Ocrevus overview
Therapeutic Classes:
Monoclonal antibody
Forms:
Injectable
How it’s taken:
By intravenous (IV) injection
What is Ocrevus used for?
Ocrevus is indicated for the treatment of relapsing and primary progressive MS. It is not a cure for MS, but it may help slow nerve damage while delaying physical disability and the frequency of relapses. It is indicated for use by adults only.
Key takeaways
Expert tips for using Ocrevus
Ocrevus is a medication that works by targeting a specific protein called CD20 that sits on the outside of certain immune cells known as B-lymphocytes. These cells play a role in the development of MS symptoms. When Ocrevus attaches to the CD20 protein, it signals the body's defense system to get rid of these B-cells, which may help slow down the worsening of MS and lead to fewer episodes where symptoms get worse, which are called relapses.
This medication is FDA-approved to manage certain forms of MS, including primary progressive MS (PPMS) and relapsing forms. It is typically administered by infusion over two to three hours or longer every six months, always under the supervision of a healthcare professional to manage any immediate reactions.
Patients taking Ocrevus might have side effects such as headaches, fatigue, or skin reactions. To help lower the risk of side effects, healthcare providers often give medications before the infusion and watch patients closely afterward. Also, because Ocrevus can weaken the immune system, it may increase the chances of getting infections or cancer.
Before starting Ocrevus therapy, patients should understand that it's not a cure for MS but may manage symptoms and slow disease progression. Tell a healthcare provider about any medical conditions, history of infections, and other medications being taken before taking the first dose of Ocrevus.
What form(s) does Ocrevus come in
Fact-check the list of forms below, removing any forms that do not apply to Ocrevus.
Add information about strengths below each form.
Injection
300 mg/10 mL
What are common Ocrevus doses?
The standard starting dose is 600 mg divided into two separate doses of 300 mg each. These initial 300 mg doses are administered via IV infusion, each over a period of approximately 2.5 hours. The two starting doses are given two weeks apart.
After the initial doses, a 600 mg dose is administered every six months as a single infusion over 2 hours or longer. Some patients may require a longer infusion time, especially if the infusion rate needs adjusting due to a reaction.
Common Ocrevus prescriptions
Ocrevus
10ml of 300mg/10ml vial
How to take Ocrevus
Your healthcare provider will prescribe your dose and schedule. This medicine is given through a needle placed in a vein and delivered as an infusion.
Patients may receive other medications before the start of an Ocrevus infusion to reduce the risk of reactions. These medications often include corticosteroids, antihistamines, and possibly a fever reducer.
After receiving Ocrevus, patients will be observed for signs of side effects. Healthcare providers usually monitor patients for a period, often at least an hour, after the infusion is complete.
Patients don't need to worry about storing the medication, as it's stored and prepared by the medical facility providing the treatment.
What to do if you miss a dose of Ocrevus
If you miss an Ocrevus infusion, get it as soon as you can instead of waiting for the next scheduled dose.
After the missed dose is given, schedule your following dose for six months later, making sure there's at least a five-month gap between doses.
Ocrevus contraindications
This medicine is not right for everyone. You should not receive it if you have had a life-threatening reaction to ocrelizumab or if you have an active hepatitis B infection.
Ocrevus warnings
Patients may experience infusion reactions. Symptoms can include itching, rash, hives, or swelling of the lips, tongue, or throat.
There might be a reduction in immunoglobulin levels with long-term use, which could affect the immune system's ability to fight infections. As a result, Ocrevus can increase the risk of infections, including upper respiratory tract and herpes-related infections.
Reactivation of hepatitis B virus can occur. Patients should get screened for hepatitis B before starting treatment.
A rare brain infection called progressive multifocal leukoencephalopathy (PML) has been reported with Ocrevus; patients should be observant of any new or worsening neurological symptoms.
There may be an increased risk of cancer, particularly breast cancer, so regular screening is advised.
Patients should complete any required vaccinations at least four weeks prior to starting Ocrevus for live or live-attenuated vaccines and, when possible, two weeks prior to starting Ocrevus for non-live vaccines.
Women need to discuss the potential risks and benefits with their doctor if they are pregnant, planning to become pregnant, or breastfeeding. Use an effective form of birth control during treatment with this medicine and for six months after the last dose.
Ocrevus interactions
If you're taking steroids or any drugs that affect your immune system, like daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, let your healthcare provider know. These medicines could make Ocrevus less effective or increase the chances of weakening your immune system. It's especially important to consider the risk of an interaction if you're switching from one of these drugs to Ocrevus, due to their lasting effects.
This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccine. You may receive live or live-attenuated vaccines at least four weeks or non-live vaccines at least two weeks before starting this medicine.
Ocrevus side effects
Serious side effects
Weakened immune system and an increased risk of infections, such as viral, bacterial, and fungal infections. This medication may reactivate a hepatitis B infection in people who have had the infection before.
Infusion reactions could range from mild to serious and may include symptoms such as fever, hives, skin rash, rapid heartbeat, fatigue, headache, nausea, or difficulty breathing.
Increased risk of progressive multifocal leukoencephalopathy, a rare brain infection that can lead to severe disability or death.
Less serious side effects
Feeling depressed or sad
Pain, itching, burning, swelling, or a lump under your skin where the needle is placed
Back, arm, or leg pain
Sources:
Ocrevus highlights of prescribing information, U.S. Food and Drug Administration (2024)
Ocrevus, Medline Plus (2022)
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