptoms such as muscle weakness, inflammation (swelling), numbness, tingling, and trouble walking.

Ocrevus for relapsing forms of MS

Relapsing forms of MS happen when your disease relapses (gets worse) and then goes into remission (a period when you have no symptoms) for a time. This means that your symptoms, such as numbness or tingling, may go away and then come back again.

Ocrevus is approved to treat the following forms of relapsing MS:

  • Clinically isolated syndrome (CIS)*. CIS happens when someone who hasn’t been diagnosed with MS experiences MS-like symptoms. This is a one-time episode that lasts at least 24 hours. People with CIS don’t necessarily have MS, but it’s often the first sign of MS.
  • Relapsing-remitting MS. This occurs when you have relapses followed by periods of remission.
  • Active secondary progressive MS. With this condition, you may have started with relapsing-remitting MS, but now your MS symptoms get gradually worse all the time.

*CIS is not technically MS, but it’s sometimes grouped together with relapsing forms of MS.

Effectiveness for relapsing forms of MS

In a clinical trial, people who took Ocrevus were less likely to have their MS-related disabilities get worse compared with people who took interferon beta-1a.

To evaluate this, researchers used the Expanded Disability Status Scale (EDSS). This is a tool to monitor how disabling a person’s MS is. A higher EDSS score means a more severe disability.

In the clinical trial, 9.8% of people who took Ocrevus had a confirmed increase in their EDSS score after 12 weeks of taking the drug. In comparison, 15.2% of people who took interferon beta-1a had a confirmed increase in their EDSS score after 12 weeks.

In the trial, people with relapsing forms of MS (as well as CIS) who took Ocrevus were 46% less likely to have a relapse compared with people taking interferon beta-1a (Rebif).

Ocrevus for primary progressive MS (PPMS)

If you have primary progressive MS (PPMS), that means you’ve never had any periods of remission. People with PPMS have symptoms that have continued to get worse since their MS started. Ocrevus is currently the only medication that’s FDA-approved to treat PPMS.

Effectiveness for PPMS

In a clinical trial, people who took Ocrevus were less likely to have their MS-related disabilities get worse compared with people who took a placebo. (A placebo is a treatment containing no active drug.)

To evaluate this, researchers used the Expanded Disability Status Scale (EDSS). This is a tool to monitor how disabling a person’s MS is. A higher EDSS score means a more severe disability.

After 12 weeks, 32.9% of people who took Ocrevus had a confirmed increase in their EDSS score. In comparison, 39.3% of people who took a placebo had a confirmed increase in their EDSS score.

Based on this, researchers concluded that people taking Ocrevus were 24% less likely to have their MS get worse compared with people taking a placebo.

The Ocrevus dosage your doctor prescribes will depend on your past reaction to Ocrevus. If you’ve had infusion side effects in the past, your doctor may lower the rate of infusion, so you get the medication more slowly. This can help lower your risk for infusion side effects.

Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

Drug forms and strengths

Ocrevus comes as a solution that’s given as an infusion (an injection into your vein that’s slowly dripped in over time). It’s always given by a healthcare professional.

Ocrevus comes in one strength: 300 mg in 10 mL of solution.

Dosage for MS

Your first infusion of Ocrevus will be a 300-mg dose. The infusion will take about 2.5 hours or more.

Your second dose will also be 300 mg, which you’ll get 2 weeks later. This infusion will also be given over about 2.5 hours or more. After the first two doses, you’ll only need to get an infusion once every 6 months. These infusions will be 600 mg, given over 3.5 hours or more.

What if I miss a dose?

If you miss your appointment for an Ocrevus infusion, call your doctor as soon as possible to reschedule. They’ll adjust your dosing schedule as needed.

Talk with your doctor if you have questions about your dosing schedule. To help make sure you don’t miss an appointment, try setting a reminder on your phone.

Will I need to use this drug long term?

Ocrevus is meant to be used as a long-term treatment. If you and your doctor determine that Ocrevus is safe and effective for you, you’ll likely take it long term.

Here are answers to some frequently asked questions about Ocrevus.

Is Ocrevus chemotherapy?

No, Ocrevus is not chemotherapy. It belongs to a class of drugs called monoclonal antibodies.

Ocrevus works by decreasing the activity of your immune system and stopping it from attacking your body. Ocrevus targets specific cells called B cells. It decreases the number of B cells in your body, which can help relieve your MS symptoms.

Can Ocrevus cause cancer?

It’s possible, though unlikely, that you may develop cancer from taking Ocrevus.

