All About Ocrevus

What is Ocrevus?

If you have multiple sclerosis (MS), your doctor may prescribe Ocrevus for you.

Ocrevus is a prescription drug that’s used for the following conditions in adults:

• active secondary progressive MS
• primary progressive MS
• relapsing-remitting MS
• clinically isolated syndrome, which may be the first sign of MS

To learn more about these conditions and how Ocrevus is used to treat them, see the “Is Ocrevus used for MS?” section below.

Ocrevus basics

Ocrevus comes as a liquid solution inside a vial. You’ll receive doses of Ocrevus from a healthcare professional by intravenous (IV) infusion. (This is an injection that’s given slowly into a vein over time.)

Ocrevus contains the drug ocrelizumab, which is a biologic medication. A biologic is made from parts of living organisms. Ocrevus isn’t available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.) Instead, ocrelizumab is available only as the brand-name drug Ocrevus.

Read on to learn how Ocrevus is given, its uses and side effects, and more.

What are Ocrevus’s side effects?

Like most drugs, Ocrevus may cause mild or serious side effects. The lists below describe some of the more common side effects that Ocrevus may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Ocrevus. They can also suggest ways to help reduce side effects.

Mild side effects

Below are short lists of some of the mild side effects that Ocrevus can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the Ocrevus medication guide.

Some mild side effects of Ocrevus have been seen mostly in people with relapsing-remitting multiple sclerosis. This is multiple sclerosis (MS) with periods of both remission and relapse. These side effects include:

• arm, leg, or back pain
• depression

And some mild side effects of Ocrevus have been seen mostly in people with primary progressive MS (PPMS), a rare form of MS. These side effects include:

• arm or leg swelling
• cough
• diarrhea
• skin infections

Other mild side effects that may occur with Ocrevus include:

• herpes infections, such as cold sores or shingles
• lower respiratory infections, such as pneumonia
• fatigue* (lack of energy)
• upper respiratory infections (URIs)*

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Ocrevus can occur, but they aren’t common. If you have serious side effects from Ocrevus, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that have been reported with the use of Ocrevus include:

• certain cancers, such as breast cancer
• allergic reaction*
• side effects from infusion (receiving treatment slowly through a needle)*

* For more information on this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Ocrevus may cause.

Infusion side effects

You might experience side effects from the infusion process after receiving an Ocrevus dose. This was a common side effect in clinical studies of the drug.

You may have infusion side effects up to 24 hours after your Ocrevus dose. You’re more likely to experience this side effect after your first few doses of Ocrevus than after later doses.

Infusion side effects can include:

• fatigue (lack of energy)
• headache
• itchy skin
• pain or swelling in your mouth
• skin redness or discoloration
• trouble breathing

Your doctor will monitor you for infusion side effects for at least 1 hour after your Ocrevus infusion.

What might help

Tell your doctor right away if you have any infusion side effects from Ocrevus. These could be life threatening if untreated.

If you have infusion side effects from Ocrevus, your doctor may slow your Ocrevus infusion. This can help lower your risk for this reaction.

Your doctor may also prescribe other drugs with Ocrevus to help lower your risk for infusion side effects. They’ll give you doses of these drugs about 30 to 60 minutes before each Ocrevus infusion.

You’ll likely be given a corticosteroid, such as methylprednisolone (Medrol) and an antihistamine, such as diphenhydramine (Benadryl). If you have a fever after your Ocrevus injection, you may also be given acetaminophen (Tylenol) or another drug to help lower your temperature.

Upper respiratory infection

Upper respiratory infections (URIs), such as the common cold, might occur after receiving Ocrevus. URIs were a common side effect in clinical studies of the drug.

URIs can cause symptoms such as:

• cough
• mucus production
• runny or stuffy nose
• sneezing

What might help

Talk with your doctor about any URI symptoms you have while receiving Ocrevus. They can suggest ways to help relieve these side effects.

