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Ocrelizumab Treatment for Multiple Sclerosis: Dosage, Side Effects & Cost
Summary of Key Points
Ocrelizumab is a prescription medication used to treat multiple sclerosis (MS) and related conditions. It works by targeting specific immune cells that contribute to nerve damage. Ocrelizumab is typically administered as an infusion and helps reduce the frequency of relapses while slowing disease progression. Always consult your healthcare provider before starting or adjusting your treatment. You can also schedule a telemedicine appointment with one of our providers for personalized care.
Names of Medication
US Brand Name: Ocrevus
Generic Name: Ocrelizumab
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.
Pharmacologic Category
Monoclonal Antibody
Anti-CD20 Agent
Ocrelizumab Dosing
Ocrelizumab is approved for treating several MS-related conditions. The dosing schedule varies depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine consultation with our providers to discuss your treatment plan.
Ocrelizumab for Multiple Sclerosis (Relapsing Forms)
Initial Dose: 300 mg IV infusion, followed by a second 300 mg infusion two weeks later.
Maintenance Dose: 600 mg IV infusion every 6 months.
Ocrelizumab for Primary Progressive Multiple Sclerosis (PPMS)
Initial Dose: 300 mg IV infusion, followed by a second 300 mg infusion two weeks later.
Maintenance Dose: 600 mg IV infusion every 6 months.
Ocrelizumab for Secondary Progressive Multiple Sclerosis (SPMS)
Initial Dose: 300 mg IV infusion, followed by a second 300 mg infusion two weeks later.
Maintenance Dose: 600 mg IV infusion every 6 months.
Ocrelizumab for Neuromyelitis Optica Spectrum Disorder (NMOSD)
Initial Dose: 300 mg IV infusion, followed by a second 300 mg infusion two weeks later.
Maintenance Dose: 600 mg IV infusion every 6 months.
Other Conditions (Optic Neuritis, Transverse Myelitis, Autoimmune Encephalitis, etc.)
The dosing for these conditions is typically similar to that for multiple sclerosis, but your healthcare provider will tailor the treatment to your specific needs. Please consult your doctor for personalized dosing information.
Dosage Forms and Strengths
Ocrelizumab is available as a solution for intravenous (IV) infusion.
Strength: 300 mg/10 mL (30 mg/mL) single-dose vial.
Administration Instructions for Ocrelizumab Infusion
Ocrelizumab is administered via intravenous (IV) infusion, meaning it is delivered directly into a vein. Infusions are typically done in a healthcare setting, such as a clinic or hospital, under the supervision of a healthcare provider. The first dose is split into two infusions given two weeks apart, with subsequent doses administered every six months. Infusions can take several hours, and you may be monitored for side effects during and after the procedure.
Ocrelizumab Side Effects and Adverse Reactions
Like all medications, Ocrelizumab can cause side effects. Some are common, while others are rare but more serious. It’s important to discuss any side effects with your healthcare provider. If you experience severe side effects, seek medical attention immediately. You can also consult one of our telemedicine providers for advice on managing side effects.
Common Ocrelizumab Side Effects
Infusion Reactions: These may include fever, chills, rash, or difficulty breathing. These reactions are common and usually occur during or shortly after the infusion.
Upper Respiratory Tract Infections: Symptoms may include cough, sore throat, or nasal congestion.
Headache: A common side effect that may occur after treatment.
Less Common but Serious Ocrelizumab Side Effects
Increased Risk of Infections: Ocrelizumab can weaken your immune system, making you more susceptible to infections.
Progressive Multifocal Leukoencephalopathy (PML): A rare but serious brain infection that can be life-threatening. Symptoms include vision problems, loss of coordination, and difficulty speaking.
Hepatitis B Reactivation: If you have a history of hepatitis B infection, Ocrelizumab may cause the virus to become active again.
Contraindications for Ocrelizumab Treatment
A contraindication is a specific condition where a treatment or medication should not be used because it may cause harm. If you have any of the following conditions, Ocrelizumab may not be safe for you. Always consult with your healthcare provider before starting any new medication, and our telemedicine team is available to help you review your options.
Active Hepatitis B infection: Ocrelizumab can weaken your immune system, which may allow the hepatitis B virus to become active again, leading to serious liver damage.
Severe infections: If you have an active infection, Ocrelizumab may worsen it by further suppressing your immune system. It’s important to resolve any infections before starting treatment.
History of life-threatening allergic reactions to Ocrelizumab: If you have had a severe allergic reaction (anaphylaxis) to Ocrelizumab or any of its ingredients, you should not take this medication.
Pregnancy: Ocrelizumab may harm an unborn baby. Women of childbearing age should use effective contraception during treatment and for at least 6 months after the last dose.
