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Ocrevus

ocrelizumab

Used for Multiple Sclerosis

Ocrevus (ocrelizumab) is a medication used to treat multiple sclerosis (MS). It's an infusion through the veins that's given by a healthcare provider at their office, at an infusion center, or at home (if your provider allows). You don't have to take Ocrevus (ocrelizumab) as often as some other MS medications.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Allison Gourley, PharmD

Last reviewed on June 10, 2022

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Contraindications Alternatives Latest news Prices Medicare

What is Ocrevus (ocrelizumab)?

What is Ocrevus (ocrelizumab) used for?

All types of multiple sclerosis (MS)

How Ocrevus (ocrelizumab) works

Ocrevus (ocrelizumab) is a monoclonal antibody. It's not exactly known how the medication works, but it's thought to work by attaching to certain proteins on the surface of immune cells to change how they function. This might help lower inflammation and symptoms of MS.

Drug Facts

Common BrandsOcrevus

Drug ClassMonoclonal antibody

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

What are the side effects of Ocrevus (ocrelizumab)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Upper respiratory tract infections (40-49%)
Infusion reactions (34-40%)
Skin infections (up to 14%)
Lower respiratory tract infections (8-10%)

Other Side Effects

Back pain
Pain in arms or legs
Swelling in arms or legs
Diarrhea
Herpes infection
Depression

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

Serious allergic reactions: hives, rash, itching, dizziness, fever, shaking, flushing, trouble breathing, chest pain

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Breast tissue changes, new lumps, redness, pain, or discharge from the nipple
Dizziness, loss of balance or coordination, confusion or trouble speaking
Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

Back pain
Diarrhea
Swelling of the ankles, hands, or feet
Worsening mood, feelings of depression

Pros and cons of Ocrevus (ocrelizumab)

Pros

Given twice per year (after a couple starter doses)

The only FDA-approved medication for primary progressive MS

Might be better tolerated than some other injectable MS medications

Manufacturer co-pay program available to help lower costs for eligible people

Cons

Needs to be given as an infusion injected through the vein

Cannot be used in children or adults older than 64 years old

Brand name only, which can be expensive

Raises your risk for infections

Pharmacist tips for Ocrevus (ocrelizumab)

Mark your appointments to see your provider and receive Ocrevus (ocrelizumab) on your calendar. This makes sure your providers can properly monitor you and also helps you remember to receive your treatments on time.

Bring a book, something else to do, or snacks with you to help pass the time while you receive Ocrevus (ocrelizumab), since the whole infusion process can take several hours. Please see the FAQs for more details about what to expect for your infusion.

If you miss your scheduled Ocrevus (ocrelizumab) infusion, contact your provider to get it as soon as possible. Then, your dosing schedule will be reset so you get your next dose 6 months after the date you receive your infusion.

If you feel itchy or develop a rash, flushing, trouble breathing, pain in your mouth and throat, fever, headache, dizziness, or fast heart rate up to 1 day after receiving your Ocrevus (ocrelizumab) infusion, get medical help right away. These can be early signs of an infusion reaction, and it could potentially progress to a more severe, life-threatening reaction.

Refer to the medication guide for more information on Ocrevus (ocrelizumab).

Frequently asked questions about Ocrevus (ocrelizumab)

What should I expect on the day I receive my Ocrevus (ocrelizumab) dose?

The whole process of getting your infusion can take up to 6 hours. When you get to your provider's office to receive your dose of Ocrevus (ocrelizumab), your provider will check your vital signs and do a physical exam to make sure you can receive the infusion. Then, your provider will give you some medications at least 30 minutes before your infusion that will help prevent infusion-related reactions from happening during treatment. Next, the Ocrevus (ocrelizumab) infusion usually takes about 2 to 4 hours to complete, depending on how you tolerate the medication. Afterwards, your provider will monitor you for any side effects or infusion-related reactions for at least 1 hour.

Can I receive vaccines if I'm taking Ocrevus (ocrelizumab)?

It's recommended that you get any live vaccines (e.g., Varivax (chickenpox vaccine)) at least 1 month before and non-live vaccines (e.g., flu shot) at least 2 weeks before starting Ocrevus (ocrelizumab). This is because it's not known if vaccines are safe with Ocrevus (ocrelizumab) or if Ocrevus (ocrelizumab) will affect how well the vaccines work for you. Additionally, babies born to mothers who received Ocrevus (ocrelizumab) during pregnancy shouldn't get live vaccines until they're seen by a provider to make sure it's safe for them. Let your provider or pharmacist know that you're taking Ocrevus (ocrelizumab) before you receive any vaccines.