Home remedies such as honey and ginger can help relieve URI symptoms.

Over-the-counter (OTC) medications may also be helpful, but make sure to talk with your doctor before starting any new medications.

Examples of OTC drugs and the symptoms they relieve include:

• dextromethorphan (Robitussin DM) for cough
• guaifenesin (Mucinex) for mucus production
• antihistamines, such as loratadine (Claritin) and cetirizine (Zyrtec), for sneezing or runny nose
• decongestants, such as oxymetazoline (Afrin) and pseudoephedrine (Sudafed), for stuffy nose

Fatigue

You may have fatigue (lack of energy) after receiving your Ocrevus infusion. It’s likely you’ll experience fatigue as an infusion side effect.

Aside from lack of energy, other symptoms of fatigue may include:

• sore muscles
• mood changes
• blurred vision
• trouble concentrating
• loss of motivation

What might help

If you have questions about how to manage fatigue while receiving Ocrevus, talk with your doctor. For more information and to learn what might help, see the “Infusion side effects” section above.

Allergic reaction

Some people may have an allergic reaction to Ocrevus. While allergic reaction wasn’t reported in clinical studies of Ocrevus, it can still happen.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth, swelling, redness, or discoloration 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. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Ocrevus. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What does Ocrevus cost?

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Ocrevus infusions in your area, visit WellRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Ocrevus manufacturer’s website to see if it has support options.

What are some frequently asked questions about Ocrevus?

Find answers to some commonly asked questions about Ocrevus.

Is Ocrevus a chemotherapy or immunosuppressant drug?

Ocrevus isn’t a type of chemotherapy, but it is an immunosuppressant drug.

Chemotherapy works by destroying cells that grow more rapidly than healthy cells, such as cancer cells. Immunosuppressant drugs work by lessening the activity of your immune system.

Ocrevus is a type of immunosuppressant called a monoclonal antibody. The drug specifically works by lowering the number of B cells (a type of white blood cell) in your body. This can help relieve your multiple sclerosis (MS) symptoms.

Does Ocrevus cause hair loss?

It isn’t likely. Hair loss wasn’t a side effect reported in clinical studies of the drug.

However, other drugs used to treat MS can cause hair loss, such as azathioprine (Imuran) and methotrexate (Trexall).

If you have hair loss while receiving Ocrevus, talk with your doctor. They can help you determine the cause of your hair loss and can suggest ways to prevent it.

Will I have weight gain or weight loss with Ocrevus?

Weight gain and weight loss weren’t side effects reported in clinical studies of Ocrevus. But keep in mind that weight changes can be a symptom of MS.

If you experience weight gain or weight loss while receiving Ocrevus, talk with your doctor. They can suggest healthy ways to manage your weight.

How does Ocrevus work?

Ocrevus is prescribed to treat certain types of MS in adults. MS causes your immune system to attack the protective covering of your brain and spinal cord. This can cause swelling in your brain and spinal cord, which interrupts the communication between your brain and body.

Ocrevus works by lowering the number of B cells (a type of white blood cell) in your body. This lessens the activity of your immune system and relieves your MS symptoms.

If you have questions about how Ocrevus works, talk with your doctor or pharmacist.

Does Ocrevus increase the risk of cancer, such as breast cancer?

In rare cases, Ocrevus may increase your risk for certain cancers, such as breast cancer. In clinical studies of Ocrevus, some people who took the drug had an increased risk for breast cancer.

Be sure to follow breast cancer screening guidelines while receiving Ocrevus. Tell your doctor right away if you have any breast pain or lumps, or if you have nipple discharge. Your doctor will perform tests to check your condition.

Can Ocrevus cause PML?

It isn’t likely that Ocrevus will cause progressive multifocal leukoencephalopathy (PML). This wasn’t reported in clinical studies of the drug.

PML is a serious virus. Symptoms may include confusion, changes in vision, changes in personality, and trouble using your legs and arms. Other medications that treat MS, such as natalizumab (Tysabri), may cause PML.