Ocrelizumab Drug Interactions
Ocrelizumab can interact with other medications, increasing the risk of side effects or reducing treatment effectiveness. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products. Below are some medications that may interact with Ocrelizumab:
Immunosuppressants: Medications like Methotrexate (Trexall) or Azathioprine (Imuran) can further suppress your immune system when taken with Ocrelizumab, increasing the risk of infections.
Live vaccines: Vaccines such as MMR (measles, mumps, rubella) or Varicella (chickenpox) should be avoided while on Ocrelizumab, as your immune system may not handle live viruses effectively.
Corticosteroids: Medications like Prednisone (Deltasone) can also suppress the immune system, and when combined with Ocrelizumab, may increase the risk of infections.
Ocrelizumab in Pregnancy
Is it safe to take Ocrelizumab when pregnant?
Ocrelizumab is generally not recommended during pregnancy unless absolutely necessary. The medication may pose risks to an unborn baby, particularly if taken during the first trimester. If you are pregnant or planning to become pregnant, it’s important to discuss the potential risks and benefits of Ocrelizumab with your healthcare provider. Additionally, effective contraception should be used during treatment and for at least six months after the last dose to avoid pregnancy during this period.
Ocrelizumab while Breastfeeding
Is it safe to take Ocrelizumab while breastfeeding?
It is not yet clear whether Ocrelizumab passes into breast milk. However, due to its potential effects on the immune system, breastfeeding while on Ocrelizumab is generally not recommended. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to carefully weigh the risks and benefits. They can help you decide whether to continue breastfeeding or explore alternative treatments.
Estimated Cost of Ocrelizumab
The cost of Ocrelizumab can vary depending on your location and insurance coverage. Without insurance, the estimated cost for a 30-day supply using a GoodRX coupon ranges from $20,000 to $30,000. Since Ocrelizumab is typically administered as an infusion every six months, the cost per infusion can be significant. Be sure to check with your insurance provider or pharmacy for more accurate pricing, and explore potential financial assistance programs if needed.
Possible Alternatives to Ocrelizumab
If Ocrelizumab is not the right option for you, there are other treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine team is also available to help you explore these options.
Multiple Sclerosis (MS)
Alternatives include medications such as Glatiramer acetate (Copaxone) or Interferon beta (Rebif). In addition to medication, lifestyle changes like regular exercise, a balanced diet, and stress management can also help manage symptoms.
Primary Progressive Multiple Sclerosis (PPMS)
There are fewer treatment options for PPMS, but some patients may benefit from medications like Siponimod (Mayzent) or physical therapy to help maintain mobility and function.
Relapsing Forms of Multiple Sclerosis
Other disease-modifying therapies, such as Dimethyl fumarate (Tecfidera) or Fingolimod (Gilenya), may be considered. Managing stress and ensuring adequate rest can also help reduce the frequency of relapses.
Secondary Progressive Multiple Sclerosis (SPMS)
Medications like Siponimod (Mayzent) or Mitoxantrone (Novantrone) may help slow disease progression. Physical and occupational therapy can also improve quality of life and help maintain function.
Neuromyelitis Optica Spectrum Disorder (NMOSD)
Rituximab (Rituxan) or Eculizumab (Soliris) are potential alternatives for treating NMOSD. Early treatment is crucial to prevent long-term damage.
Optic Neuritis
Corticosteroids, such as Methylprednisolone (Medrol), may help reduce inflammation and speed recovery. Regular eye exams and managing underlying conditions like MS are also important for long-term eye health.
Transverse Myelitis
Treatment options for transverse myelitis include corticosteroids and plasma exchange. Physical therapy can also play a key role in improving mobility and strength.
Acute Disseminated Encephalomyelitis (ADEM)
Corticosteroids are often the first line of treatment for ADEM. In some cases, intravenous immunoglobulin (IVIG) or plasma exchange may be used to manage symptoms.
Autoimmune Encephalitis
Treatment for autoimmune encephalitis typically involves corticosteroids, IVIG, or Rituximab (Rituxan). Early intervention is essential to prevent long-term neurological damage.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Common treatments for CIDP include IVIG, corticosteroids, or plasma exchange. Physical therapy can also help maintain muscle strength and improve overall function.
Recent Updates on Ocrelizumab Research
Ongoing research continues to explore the long-term effects and benefits of Ocrelizumab in treating multiple sclerosis and other autoimmune conditions. Recent studies suggest that Ocrelizumab may slow disability progression in patients with primary progressive multiple sclerosis (PPMS), offering hope for those with limited treatment options. Additionally, researchers are investigating whether Ocrelizumab could be effective in treating other autoimmune diseases, such as neuromyelitis optica spectrum disorder (NMOSD).
New studies are also focusing on optimizing Ocrelizumab’s dosing schedule to reduce side effects while maintaining its effectiveness. As more data becomes available, it may lead to improved treatment protocols and better outcomes for patients.
Staying informed about the latest research is important. Be sure to discuss any new findings with your healthcare provider. If you have questions or concerns about your treatment, our telemedicine team is here to offer guidance and support.