In clinical trials, there was an increased risk of breast cancer in people taking Ocrevus.

Of the 781 women taking Ocrevus, 6 developed breast cancer. In comparison, none of the 668 women taking either a placebo (a treatment with no active drug) or interferon beta-1a (Rebif) developed breast cancer.

While taking Ocrevus, you should follow current breast cancer screening guidelines. This means some women (usually ages 45 years and older) should get a mammogram every year or every 2 years to check for breast cancer. (Mammograms are images that can show any tumors or growths in the breast tissue.)

Some women may begin mammogram screenings earlier than age 45, based on their family or personal history.

Although the risk of cancer as a side effect is very low, it’s important to follow breast cancer screening guidelines while taking Ocrevus.

You should also see your doctor right away if you notice any lumps or pain in your breast or any discharge from your nipple. Your doctor can do more tests to determine if there’s an issue.

Should I avoid getting certain vaccines during my Ocrevus treatment?

Yes, you should avoid certain vaccines while taking Ocrevus. You should not get any live vaccines during your Ocrevus treatment or at least 4 weeks before starting treatment. This is because live vaccines contain weakened forms of viruses or bacteria.

Live vaccines don’t cause infections in people with healthy immune systems.

However, because Ocrevus weakens your immune system, your body may not be able to fight live vaccines as well as it should. This can make you sick and may actually cause you to get the disease that the vaccine protects against.

Live vaccines you should avoid while taking Ocrevus include:

If possible, you should also avoid getting non-live vaccines while taking Ocrevus. Non-live vaccines don’t have any live viruses or bacteria in them. However, because Ocrevus may weaken your immune system, your body will not be able to build up immunity to these vaccines.

This means that although the vaccines won’t make you sick, they may not work as well as they should to protect you. If possible, you should get non-live vaccines at least 2 weeks before starting Ocrevus treatment.

Non-live vaccines include:

Talk with your doctor about any vaccines you may need before starting Ocrevus.

Will I need to have any other tests done before starting Ocrevus?

Yes, you’ll need to be tested for hepatitis B before you start taking Ocrevus. This is important because Ocrevus will weaken your immune system. Therefore, if you have hepatitis B, your body won’t be able to fight the infection. This can lead to serious liver problems.

In some cases, your doctor may also do an MRI scan of your brain. This is a way for your doctor to see an image of your brain. An MRI can show if the medication is working for your MS or if the damage (sometimes called lesions) is getting worse.

Talk with your doctor if you have any questions about testing that needs to be done before you start taking Ocrevus.

Ocrevus is FDA-approved to treat certain types of multiple sclerosis (MS) in adults.

What happens in MS

With MS, your immune system mistakenly attacks the covering of your brain and spinal cord, called the myelin sheath.

When your immune system attacks these areas, it can cause inflammation (swelling) in your brain and spinal cord. This disrupts communication between your brain and other areas of your body.

Symptoms of MS include muscle weakness, numbness, tingling, and trouble walking. You may also experience changes in vision, such as trouble seeing.

What Ocrevus does

Ocrevus works in your body by decreasing certain cells called B cells that make your MS symptoms worse. Ocrevus belongs to a class of drugs called monoclonal antibodies. (A drug class is a group of medications that work in a similar way.)

It’s believed that having too many B cells causes MS relapses (when the disease is active, and symptoms flare up). By reducing the number of these cells in your body, Ocrevus can help relieve your MS symptoms and make relapses occur less often.

How long does it take to work?

Ocrevus begins working after your first infusion. However, each person taking Ocrevus will react differently to the medication. Some people may see their MS symptoms reduced after only one dose. For others, it may take more time before they notice results.

Other drugs are available that can treat your multiple sclerosis (MS). Some may be a better fit for you than others. If you’re interested in finding an alternative to Ocrevus, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for relapsing forms of MS

Other drugs may be used to treat relapsing forms of MS, as well as CIS. (CIS is not technically MS, but it’s sometimes grouped together with relapsing forms of MS.)

Examples of these drugs include:

  • fingolimod (Gilenya)
  • dimethyl fumarate (Tecfidera)
  • teriflunomide (Aubagio)
  • alemtuzumab (Lemtrada)
  • natalizumab (Tysabri)
  • interferon beta-1a (Avonex)
  • interferon beta-1b (Betaseron)
  • glatiramer acetate (Copaxone)
  • peginterferon beta-1a (Plegridy)
  • siponimod (Mayzent)
  • cladribine (Mavenclad)

Alternatives for PPMS

Ocrevus is the only medication that’s FDA-approved to treat primary progressive MS (PPMS). However, other medications such as siponimod (Mayzent) or rituximab (Rituxan) may be used off-label to treat PPMS.