If you’re concerned about getting PML while receiving Ocrevus, talk with your doctor.

Is Ocrevus used for MS?

Ocrevus is prescribed to treat certain types of multiple sclerosis (MS) in adults.

MS is a condition that causes your immune system to attack the protective covering of your brain and spinal cord. This can cause swelling in your brain and spinal cord, which interrupts the communication between your brain and body.

Below are brief descriptions of each condition Ocrevus is used to treat.

• Clinically isolated syndrome (CIS). With CIS, you experience MS symptoms for at least 24 hours. Although CIS is usually the first sign of MS, it often occurs before an official MS diagnosis.
• Relapsing-remitting MS. Relapsing-remitting MS has repeated episodes of relapse (worsened MS symptoms) and remission (no MS symptoms).
• Active secondary progressive MS. Active secondary progressive MS usually starts as relapsing-remitting MS. But over time, your MS symptoms continue to worsen.
• Primary progressive MS (PPMS). If you have PPMS, you have continued worsening MS symptoms without ever having periods of remission.

What should be considered before receiving Ocrevus?

Before receiving Ocrevus, it’s important to talk with your doctor about other medical conditions you have. This includes any recent infections you’ve had. You should also tell them if you’ve had any problems receiving Ocrevus in the past. These and other important considerations are discussed below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before receiving Ocrevus, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Ocrevus.

Interactions with drugs or supplements

Ocrevus can interact with several types of drugs. These drugs include:

• other multiple sclerosis (MS) drugs, such as fingolimod (Gilenya), mitoxantrone, natalizumab (Tysabri), and teriflunomide (Aubagio)
• drugs that weaken your immune system, such as corticosteroids

This list does not contain all types of drugs that may interact with Ocrevus. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with the use of Ocrevus.

Other interactions

Make sure your vaccinations are up to date before receiving Ocrevus. Talk with your doctor about any vaccines you may need.

During treatment with Ocrevus, you should not receive live vaccines. Live vaccines are made from a weakened form of the virus or bacteria the vaccine is meant to protect you from. Ocrevus can weaken your immune system. So receiving live vaccines while being treated with Ocrevus can raise your risk for getting an infection from the vaccine. You should wait at least 4 weeks after having a live vaccine before receiving Ocrevus.

Examples of live vaccines include:

• intranasal flu (FluMist)
• measles, mumps, rubella (MMR)

It isn’t known whether it’s safe to have non-live vaccines while receiving Ocrevus. For this reason, you should wait at least 2 weeks after having a non-live vaccine to start Ocrevus treatment, if possible.

Examples of non-live vaccines include:

• COVID-19
• flu shots

Warnings

Ocrevus may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you receive Ocrevus. Factors to consider include those in the list below.

• Active infection. Before starting Ocrevus treatment, tell your doctor about any infections you have. Your body won’t be able to fight an infection as well as before once you start receiving Ocrevus. So your doctor will want to make sure your infection is treated before you receive Ocrevus.
• Hepatitis B. Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). Make sure to tell your doctor if you have hepatitis B or have had it in the past. Before starting Ocrevus, your doctor will test you for HBV. If you have an active hepatitis B infection, your doctor will treat it before starting Ocrevus or recommend another treatment for your multiple sclerosis MS. This is because the drug can lower your body’s ability to fight an active hepatitis B infection, which could lead to serious liver damage.
• Allergic reaction. If you’ve had an allergic reaction to Ocrevus or any of its ingredients, you should not receive Ocrevus. Ask your doctor what other medications are better options for you.
• Recent live vaccination. You should not start Ocrevus treatment if you’ve had a live vaccine in the past 4 weeks. Ocrevus can weaken your immune system. And receiving live vaccines while receiving Ocrevus can raise your risk for getting an infection from the vaccine. For more information, see the “What should be considered before receiving Ocrevus?” section above.

