Ocrevus (ocrelizumab)

Ocrevus is a brand-name intravenous (IV) infusion prescribed for certain types of multiple sclerosis and clinically isolated syndrome. Ocrevus contains the active ingredient ocrelizumab and belongs to the monoclonal antibodies drug class.

Ocrevus is FDA-approved to treat the following conditions in adults:
Clinically isolated syndrome (CIS): CIS happens when someone who has not received a diagnosis of multiple sclerosis (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.
CIS
multiple sclerosis (MS)
Relapsing-remitting MS (RRMS): With RRMS, your disease typically relapses (gets worse) and then goes into remission (a period when you have no symptoms).
RRMS
Active secondary progressive MS: With active secondary progressive MS, you may have started with RRMS, but now your MS symptoms gradually worsen all the time.
secondary progressive MS
Primary progressive MS (PPMS): With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to worsen since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.
PPMS
You’ll find key information about Ocrevus below.
Drug form: intravenous (IV) infusion given by a healthcare professional
Generic available? no
Prescription required? yes
Controlled substance? no
Year of FDA approval: 2017
2017
Ocrevus generic
Ocrevus is only available 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 ingredient ocrelizumab.
Ocrevus side effects
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 bother you.
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.
MedWatch
Below is a partial list of mild side effects of Ocrevus. To learn about other mild side effects, talk with your doctor or pharmacist, or view the drug’s prescribing information.
prescribing information
The most common mild side effects for people taking Ocrevus can include:
upper or lower respiratory infection, such as a cold or pneumonia
cold
pneumonia
herpes infections such as shingles or cold sores
herpes
shingles
cold sores
depression (in people with RRMS)
depression
pain in your back, arms, or legs (in people with RRMS)
skin infections (in people with 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.
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 breastpain in the breast or nippledischarge from the nipple
breast cancer
a lump in your breast
pain in the breast or nipple
discharge from the nipple
Colitis (inflammation of the colon). Symptoms can include: pain or cramping in your abdomendiarrheablood in your stool
Colitis
pain or cramping in your abdomen
diarrhea
blood in your stool
Increased risk of certain infections, including the herpes infection, if you are exposed to the virus. Symptoms of a serious herpes infection can include: cold soresskin rasheye redness or painvision changesstiffness in your neckconfusionsevere or persistent headache
herpes
cold sores
cold sores
skin rash
eye redness or pain
vision changes
stiffness in your neck
stiffness in your neck
confusion
severe or persistent headache
Reactivation of existing hepatitis B. Symptoms can include: fatigue or drowsinessconfusionjaundice (yellowing of the skin or the whites of your eyes)urine or stools that are darker than usualswelling or pain in the upper-right side of your abdomennausea or vomiting, including vomiting blood
hepatitis B
fatigue or drowsiness
fatigue
confusion
jaundice (yellowing of the skin or the whites of your eyes)
jaundice
urine or stools that are darker than usual
swelling or pain in the upper-right side of your abdomen
nausea or vomiting, including vomiting blood
vomiting blood
Other serious side effects are explained below in “Side effect details.” These include:
allergic reaction
allergic reaction
infusion side effects, such as infusion reactions
progressive multifocal leukoencephalopathy (PML)
progressive multifocal leukoencephalopathy (PML)
You may wonder how often certain side effects occur with this drug or whether certain side effects pertain to it. Here are some details on some of the side effects this drug may or may not cause.
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
flushing
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 is unknown 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.
Some people may experience fatigue (lack of energy) while taking Ocrevus. In most cases, fatigue is a side effect of an infusion. For more information, see the “Infusion side effects” section below.
fatigue
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.
corticosteroid
methylprednisolone
antihistamine
Benadryl
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
Some people may experience infusion reactions while receiving Ocrevus. This was a common side effect in clinical trials of the drug. In rare cases, symptoms were considered severe.
clinical trials
In clinical trials, it was more common for people to experience infusion side effects with their first dose of Ocrevus than with later doses.
clinical trials
PML is a rare but serious brain infection caused by the John Cunningham (JC) virus. PML did not occur in anyone receiving Ocrevus during clinical trials, but it has been reported since the drug received approval. It is unknown how commonly PML has occurred in people using Ocrevus.