You may wonder how Ocrevus compares with other medications that are prescribed for similar uses. Here we look at how Ocrevus and Lemtrada are alike and different.

Ingredients

The active drug ingredient in Ocrevus is ocrelizumab. The active drug ingredient in Lemtrada is alemtuzumab.

Uses

Ocrevus is FDA-approved to treat the following conditions in adults:

  • Clinically isolated syndrome (CIS). CIS happens when someone who hasn’t been diagnosed with MS experiences MS-like symptoms. This is a one-time episode that lasts at least 24 hours. People with CIS don’t necessarily have MS, but it’s often the first sign of MS.
  • Relapsing-remitting MS. With this type of MS, your disease typically relapses (gets worse) and then goes into remission (a period when you have no symptoms).
  • Active secondary progressive MS. With this condition, you may have started with relapsing-remitting MS, but now your MS symptoms get gradually worse all the time.
  • Primary progressive MS (PPMS). With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to get worse since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.

Lemtrada is approved to treat relapsing-remitting MS and active secondary progressive MS in adults. It’s not approved to treat PPMS or CIS.

Drug forms and administration

Ocrevus and Lemtrada are both given as an infusion (an injection into your vein that’s slowly dripped in over time). They should only be given by a healthcare professional.

Side effects and risks

Ocrevus and Lemtrada have some similar side effects and other that differ. Below are examples of these side effects.

Mild side effects

These lists contain examples of up to 10 of the most common mild side effects that can occur with each drug or with both Ocrevus and Lemtrada (when taken individually).

  • Can occur with Ocrevus:
    • lower respiratory infection, such as pneumonia
  • Can occur with Lemtrada:
  • Can occur with both Ocrevus and Lemtrada:
    • upper respiratory tract infection, such as a cold
    • pain in your back, arms, or legs*

* In clinical trials of Ocrevus, this side effect was only reported by people with relapsing forms of MS or with CIS. It was not reported by people with PPMS.

Serious side effects

These lists contain examples of serious side effects that can occur with Lemtrada or with both drugs (when taken individually).

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Ocrevus and Lemtrada to be effective for treating MS.

Costs

Ocrevus and Lemtrada are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Ocrevus costs significantly less than Lemtrada. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the specialty pharmacy you use.

Like Lemtrada (above), the drug Rituxan has uses similar to those of Ocrevus. Here’s a comparison of how Ocrevus and Rituxan are alike and different.

Ingredients

The active drug ingredient in Ocrevus is ocrelizumab. The active drug ingredient in Rituxan is rituximab.

Uses

Ocrevus is FDA-approved to treat the following conditions in adults:

  • Clinically isolated syndrome (CIS). CIS happens when someone who hasn’t been diagnosed with MS experiences MS-like symptoms. This is a one-time episode that lasts at least 24 hours. People with CIS don’t necessarily have MS, but it’s often the first sign of MS.
  • Relapsing-remitting MS. With this type of MS, your disease typically relapses (gets worse) and then goes into remission (a period when you have no symptoms).
  • Active secondary progressive MS. With this condition, you may have started with relapsing-remitting MS, but now your MS symptoms get gradually worse all the time.
  • Primary progressive MS (PPMS). With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to get worse since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.

Rituxan is not FDA-approved to treat MS. However, it can be used off-label to treat MS. (Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.)

Rituxan is FDA approved to treat the following conditions:

Drug forms and administration

Ocrevus and Rituxan are both given as an infusion (an injection into your vein that’s slowly dripped in over time). They should only be given by a healthcare professional.

Side effects and risks

Ocrevus and Rituxan have some similar side effects and others that differ. Below are examples of these side effects.

Note: The Rituxan side effects listed below are from clinical trials for approved uses of the drug. These side effects were reported in people taking Rituxan for conditions other than MS. Therefore, side effects may differ slightly from what’s listed below.

Mild side effects

These lists contain examples of up to 10 of the most common mild side effects that can occur with each drug, or with both Ocrevus and Rituxan (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Ocrevus, with Rituxan, or with both drugs (when taken individually).

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Ocrevus and Rituxan to be effective for treating MS.

Costs

Ocrevus and Rituxan are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Ocrevus costs significantly more than Rituxan. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the specialty pharmacy you use.

There are no known interactions between Ocrevus and alcohol.