Use with alcohol

There aren’t any known issues with drinking alcohol while receiving Ocrevus.

Talk with your doctor about the amount of alcohol that’s safe for you to drink while receiving Ocrevus.

Pregnancy and breastfeeding

It’s not known whether it’s safe for you to receive Ocrevus during pregnancy or while breastfeeding. If you’re pregnant, breastfeeding, or planning to become pregnant or breastfeed while receiving Ocrevus, talk with your doctor. They can discuss other treatment options with you.

If you do receive Ocrevus while pregnant, consider enrolling in a pregnancy registry. You can do so by calling 833-872-4370 or visiting this site. Pregnancy registries are helpful because they collect information about the effects of medications when used during pregnancy. By reporting effects of Ocrevus during pregnancy, you can help your doctor and researchers better understand the risks of receiving the drug.

How is Ocrevus given?

Your doctor will explain how Ocrevus will be given to you. They will also explain how much you’ll be given and how often. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Receiving Ocrevus

Ocrevus comes as a liquid solution inside a vial. A healthcare professional will give you your doses of Ocrevus by intravenous (IV) infusion. (This is an injection that’s given slowly into a vein over time.)

You won’t give yourself doses of Ocrevus. However, you may be able to receive your Ocrevus infusions at home. Talk with your doctor about whether it’s best to receive your infusions in a doctor’s office, clinic, infusion center, or at home.

Dosage

Your first two doses of Ocrevus will be starter doses. Your first starter dose will be a 300-milligram (mg) infusion given over at least 2.5 hours. Your second starter dose will be the same and will be given 2 weeks later.

After receiving two starter doses, you’ll get one infusion of Ocrevus every 6 months. Each infusion will be 600 mg. Your Ocrevus infusion will likely take either 2 hours or 3.5 hours. But it could take longer, depending on how well your body tolerates your first few doses.

Receiving Ocrevus with other drugs

To help lower your risk for side effects from Ocrevus, your doctor may prescribe other drugs along with it. They’ll give you doses of these drugs about 30 to 60 minutes before each Ocrevus infusion.

You’ll likely be given a corticosteroid, such as methylprednisolone (Medrol), and an antihistamine, such as diphenhydramine (Benadryl). These medications help lower your risk for infusion side effects. If you have fever after your Ocrevus injection, you may also be given acetaminophen (Tylenol) or another drug to help lower your temperature.

Questions about receiving Ocrevus

The following are answers to some common questions about receiving Ocrevus.

• What if I miss a dose of Ocrevus? If you miss an appointment to receive your Ocrevus infusion, call your doctor right away to reschedule. After getting your missed dose, you’ll have to wait at least 5 months before getting your next infusion. Your doctor will adjust your dosing schedule if needed.
• Will I need to use Ocrevus long term? Yes, you’ll probably use Ocrevus long term. But talk with your doctor about how long you should use the drug.
• How long does Ocrevus take to work? Ocrevus starts working right away after you receive your first dose. But it may take several doses before your symptoms start to ease.

Talking with your doctor

You may have questions about Ocrevus and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions like:
  • How will Ocrevus affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

What to ask your doctor

If you have questions about receiving Ocrevus for multiple sclerosis (MS), talk with your doctor or pharmacist.

You may want to ask your doctor about other treatment for MS, such as rituximab (Rituxan) or alemtuzumab (Lemtrada). Below is a list of articles you might find helpful:

• MS Treatment Chart: Comparing Disease-Modifying Therapies
• Multiple Sclerosis (MS) Drugs
• Multiple Sclerosis (MS) Treatments

Here are a few other questions you may want to ask your doctor about Ocrevus:

• Can I receive my Ocrevus infusions at home?
• How long will Ocrevus stay in my system?
• Should I use other MS treatments while receiving Ocrevus?
• What should I expect after getting an Ocrevus infusion?

You can also learn more about MS and its treatment options by subscribing to Healthline’s MS newsletter.