John Cunningham (JC) virus
clinical trials
PML can be very serious and may be life threatening. Symptoms of PML can include:
changes in memory
confusion
weakness on one side of your body that worsens over time
problems using your arms and legs
vision changes
changes in personality
If you have any symptoms of PML, talk with your doctor as soon as you notice them. They’ll likely recommend you stop receiving Ocrevus and perform a physical examination. They may also order an MRI scan to help provide a diagnosis.
If your doctor diagnoses you with PML, they will stop treatment with Ocrevus and treat the infection. For more information about this condition, talk with your doctor.
Weight gain and weight loss (not side effects)
Changes in weight were not seen in clinical trials of people taking Ocrevus. However, weight changes may be symptoms of MS itself. You may gain weight if you’re having difficulty moving around or exercising.
clinical trials
However, if you have limited mobility and difficulty moving around, you may lose some muscle, which could result in some weight loss.
Although Ocrevus does not typically cause weight changes, 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.
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.
Trexall
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.
Ocrevus for MS
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.
multiple sclerosis (MS)
MS can cause symptoms such as muscle weakness, inflammation (swelling), numbness, tingling, and trouble walking.
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 has not received a diagnosis of multiple sclerosis (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. (CIS is not technically MS, but it’s sometimes grouped together with relapsing forms of MS.)
CIS
multiple sclerosis (MS)
Relapsing-remitting MS (RRMS). With RRMS, your disease typically relapses and then goes into remission.
RRMS
Active secondary progressive MS: With active secondary progressive MS, you may have started with RRMS, but now your MS symptoms gradually worsen all the time.
secondary progressive MS
Clinical studies have found Ocrevus effective for treating CIS and relapsing forms of MS. To learn more about the drug’s effectiveness, talk with your doctor or see the prescribing information for Ocrevus.
Clinical studies
prescribing information
If you have PPMS, you’ve never had any periods of remission. People with PPMS have symptoms that have continued to worsen since their MS started. Ocrevus is currently the only medication that’s FDA-approved to treat PPMS.
PPMS
Clinical studies have found Ocrevus effective for treating PPMS. To learn more about the drug’s effectiveness, talk with your doctor or see the prescribing information for Ocrevus.
Clinical studies
prescribing information
Ocrevus dosage
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.
Ocrevus comes as a solution that’s given as an intravenous (IV) 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 milligrams (mg) in 10 mL of solution.
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.
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.
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.
Common questions about Ocrevus
Here are answers to some frequently asked questions about Ocrevus.
No, Ocrevus is not chemotherapy. It belongs to a class of drugs called monoclonal antibodies.
chemotherapy
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.
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. However, this risk was rare.
clinical trials
While taking Ocrevus, you should follow current breast cancer screening guidelines. This means some females* (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.)
current breast cancer screening guidelines
mammogram
Based on their family or personal history, some people may begin mammogram screenings earlier than age 45.
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.
* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
Sex and gender
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 do not 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 to avoid while taking Ocrevus include:
measles, mumps, and rubella (MMR)
intranasal flu
smallpox
chickenpox
chickenpox
rotavirus
rotavirus
yellow fever
yellow fever
typhoid
typhoid
If possible, 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:
influenza (flu shot)
influenza (flu shot)
tetanus, diphtheria, and acellular pertussis (TDaP)
hepatitis
human papillomavirus (HPV)
human papillomavirus (HPV)
pneumonia
pneumonia
meningitis
meningitis
shingles (Shingrix vaccine)
Shingrix
Talk with your doctor about any vaccines you may need 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.
hepatitis B
Sometimes, 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.
lesions
Talk with your doctor if you have any questions about testing that needs to be done before you start taking Ocrevus.
