Why is this medication prescribed?

Ocrevus (ocrelizumab) is a medication that is prescribed for the treatment of certain autoimmune conditions, specifically relapsing forms of multiple sclerosis (MS) and primary progressive multiple sclerosis (PPMS). It is an immunomodulatory drug that helps to reduce the frequency and severity of MS relapses and slows down the progression of disability in both relapsing and progressive forms of the disease.

Ocrevus is a monoclonal antibody that targets a specific protein called CD20, which is found on the surface of certain immune cells called B cells. By binding to CD20, Ocrevus depletes the B cells from the bloodstream, leading to a reduction in the immune response that contributes to the damage of the myelin sheath, which is the protective covering of nerve fibers in the central nervous system. This helps to prevent inflammation and the subsequent destruction of myelin, which are hallmarks of multiple sclerosis.

For relapsing forms of MS, Ocrevus is used to reduce the frequency of relapses, delay the accumulation of disability, and decrease the number of new or enlarging lesions in the brain or spinal cord detected by magnetic resonance imaging (MRI). It is typically prescribed for individuals who have experienced relapses or have evidence of new or active lesions despite using other disease-modifying therapies.

In the case of primary progressive MS, which is characterized by a gradual worsening of symptoms without distinct relapses, Ocrevus is the first and currently the only medication approved for this form of the disease. It aims to slow down the progression of disability and reduce the accumulation of lesions seen on MRI scans.

How should this medicine be used?

Ocrevus (ocrelizumab) is administered as an intravenous infusion, which means it is given directly into the bloodstream through a vein. The infusion is typically performed in a healthcare setting, such as a clinic or hospital, by a trained healthcare professional. Here is a general guideline on how Ocrevus is used:

• Dosage: The standard dosage of Ocrevus for multiple sclerosis treatment is 600 mg given every 6 months.
• Pre-medication: Before starting the infusion, your healthcare provider may administer medications such as corticosteroids, antihistamines, and/or acetaminophen to help minimize potential infusion-related reactions. These pre-medications are typically given shortly before the infusion.
• Infusion process: The Ocrevus infusion is typically given over a span of several hours. The exact duration may vary depending on factors such as your tolerance and the specific protocol followed by your healthcare provider. The first infusion is usually divided into two separate doses, given two weeks apart. Subsequent infusions are given as a single dose every 6 months.
• Monitoring: During the infusion, healthcare professionals will closely monitor your vital signs and watch for any signs of adverse reactions or side effects. They may also conduct periodic blood tests to assess your response to the medication and ensure your safety.
• Follow-up appointments: After each infusion, you may be scheduled for follow-up appointments to assess your treatment progress, monitor your disease activity, and discuss any concerns or questions you may have.

It is crucial to follow your healthcare provider’s instructions and attend all scheduled appointments to ensure the safe and effective use of Ocrevus. If you have any questions or concerns about the administration or usage of Ocrevus, it is best to consult with your healthcare provider for personalized guidance and advice.

Other uses for this medicine

Ocrevus (ocrelizumab) is primarily approved for the treatment of multiple sclerosis (MS), specifically relapsing forms of MS and primary progressive MS. However, it is important to note that Ocrevus is a prescription medication, and its use should be guided by a healthcare professional. While it is primarily used for MS, off-label use of medications may occur in certain cases. Off-label use refers to using a medication for a purpose not specifically approved by regulatory authorities.

What special precautions should I follow?

As for special precautions associated with Ocrevus, here are some important considerations:

• Infections: Ocrevus can increase the risk of infections, including respiratory tract infections and herpes viral infections. Before starting Ocrevus, it is essential to inform your healthcare provider about any current infections or a history of recurring infections. It is also important to report any signs of infection, such as fever, cough, or urinary symptoms, during treatment.
• Vaccinations: It is generally recommended to complete all necessary vaccinations before starting treatment with Ocrevus, as it can affect the body’s immune response to vaccines. Live or live-attenuated vaccines should be avoided during treatment and for at least six months after the last Ocrevus infusion.
• Pre-existing medical conditions: Inform your healthcare provider about any pre-existing medical conditions, including infections, liver problems, and compromised immune function. Ocrevus may not be suitable or require extra caution in certain situations.
• Allergic reactions: Some individuals may experience allergic reactions during or after the Ocrevus infusion. Signs of an allergic reaction may include hives, itching, swelling, dizziness, or difficulty breathing. It is crucial to inform your healthcare provider immediately if you experience any of these symptoms.
• Pregnancy and breastfeeding: The safety of Ocrevus during pregnancy or breastfeeding has not been established. If you are pregnant, planning to become pregnant, or breastfeeding, it is essential to discuss the potential risks and benefits of Ocrevus with your healthcare provider.
• Other medications: It is important to inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements. Some medications may interact with Ocrevus and require adjustment of dosages or monitoring.

