Ocrevus (Ocrelizumab) – Intravenous
What Is Ocrevus Used For?
Ocrevus is used to treat adults with relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. It is also approved to treat primary progressive MS.2
How to Take Ocrevus
Taking certain medications before receiving Ocrevus helps prevent side effects. Typically, an antihistamine (like Benadryl) and corticosteroid (like dexamethasone) are given as premedications 30 to 60 minutes before the infusion of Ocrevus begins. Then, a 300-milligram (mg) infusion of Ocrevus is given, followed by another 300-milligram infusion two weeks later. After these initial doses, a 600-milligram infusion is given once every six months. You will receive the infusion over a two-hour period or longer each time.1
Ocrevus is stored under refrigeration. Medical personnel prepare the medication by diluting the solution in a bag of normal saline. Just before administration, the infusion bag is brought to room temperature.1
How Long Does Ocrevus Take to Work?
Studies have shown that Ocrevus can have some effect at reducing MS progression within 12 weeks, but it may take six months or longer to achieve full effect.3
What Are the Side Effects of Ocrevus?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
The most common side effects of Ocrevus are:1
- Skin infections
- Lower respiratory infection
- Upper respiratory infection
- Injection site reactions, including rash, itching, redness, nausea, fatigue, and headache
Severe Side Effects
Severe side effects associated with Ocrevus are not uncommon. However, you will be monitored by a healthcare worker before and after your infusion. Reactions are possible up to 24 hours after the injection, so make sure you immediately contact your healthcare provider if you experience any of the following severe side effects:1
- Injection site reactions, including shortness of breath, low blood pressure, increased heart rate, and swelling
- Progressive multifocal leukoencephalopathy (PML)
- Reactivation of hepatitis B virus (HBV)
Long-Term Side Effects
Although still being studied, long-term use of Ocrevus may be associated with an increased risk of breast cancer in women receiving Ocrevus.4 Speak to your healthcare provider about any family history of cancer before beginning treatment.
Report Side Effects
Ocrevus may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Ocrevus Should I Take?
A healthcare provider will administer Ocrevus intravenously (in the vein) either at an infusion center, healthcare provider’s office, or your home, as follows:1
- An initial dose of 300 milligrams, followed by a second 300-milligram IV infusion two weeks later
- Subsequent doses of single 600-milligram IV infusions every six months
A healthcare provider will monitor you closely for at least one hour after receiving the infusion to watch for severe reactions.
During treatment, your healthcare provider may decrease the infusion rate if you experience mild side effects. If you experience severe side effects, your healthcare provider may stop the infusion until all side effects have been resolved and then infuse at a slower rate. Any life-threatening infusion side effects will result in immediate and permanent discontinuation of Ocrevus.
Treatment with Ocrevus may be delayed if you have any active infection.
Doses are administered every six months, except for the first two doses. Make sure that your infusion is scheduled appropriately. If you miss an appointment, contact your healthcare provider as soon as possible for further assistance on how to resume Ocrevus. Do not wait until the next scheduled infusion.
Overdose: What Happens If I Take Too Much Ocrevus?
Ocrevus is administered by trained healthcare providers. At this time, no overdose information exists for Ocrevus. It is anticipated that an overdose of Ocrevus would mimic the severe side effects listed in the above section.
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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.
This medicine may cause a rare but serious type of an allergic reaction called an infusion reaction. This can be life-threatening and requires immediate medical attention. Tell your doctor right away if you start to have a cough, difficulty with swallowing, sore throat, dizziness, headache, nausea, fast heartbeat, trouble breathing, chest tightness, swelling in your face or hands, fever, chills, skin itching, redness, rash, or hives, lightheadedness or faintness, or unusual tiredness or weakness while you are receiving this medicine.
Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for 6 months after the last dose. If you think you have become pregnant while receiving this medicine, tell your doctor right away.
This medicine may increase your risk of developing infections. Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.
Check with your doctor right away if you have ear congestion, chills, cough, chest tightness, fever, sneezing, sore throat, body aches or pain, headache, loss of voice, runny or stuffy nose, unusual tiredness or weakness, or trouble breathing. These could be symptoms of a lung infection.
This medicine may increase your risk for herpes infection. Tell your doctor right away if you have a fever, blistering, burning, crusting, irritation, itching, reddening, stinging, or swelling of the skin, painful cold sores, or blisters on the lips, nose, eyes, genitals, or trunk of the body, skin rash, pain, or itching, changes in vision, confusion, eye pain or redness, headache, or stiff neck.
Check with your doctor if you have weakness on one side of the body, clumsiness, blurred vision, changes in thinking, memory problems, confusion, or personality changes. These could be symptoms of a serious and rare brain infection called progressive multifocal leukoencephalopathy (PML).
This medicine may cause hepatitis B virus reactivation. Tell your doctor right away if you have any symptoms of liver problems, such as yellow skin or eyes, dark brown-colored urine, right-sided stomach pain, fever, or severe tiredness.
While you are being treated with ocrelizumab, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor’s approval. You may receive live or live-attenuated vaccines at least 4 weeks or non-live vaccines at least 2 weeks before starting this medicine. Ocrelizumab may lower your body’s resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Using this medicine may increase your risk of getting cancer (eg, breast cancer). Talk to your doctor if you have concerns about this risk.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are Reasons I Shouldn’t Take Ocrevus?
You should not receive Ocrevus if you:
- Have received any live vaccines, such as measles, mumps, rubella (MMR), rotavirus, chickenpox, and yellow fever vaccines, less than four weeks before starting treatment.
- Have received non-live vaccines, such as the flu, shingles, hepatitis B, and pneumococcal vaccines, less than two weeks before starting treatment.
- Have an active infection
- Have a history of cancer or HBV infection and have not been screened for active infection
If you have an active HBV infection, your healthcare provider will not prescribe you this medication. This is because Ocrevus works on the immune system and latent HBV can reactivate, even in the case of a previously resolved infection. This means the HBV that has been successfully treated in the past may return.
What Other Medications Interact With Ocrevus?
Live vaccines may interact with Ocrevus and should not be administered while receiving Ocrevus. All live vaccines should be completed at least four weeks prior to initiating treatment with Ocrevus.
What Medications Are Similar?
Drugs that are similar to Ocrevus include:
- Kesimpta (ofatumumab): Self-administered injection once a month
- Tysabri (natalizumab): Infusion every four weeks
- Lemtrada (alemtuzumab): Infusion is given five days in a row, then three days in a row a year later
- Copaxone (glatiramer acetate): Injection under the skin three times a week
This is a list of drugs also prescribed for the targeted condition(s). It is NOT a list of drugs recommended to take with Ocrevus. In fact, you should not take these drugs together. Ask your pharmacist or a healthcare provider if you have questions.