How Ocrevus works
Ocrevus is FDA-approved to treat certain types of multiple sclerosis (MS) in adults.
multiple sclerosis (MS)
With MS, your immune system mistakenly attacks the myelin sheath, a protective membrane that covers your brain and spinal cord.
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 difficulty walking. You may also experience changes in vision, such as difficulty seeing.
Ocrevus works in your body by decreasing certain cells called B cells that worsen your MS symptoms. Ocrevus belongs to a class of drugs called monoclonal antibodies. (A drug class is a group of medications that work in a similar way.)
Experts believe 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.
Ocrevus begins working after your first infusion. However, each person taking Ocrevus will react differently to the medication. Some people may see a reduction in their MS symptoms after only one dose. For others, it may take more time before they notice results.
Alternatives to Ocrevus
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.
off-label
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)
Gilenya
dimethyl fumarate (Tecfidera)
Tecfidera
teriflunomide (Aubagio)
Aubagio
alemtuzumab (Lemtrada)
natalizumab (Tysabri)
Tysabri
interferon beta-1a (Avonex)
Avonex
interferon beta-1b (Betaseron)
glatiramer acetate (Copaxone)
Copaxone
peginterferon beta-1a (Plegridy)
Plegridy
siponimod (Mayzent)
Mayzent
cladribine (Mavenclad)
Mavenclad
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.
primary progressive MS (PPMS)
Rituxan
Ocrevus vs. Lemtrada
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.
The active ingredient in Ocrevus is ocrelizumab. The active ingredient in Lemtrada is alemtuzumab.
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.
CIS
Relapsing-remitting MS (RRMS). With RRMS, your disease typically relapses (worsens) and then goes into remission (a period when you have no symptoms).
RRMS
Active secondary progressive MS: With active secondary progressive MS, you may have started with RRMS, but now your MS symptoms gradually worsen all the time.
secondary progressive MS
Primary progressive MS (PPMS): With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to worsen since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.
PPMS
Lemtrada is approved to treat RRMS and active secondary progressive MS in adults. It’s not approved to treat PPMS or CIS.
Ocrevus and Lemtrada are both given as an intravenous (IV) infusion (an injection into your vein that’s slowly dripped in over time). They should only be given by a healthcare professional.
Ocrevus and Lemtrada have some similar side effects and others that differ. Below are examples of these side effects.
These lists contain examples of some 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 pneumoniadepression (in people with relapsing forms of MS)
lower respiratory infection, such as pneumonia
pneumonia
depression (in people with relapsing forms of MS)
depression
Can occur with Lemtrada:rashheadachefevernauseaurinary tract infection
rash
headache
fever
nausea
urinary tract infection
urinary tract infection
Can occur with both Ocrevus and Lemtrada:herpes infections, such as shingles or cold soresupper respiratory tract infection, such as a coldpain in your back, arms, or legs*
herpes infections, such as shingles or cold sores
herpes
shingles
cold sores
upper respiratory tract infection, such as a cold
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. People with PPMS did not report it.
clinical trials
These lists contain examples of serious side effects that can occur with Lemtrada or with both drugs (when taken individually).
Can occur with Ocrevus:colitis (inflammation of the colon)increased risk of certain infections, including the herpes infection, if you are exposed to the virusreactivation of existing hepatitis B
colitis (inflammation of the colon)
colitis
increased risk of certain infections, including the herpes infection, if you are exposed to the virus
herpes
reactivation of existing hepatitis B
hepatitis B
Can occur with Lemtrada:other autoimmune conditions, such as changes in your number of platelets (a type of blood cell)thyroid disordersstrokeserious kidney diseasesuicidal thoughts or behaviorliver damage
other autoimmune conditions, such as changes in your number of platelets (a type of blood cell)
autoimmune conditions
thyroid disorders
thyroid disorders
stroke
stroke
serious kidney disease
suicidal thoughts or behavior
suicidal thoughts or behavior
liver damage
Can occur with both Ocrevus and Lemtrada:allergic reactioncancer (such as breast cancer with Ocrevus, and thyroid cancer or skin cancer with Lemtrada)infusion reactionsprogressive multifocal leukoencephalopathy (a rare but serious brain infection)
allergic reaction
allergic reaction
cancer (such as breast cancer with Ocrevus, and thyroid cancer or skin cancer with Lemtrada)
breast cancer
thyroid cancer
skin cancer
infusion reactions
progressive multifocal leukoencephalopathy (a rare but serious brain infection)
progressive multifocal leukoencephalopathy
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
Ask the tough question: “Are you considering suicide?”