If you drink alcohol, talk with your doctor about how much is safe for you to drink during your Ocrevus treatment.

Ocrevus can interact with several other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Ocrevus and other medications

Below is a list of medications that can interact with Ocrevus. This list does not contain all drugs that may interact with Ocrevus.

Before taking Ocrevus, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Ocrevus and vaccines

You should avoid getting live and non-live vaccines while taking Ocrevus. There are also certain recommendations about how far in advance you should get live and non-live vaccines before starting treatment.

Live vaccines

You shouldn’t get any live vaccines while taking Ocrevus. This is because live vaccines contain weakened forms of viruses or bacteria in them.

Live vaccines don’t cause infections in people with healthy immune systems. However, because Ocrevus weakens your immune system, your body may not be able to fight live vaccines as well as it should. This can make you sick and may actually cause you to get the disease that the vaccine protects against.

Make sure to get any needed live vaccines at least 4 weeks before starting Ocrevus.

Live vaccines that you should not get while taking Ocrevus include:

Non-live vaccines

You should also try to avoid non-live vaccines while taking Ocrevus. Non-live vaccines don’t have any live viruses or bacteria in them. However, because Ocrevus can weaken your immune system, your body won’t be able to build up immunity to these vaccines.

This means that although the vaccines will not make you sick, they may not work as well as they should to protect you. You should get non-live vaccines at least 2 weeks before starting Ocrevus treatment, if possible.

Non-live vaccines include:

Before starting Ocrevus, talk to your doctor about any vaccines you may need.

Ocrevus and other drugs that weaken your immune system

While taking Ocrevus, you shouldn’t take other medications that may weaken your immune system.

This is because Ocrevus weakens your immune system. If you take it with another medication that also has this effect, your immune system may get too weak. This could make your body unable to fight infections.

Examples of drugs that can weaken your immune system include corticosteroids (when used in high doses). Prednisone and methylprednisolone (Medrol) are types of corticosteroids.

Other MS medications may also affect your immune system, so you should talk with your doctor if you’re switching from another MS medication to Ocrevus.

They may want you to wait to start Ocrevus. This is because some MS medications may last weeks or months in your body. Your doctor will be able to help you determine how long to wait between stopping your old MS medication and starting Ocrevus.

Examples of MS medications that have an effect on your immune system for a long period of time include:

Talk with your doctor about any other medications you’re taking before you start Ocrevus.

Ocrevus and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Ocrevus. However, you should still check with your doctor or pharmacist before using any of these products while taking Ocrevus.

Ocrevus and foods

There aren’t any foods that have been specifically reported to interact with Ocrevus. If you have any questions about eating certain foods with Ocrevus, talk with your doctor.

It’s not known if Ocrevus is safe to take during pregnancy. However, some reports show that babies born to women taking medications similar to Ocrevus had weakened immune systems at birth.

Pregnant animals taking Ocrevus had an increased risk of miscarriage or death of the offspring after birth. Animal offspring born to mothers taking Ocrevus also had a higher risk of problems with their kidneys, bone marrow, and in males, their testicles. Additionally, they had weakened immune systems. However, animal studies do not always predict what will happen in humans.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Ocrevus. They’ll likely recommend a different treatment for your MS.

It’s unknown if Ocrevus is safe to use during pregnancy. Because Ocrevus may be harmful to a developing fetus, it’s recommended that women who could get pregnant use birth control while taking Ocrevus and for 6 months after their last infusion of the drug.

You should continue using effective birth control for at least 6 months after your last infusion of Ocrevus. For information about your birth control options, talk with your doctor.

It’s not known if it’s safe to breastfeed while taking Ocrevus. There’s no data on whether Ocrevus passes into breast milk or if it may have an effect on children who are breastfed.

If you’re breastfeeding or plan to breastfeed while taking Ocrevus, talk with your doctor about the benefits and risks.

Your doctor may recommend that you take certain medications before you get each dose of Ocrevus. These medications can help lower your risk for having side effects from the infusion. (An infusion is an injection into your vein that’s slowly dripped in over time.)

You’ll usually be given a corticosteroid such as methylprednisolone (Medrol) about 30 minutes before your Ocrevus infusion. Like Ocrevus, this drug is given intravenously (into a vein).

You’ll also be given an antihistamine, such as diphenhydramine (Benadryl), about 30 to 60 minutes before your Ocrevus infusion. You may also take acetaminophen (Tylenol) or another fever-reducing drug before starting your infusion.

Talk with your doctor about which medications you’ll need to take before your Ocrevus infusions.