Remember, these precautions are general guidelines, and it is crucial to consult with your healthcare provider for personalized advice and information specific to your situation. They can assess your individual circumstances and provide you with the most accurate and up-to-date guidance regarding the use of Ocrevus.

What special dietary instructions should I follow?

There are no specific dietary instructions associated with the use of Ocrevus (ocrelizumab). Generally, you can continue with your regular diet while undergoing treatment. However, it’s always a good idea to maintain a healthy and balanced diet to support overall well-being and immune system function.

What should I do if I forget a dose?

Regarding missed doses of Ocrevus, it’s important to note that Ocrevus is administered as an intravenous infusion typically given every 6 months. The medication is delivered under the supervision of healthcare professionals. Therefore, you do not have to worry about missing a dose or self-administering it at home.

What side effects can this medication cause?

Ocrevus (ocrelizumab) may cause various side effects in some individuals. It’s important to note that not everyone experiences side effects, and their severity can vary. Common side effects of Ocrevus include:

• Infusion reactions: Infusion reactions are the most common side effects of Ocrevus. These reactions can occur during or within 24 hours after the infusion. Symptoms may include rash, itching, hives, fever, fatigue, headache, dizziness, nausea, throat irritation, or difficulty breathing. Healthcare professionals closely monitor patients during the infusion to manage these reactions.
• Infections: Ocrevus may increase the risk of infections, including upper respiratory tract infections, urinary tract infections, and herpes viral infections. If you experience symptoms of an infection, such as fever, cough, pain or burning during urination, or cold sores, it’s important to notify your healthcare provider.
• Progressive Multifocal Leukoencephalopathy (PML): PML is a rare and serious viral infection of the brain that can occur with Ocrevus or other immunosuppressive medications. Symptoms may include progressive weakness on one side of the body, clumsiness, vision problems, confusion, and changes in thinking or personality. If you experience any of these symptoms, it is crucial to seek immediate medical attention.
• Reactivation of hepatitis B virus: Ocrevus may lead to the reactivation of hepatitis B virus in individuals who have had a prior infection. Regular monitoring for hepatitis B infection is necessary during treatment.
• Other side effects: Additional side effects that have been reported with Ocrevus include respiratory tract infections, skin infections, infusion-related skin reactions, low blood cell counts (such as low white blood cell or low platelet counts), and an increased risk of certain types of cancers.

It’s important to discuss potential side effects with your healthcare provider before starting Ocrevus. They will monitor your condition and address any concerns you may have. If you experience any side effects or have questions during your treatment, it is advisable to contact your healthcare provider for guidance and appropriate management.

What should I know about storage and disposal of this medication?

• Storage: Ocrevus is typically stored and handled by healthcare professionals in healthcare settings. As a patient, you do not need to store Ocrevus at home. The medication will be prepared and administered during your scheduled infusions.
• Disposal: Proper disposal of medical waste, including empty vials or any other materials used during the infusion, should be handled according to local regulations and guidelines. It is recommended to consult with your healthcare provider or the facility where you receive your infusions for specific instructions on how to dispose of any medical waste associated with Ocrevus.

In case of emergency/overdose

• Emergency situations: In case of an emergency, such as a severe allergic reaction or a medical emergency during the Ocrevus infusion, it is crucial to seek immediate medical assistance by calling your local emergency services or going to the nearest emergency room.
• Overdose: Since Ocrevus is administered by healthcare professionals during infusions, the risk of an overdose is low. However, if you suspect an overdose or have concerns related to the administration of the medication, it is important to contact your healthcare provider or the facility where you receive your infusions for guidance.

What other information should I know?

• Regular monitoring: While on Ocrevus, your healthcare provider will conduct regular monitoring to assess the effectiveness of the treatment, monitor your disease activity, and manage any potential side effects. It is important to attend all scheduled appointments and follow their recommendations for monitoring and follow-up care.
• Informing healthcare providers: Make sure to inform all healthcare providers involved in your care, including dentists and specialists, that you are receiving treatment with Ocrevus. This is important for them to have a comprehensive understanding of your medical history and ongoing treatments.
• Medication interactions: It’s important to inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements. Some medications may interact with Ocrevus, and your healthcare provider can provide guidance on potential interactions and adjust dosages if needed.
• Keep a record: It can be helpful to keep a record of your Ocrevus infusions, including dates, dosages, and any notable side effects or changes in your symptoms. This information can assist both you and your healthcare provider in monitoring your treatment progress and managing your condition effectively.

As always, it is essential to follow your healthcare provider’s instructions and communicate any concerns or questions you may have regarding the storage, administration, or usage of Ocrevus. They are in the best position to provide personalized advice and address any specific considerations related to your treatment.