Listen to the person without judgment.
Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
Stay with the person until professional help arrives.
Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

988 Suicide and Crisis Lifeline
Find more links and local resources.
Find more links and local resources.
These drugs haven’t been directly compared in clinical studies. However, studies have found both Ocrevus and Lemtrada effective for treating MS.
Ocrevus
Lemtrada
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.
The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the specialty pharmacy you use.
Ocrevus vs. Rituxan
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.
Rituxan
The active ingredient in Ocrevus is ocrelizumab. The active ingredient in Rituxan is rituximab.
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.
CIS
Relapsing-remitting MS (RRMS). With RRMS, your disease typically relapses (worsens) and then goes into remission (a period when you have no symptoms).
RRMS
Active secondary progressive MS: With active secondary progressive MS, you may have started with RRMS, but now your MS symptoms get gradually worse all the time.
secondary progressive MS
Primary progressive MS (PPMS): With PPMS, you’ve never had any periods of remission. If you have this condition, your symptoms have continued to worsen since your MS started. Currently, Ocrevus is the only drug that’s approved to treat PPMS.
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.)
off-label
Rituxan is FDA-approved to treat the following conditions:
non-Hodgkin’s lymphoma (NHL) (cancer that starts in your white blood cells) in adults and children ages 6 months and older
non-Hodgkin’s lymphoma (NHL)
white blood cells
chronic lymphocytic leukemia (cancer affecting your white blood cells) in adults
chronic lymphocytic leukemia
rheumatoid arthritis (your immune system attacks your joints, causing swelling and pain) in adults
rheumatoid arthritis
granulomatosis with polyangiitis and microscopic polyangiitis (with these conditions, your blood vessels swell, and your blood flow is restricted, which may cause organ damage) in adults and children ages 2 years and older
granulomatosis with polyangiitis
pemphigus vulgaris (your immune system attacks your skin, causing severe blisters) in adults
pemphigus vulgaris
mature B-cell NHL and acute leukemia in children ages 6 months and older
B-cell NHL
acute leukemia
Ocrevus and Rituxan are both given as an intravenous (IV) infusion (an injection into your vein that’s slowly dripped in over time). They should only be given by a healthcare professional.
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.
These lists contain examples of some of the most common mild side effects that can occur with each drug, or with both Ocrevus and Rituxan (when taken individually).
Can occur with Ocrevus:lower respiratory infection, such as pneumoniapain in your back, arms, or legs (in people with relapsing-remitting MS)skin infections
lower respiratory infection, such as pneumonia
pneumonia
pain in your back, arms, or legs (in people with relapsing-remitting MS)
skin infections
Can occur with Rituxan:decrease in blood cells, such as white blood cellsurinary tract infectionmuscle spasms nausea
decrease in blood cells, such as white blood cells
white blood cells
urinary tract infection
urinary tract infection
muscle spasms
nausea
Can occur with both Ocrevus and Rituxan:upper respiratory infection, such as a coldherpes infections, such as shingles or cold soresdepression
upper respiratory infection, such as a cold
cold
herpes infections, such as shingles or cold sores
herpes
shingles
cold sores
depression
depression
These lists contain examples of serious side effects that can occur with Ocrevus, with Rituxan, or with both drugs (when taken individually).