As with all medications, the cost of Ocrevus can vary. The actual price you’ll pay will depend on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Ocrevus at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before they approve coverage for Ocrevus. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Ocrevus.

If you’re not sure if you’ll need to get prior authorization for Ocrevus, contact your insurance plan.

Financial and insurance assistance

If you need financial support to pay for Ocrevus, or if you need help understanding your insurance coverage, help is available.

Genentech, the manufacturer of Ocrevus, offers a number of resources, including the Ocrevus Co-pay Program. For more information and to find out if you’re eligible for support, call 844-OCREVUS (844-627-3887) or visit the program website.

Ocrevus is given as an intravenous (IV) infusion. This means a needle goes into a vein in your arm and delivers the medication slowly over time. Getting the medication slowly lowers your risk for having a reaction to the drug.

Your first dose of Ocrevus will be given over the course of 2.5 hours or longer. Then, you’ll get a second dose of medication 2 weeks after your first dose. This infusion will also be given over 2.5 hours or longer.

After your first two doses of medication, you only need to get one dose every 6 months. These doses will be given over the course of 3.5 hours or longer.

Your doctor’s office will work with you to make sure the infusion appointments fit your schedule. To help make sure you don’t miss an appointment, try setting a reminder on your phone.

Before taking Ocrevus, talk with your doctor about your health history. Ocrevus may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Hepatitis B virus (HBV) infection. If you have a history of hepatitis B, talk with your doctor before starting Ocrevus. Your doctor will test you for HBV before you start taking Ocrevus. If you test positive, you should be treated for HBV before taking Ocrevus. Your doctor may monitor your liver and blood levels more frequently during your treatment if you have a history of HBV. Talk with your doctor about any medical conditions you have before starting Ocrevus.
  • Recent live vaccinations. You should not start Ocrevus until at least 4 weeks after receiving any live vaccines. Ocrevus may weaken your immune system, and live vaccines can cause you to become sick. For more information, see the “Interactions” section above.
  • Current infections. Tell your doctor about any current infections you have before starting Ocrevus. Ocrevus may weaken your immune system, which means your body won’t be able to fight infections as easily. In most cases, your doctor will treat you for any infections before you start taking Ocrevus.
  • Allergic reaction. You should not take Ocrevus if you’ve had an allergic reaction to this medication or any component of this medication in the past. Talk with your doctor about other options to treat your MS.
  • Pregnancy. It’s unknown if Ocrevus is safe to take during pregnancy. For more information, see the “Ocrevus and pregnancy” section above.
  • Breastfeeding. It’s not known if Ocrevus is safe to take while you’re breastfeeding. For more information, see the “Ocrevus and breastfeeding” section above.

Note: For more information about the potential negative effects of Ocrevus, see the “Ocrevus side effects” section above.

The following information is provided for clinicians and other healthcare professionals.

Indications

Ocrevus is FDA-approved to treat the following conditions in adults:

  • Clinically isolated syndrome (CIS). CIS happens when someone who hasn’t been diagnosed with MS experiences MS-like symptoms. This is a one-time episode that lasts at least 24 hours. People with CIS don’t necessarily have MS, but it’s often the first sign of MS.
  • Relapsing-remitting MS. With this type of MS, your disease typically relapses (gets worse) and then goes into remission (a period when you have no symptoms).
  • Active secondary progressive MS. With this condition, you may have started with relapsing-remitting MS, but now your MS symptoms get gradually worse all the time.
  • Primary progressive MS (PPMS). With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to get worse since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.

Mechanism of action

It’s not known exactly how Ocrevus works to treat MS. However, it’s believed to attach to CD20 on B lymphocytes, which are a major component of MS inflammation.

After the Ocrevus is bound, it causes cell death to B lymphocytes, leading to a decreased number of these immune cells. This causes decreased symptoms, which in turn reduces the number of relapses.

Pharmacokinetics and metabolism

Ocrevus has a volume of distribution of about 2.78 L. Its half-life is about 33 weeks. It’s not known exactly how Ocrevus is cleared. However, because it’s an antibody, it’s believed to be cleared in the same way as endogenous antibodies (via catabolism).

Contraindications

Ocrevus is contraindicated in people with a history of allergic reaction or life threatening infusion reactions to the drug. It’s also contraindicated in anyone with an active hepatitis B virus infection.

Storage

Ocrevus vials should be stored between 2° and 8°C (36° and 46°F). The vials should be kept in the outer carton to protect the drug from light until use. Do not shake or freeze Ocrevus vials.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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