Can Ocrevus (ocrelizumab) be used in children or older adults?

Ocrevus (ocrelizumab) should only be used in people who are 18 to 64 years of age. The clinical studies for this medication didn't include young children and also didn't include enough older adults. So, it's not known if Ocrevus (ocrelizumab) is safe or works well in children younger than 18 years old or adults 65 years of age and older. Ask your provider about available treatment options for children with MS or older adults.

Can Ocrevus (ocrelizumab) be used in pregnancy?

There haven't been enough studies looking at how Ocrevus (ocrelizumab) affects pregnant females and their unborn baby, so it's not completely known if it's safe to use during pregnancy. In studies done on animals, Ocrevus (ocrelizumab) caused harm to unborn baby animals. To be safe, it's recommended for females who can become pregnant to use birth control during treatment and for at least 6 months after your last dose of Ocrevus (ocrelizumab). If you're pregnant or thinking of getting pregnant, talk to your provider to see if Ocrevus (ocrelizumab) is right for you. If you're pregnant and are prescribed Ocrevus (ocrelizumab) or if you become pregnant while receiving treatment, it's recommended that you enroll in the Ocrevus pregnancy registry by visiting the registry website or by calling 1-833-872-4370. This pregnancy registry can closely monitor your and your baby's health.

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What are the risks and warnings for Ocrevus (ocrelizumab)?

Ocrevus (ocrelizumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Reactions after injection

Ocrevus (ocrelizumab) can cause reactions up to 1 day after receiving the medication. These reactions can include itching, hives, trouble breathing, pain in the mouth or throat, neck swelling, flushing, fever, headache, dizziness, fast heart rate, and anaphylaxis. To lower your risk and severity of these reactions, your provider might give you a few medications about 30 minutes to 1 hour before your Ocrevus (ocrelizumab) infusion. These medications include a steroid, antihistamine, and acetaminophen (Tylenol). Let your provider know if you get any of these reactions during the infusion so they can slow or stop the infusion. They can also give you medications to treat your symptoms. If you get these reactions when you're at home, get medical help right away.

Risk of infections

Risk factors: Active, chronic (long-term), or recurrent infection | Other conditions that raise your risk of infection | Taking medications that weaken your immune system

Ocrevus (ocrelizumab) can affect your body's ability to fight off infections, which can raise your risk of bacterial, viral, or fungal infections. The risk is higher for people who have an active infection or an infection that keeps coming back, people with certain chronic conditions that make it easier to develop infections, and people taking medications that weaken your immune system.

Additionally, Ocrevus (ocrelizumab) can reactivate the hepatitis B virus (HBV) if you're a carrier of the virus. You'll need to get tested for hepatitis B before starting Ocrevus (ocrelizumab) and get appropriate treatment if your provider detects that you're infected.

If you develop symptoms of an infection (e.g., fever, cough, difficulty breathing, diarrhea, weakness, sweating, chills) while taking Ocrevus (ocrelizumab), go to the hospital right away so you can be tested for an infection. You might have to stop taking Ocrevus (ocrelizumab) so your body can fight the infection. Tell your provider about your medical conditions and medications so they can make sure Ocrevus (ocrelizumab) is safe for you.

Low antibodies

Because of the way Ocrevus (ocrelizumab) works, it's expected for the medication to lower the antibody levels in your body. Low antibody levels can potentially raise your risk for infections. Your provider will monitor your antibody levels during and after treatment with Ocrevus (ocrelizumab). If you end up with a serious infection or an infection that keep coming back, you might need to stop Ocrevus (ocrelizumab) treatment.

Cancer

Although rare, Ocrevus (ocrelizumab) might raise your risk of developing certain types of cancers. You'll likely need certain labs and occasional physical exams while you receive Ocrevus (ocrelizumab) treatment to monitor your risk of cancer. If you experience symptoms, such as swollen lymph nodes in your neck, armpits, or groin, fatigue, unexplained weight loss, loss of appetite, lumps on your skin, pelvic or back pain, or changes in the shape or size of your breasts, contact your provider. They can check out these symptoms more closely.

Ocrevus (ocrelizumab) dosage forms

Typical dosing for Ocrevus (ocrelizumab)

You'll receive 300 mg injected into the veins (intravenously or IV) every 2 weeks for the first two treatments. Then, you'll receive 600 mg IV every 6 months for your following treatments.

Ocrevus (ocrelizumab) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ocrevus (ocrelizumab) will not be safe for you to take.