Can occur with Ocrevus:cancer, such as breast cancercolitis (inflammation of the colon)increased risk of certain infections, including the herpes infection, if you are exposed to the virusreactivation of existing hepatitis B
cancer, such as breast cancer
breast cancer
colitis (inflammation of the colon)
colitis
increased risk of certain infections, including the herpes infection, if you are exposed to the virus
herpes
reactivation of existing hepatitis B
hepatitis B
Can occur with Rituxan:tumor lysis syndrome (when cancer cells release harmful chemicals into your blood)heart problems, such as heart attackkidney problems, such as decreased urinestomach or intestinal blockage or perforation (holes)severe rashes or skin reactions that can be fatal, such as toxic epidermal necrolysis
tumor lysis syndrome (when cancer cells release harmful chemicals into your blood)
tumor lysis syndrome
heart problems, such as heart attack
heart attack
kidney problems, such as decreased urine
stomach or intestinal blockage or perforation (holes)
perforation
severe rashes or skin reactions that can be fatal, such as toxic epidermal necrolysis
toxic epidermal necrolysis
Can occur with both Ocrevus and Rituxan:allergic reactioninfusion reactionsprogressive multifocal leukoencephalopathy (a rare but serious brain infection)
allergic reaction
allergic reaction
infusion reactions
progressive multifocal leukoencephalopathy (a rare but serious brain infection)
progressive multifocal leukoencephalopathy
These drugs haven’t been directly compared in clinical studies. However, studies have found both Ocrevus and Rituxan effective for treating MS.
Ocrevus
Rituxan
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.
The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the specialty pharmacy you use.
Ocrevus and alcohol
There are no known interactions between Ocrevus and alcohol.
If you drink alcohol and have questions about consuming it during Ocrevus treatment, talk with your doctor.
Ocrevus interactions
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.
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.
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.
Avoid getting any live vaccines while taking Ocrevus. This is because live vaccines contain weakened forms of viruses or bacteria.
Live vaccines do not 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:
measles, mumps, rubella (MMR)
intranasal flu
smallpox
chickenpox
chickenpox
rotavirus
rotavirus
yellow fever
yellow fever
typhoid
typhoid
You should also try to avoid getting 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:
influenza (flu shot)
influenza (flu shot)
tetanus, diphtheria, and acellular pertussis (TDaP)
hepatitis
human papillomavirus (HPV)
human papillomavirus (HPV)
pneumonia
pneumonia
meningitis
meningitis
shingles (Shingrix vaccine)
Shingrix
Before starting Ocrevus, talk with your doctor about any vaccines you may need.
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.
corticosteroids
methylprednisolone
Other MS medications may also affect your immune system, so 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:
fingolimod (Gilenya)
Gilenya
teriflunomide (Aubagio)
Aubagio
mitoxantrone
Talk with your doctor about any other medications you’re taking before you start Ocrevus.
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.
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.
Ocrevus and pregnancy, breastfeeding, and birth control
If you can become pregnant, are breastfeeding, or are using birth control, it’s important to consider whether Ocrevus is a safe choice for you.
You can also refer to this article for more information. If you have additional questions, talk with your doctor.
this article
Ocrevus use with other drugs
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 intravenous (IV) 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).
corticosteroid
methylprednisolone
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.
antihistamine
Benadryl
Talk with your doctor about which medications you’ll need to take before your Ocrevus infusions.
Ocrevus cost
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.
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.
program website
How Ocrevus is given
You will receive Ocrevus 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.
Ocrevus precautions
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 will require treatment 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.
hepatitis B
Recent live vaccinations: Do 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: Do 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 is unknown whether Ocrevus is safe to take during pregnancy. For more information, read this article on pregnancy, breastfeeding, and birth control.
this article
Breastfeeding: It is unknown whether Ocrevus is safe to take while you’re breastfeeding. For more information, read this article on pregnancy, breastfeeding, and birth control.
this article
Note: For more information about the potential negative effects of Ocrevus, see the “Ocrevus side effects” section above.
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 another 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.