Ocrevus (Ocrelizumab) for Multiple Sclerosis

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Ocrevus (ocrelizumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with relapsing forms of multiple sclerosis (RMS) or primary progressive multiple sclerosis (PPMS).

What Members Say

MHT logo These insights are based on 24,118 comments about Ocrevus from MyMSTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Twice-yearly infusions feel easier to manage than more frequent treatment schedules.
Walking, energy, balance, and brain fog can improve over time.
Premedication at infusion centers helps reduce infusion reactions.

Considerations:

Infusion days take planning and can last several hours, plus observation time.
Infusion reactions may include itching, throat symptoms, flushing, or blood pressure changes.
Infection concerns may include bronchitis, shingles, and respiratory infections.

How Ocrevus Works and How It’s Taken

Ocrevus works by targeting CD20, a protein found on certain B cells in the immune system. It lowers the number of these B cells by helping the body break them down. The exact way it helps in multiple sclerosis is not fully known. But by reducing these immune cells, it may help lower the harmful immune activity that damages the brain and spinal cord.

Doctors prescribe Ocrevus in adults with RMS or PPMS to help slow down the progression of MS. The medication is given as an intravenous infusion, which means it is slowly delivered into a vein over a few hours. Treatment starts with two infusions given two weeks apart. After that, it is given once every six months.

Top Advice From Members on Ocrevus

These insights are based on 24,118 comments about Ocrevus from MyMSTeam members.

Members who use Ocrevus often say it helps to plan ahead for infusion day, keep track of how you feel afterward, and stay in close touch with your neurology team about side effects, infections, and scheduling. Many also say it helps to set realistic expectations, since some people notice benefits quickly, while others say it takes longer or mainly helps keep their MS stable.

1

Plan for a long infusion day and bring comfort items.

“I’m on Ocrevus, plan to be at the infusion center for several hours. I normally take my backpack with snacks, iPad, small blanket. They also provide a pillow and blanket.”
2

Expect to feel tired or have a headache afterward, and take it easy.

“After my first infusion of Ocrevus I had a headache, an out-of-it/light-headed feeling, and extreme fatigue for days. Then, that all got better.”
3

Take simple precautions to avoid infections and illness exposure.

“Skipping Christmas with the extended family. Lots of people sick. I’ll stay home due to lack of immunity. Don’t care though. Rather not get sick!”

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Ocrevus Side Effects

In clinical studies of Ocrevus for RMS and PPMS, the most common side effects occurred in about 10 percent to 49 percent of people. These included:

Upper respiratory tract infections (like colds or sinus infections)
Infusion reactions (symptoms that can happen during the infusion or within 24 hours after)
Skin infections
Lower respiratory tract infections (like bronchitis)

Serious Side Effects and Warnings

Ocrevus can cause serious side effects that require immediate medical attention. These include:

Infusion reactions (can be serious and may require hospitalization)
Serious infections (including herpes infections that can be life-threatening, and hepatitis B virus reactivation)
Progressive multifocal leukoencephalopathy (a rare brain infection that can lead to severe disability or death)
Reduced immunoglobulins (lower antibody levels, which can raise the risk of serious infections)
Increased risk of cancer, including breast cancer
Immune-mediated colitis (inflammation of the colon that can cause new or persistent diarrhea and may be severe)
Liver injury (can cause symptoms like fatigue, nausea, dark urine, or yellowing of the skin or eyes)

Get medical help right away if you think you are having a serious reaction.

How To Save on Ocrevus

Genentech, the manufacturer of Ocrevus, offers the Ocrevus Co-pay Program. Eligible people with commercial insurance could pay as little as $0 per treatment. If you have government insurance or no insurance, the website offers information on other ways to save on your prescription.

To learn more, visit Ocrevus’s financial support page, or call 800-888-2882.

What To Know Before Taking Ocrevus

Before starting Ocrevus, your doctor will test or check for hepatitis B virus, and will check your blood immunoglobulin levels and liver function markers (aminotransferases, alkaline phosphatase, and bilirubin).

You should get any needed vaccines before starting treatment. Get live or live-attenuated vaccines at least four weeks before your first dose. When possible, get non-live vaccines at least two weeks before starting. You should not receive live or live-attenuated vaccines during treatment and after stopping Ocrevus until your B cells have recovered.

Tell your doctor if you have any allergies to ocrelizumab or any ingredients in Ocrevus.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

Also let your doctor know if you have had recent infections, cancer, or liver problems in the past.

Do not take Ocrevus if you have an active hepatitis B infection or if you have had a life-threatening infusion reaction to Ocrevus.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Ocrevus, talk with your doctor about the risks and benefits. If you can become pregnant, use effective birth control while receiving Ocrevus and for six months after your last infusion.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Ocrevus?
In studies of RMS, Ocrevus reduced yearly relapse rates (average number of relapses per year) by 46 percent to 47 percent compared with Rebif over 96 weeks. It also reduced the risk of disability getting worse by 40 percent, and lowered MRI signs of disease activity, including new or growing brain lesions by 77 percent to 83 percent. In a study of PPMS, Ocrevus reduced the risk of disability getting worse by 24 percent, and also reduced the risk of walking getting worse by 25 percent compared with placebo (an inactive treatment) over 120 weeks.

How often is Ocrevus taken for multiple sclerosis?
Ocrevus is given by IV infusion. The starting dose is split into two infusions of 300 milligrams given two weeks apart. After that, it is given as one infusion of 600 milligrams every six months.

What should I do if I miss a dose of Ocrevus for multiple sclerosis?
If you miss a planned infusion, it should be given as soon as possible rather than waiting until the next scheduled dose. After that, the next dose is scheduled six months after the missed dose is given.

What tests or checks are needed before and during treatment with Ocrevus for multiple sclerosis?
Before starting Ocrevus, hepatitis B screening is required, along with blood tests for immunoglobulins, liver enzymes, alkaline phosphatase, and bilirubin. Before every infusion, your care team should check whether you have an active infection, because treatment should be delayed until the infection has resolved. During treatment, immunoglobulin levels should be monitored, and liver blood tests may be done if needed.