Pronunciation: OH-creh-vus
Generic name: ocrelizumab
Dosage form: intravenous infusion, subcutaneous injection
Drug class: CD20 monoclonal antibodies

Medically reviewed by Melisa Puckey, BPharm. Last updated on Oct 7, 2024.

What is Ocrevus infusion?

Ocrevus (ocrelizumab) is a treatment for relapsing and progressive multiple sclerosis (MS) to help reduce relapses and slow disability progression. Ocrevus binds and destroys B cells, which are involved in MS progression. Ocrevus is used for primary progressive MS and relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults. Ocrevus active ingredient is ocrelizumab.

Multiple sclerosis is a disabling condition caused by your immune system mistakenly attacking and damaging the protective cover (myelin sheath) of nerves in your brain, spinal cord, and optic nerves. B cells and T cells are part of the immune system that causes damage to the myelin sheath.

Ocrevus mechanism of action is believed to be binding to proteins (antigens) called CD20 on the outside of  B cells and destroying them. Fewer B cells in the body mean less damage to the nerves which helps to reduce the number of relapses and brain lesions and to slow the progression of disability. B cells, a type of white blood cell, are part of the immune system that causes MS by damaging the myelin sheath.  Ocrevus is a CD20-directed cytolytic antibody.

Ocrevus infusion is given over a couple of hours, and Ocrevus Zunovo is given as an injection under the skin (subcutaneous injection) for approximately 10 minutes. Both are given twice a year as a maintenance dose by your healthcare professional. 

What is Ocrevus used for?

Ocrevus infusion is an MS medicine FDA approved to be used for:

• relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
• primary progressive MS in adults.

Ocrevus received FDA approval in March 2017; it is given as an infusion. Ocrevus Zunovo became FDA-approved on September 13, 2024. It contains ocrelizumab and hyaluronidase and is given as a subcutaneous injection.

Ocrevus Side Effects

Common Ocrevus infusion side effects

When used for RMS, common Ocrevus side effects are infusion reactions and cold symptoms such as stuffy nose, sneezing, and sore throat, which are symptoms of an upper respiratory tract infection.  These occurred in 10% or more patients and greater than Rebif, 

Common Ocrevus side effects when used for PPMS are lower respiratory tract infections, cold symptoms such as stuffy nose, sneezing, and sore throat, which are symptoms of an upper respiratory tract infection, skin infections, and also infusion reactions.  These occurred ≥10% and > placebo).

Serious Ocrevus infusion side effects

Ocrevus may cause serious allergic reactions, including severe allergic reactions, brain infections (progressive multifocal leukoencephalopathy (PML)), other serious infections, Hepatitis B virus (HBV) reactivation, and decreased immunoglobulins.

Get emergency medical help if you have signs of an allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.

Ocrevus may cause a brain infection that can lead to disability or death. Tell your doctor if you have problems with speech, thought, vision, or muscle movement. These symptoms can get worse quickly.

Some side effects may occur during the injection or up to 24 hours later. Tell your caregiver right away if you feel dizzy, tired, nauseated, light-headed, feverish, itchy, warm and tingly, or if you have a skin rash, headache, fast heartbeats, chest tightness, pain or irritation in your throat, or trouble breathing.

Call your doctor at once if you have:

• diarrhea or more frequent bowel movements than usual, or black, tarry, sticky or bloody stools, or stomach pain or tenderness;
• fast heartbeats, tiredness;
• headache, nausea, dizziness;
• itchy skin, rash, hives;
• fever, chills, cough;
• throat pain or irritation;
• wheezing, breathing problem, feeling short of breath;
• flushing (sudden warmth, redness, or tingly feeling);
• skin sores, blisters, pus, or oozing;
• cold sores or fever blisters on or around your lips;
• nerve pain (tingling, burning pain, "pins and needles" feeling);
• mood or behavior changes, confusion, memory problems;
• weakness on one side of your body; or
• problems with speech, vision, or muscle movement.

Your Ocrevus treatments may be delayed or permanently discontinued if you have certain side effects.

These are not all the possible side effects of this medication. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What is the Ocrevus copay card?

With the Ocrevus copay card, you may pay as little as $0, depending on your health insurance plan.  Click on Ocrevus Co-pay Cards and Price Guide for links to the Ocrevus Co-pay Program and the start form.

Warnings

Infusion reactions: Infusion reactions are a side effect of Ocrevus, which can be serious and may require you to be hospitalized. When you receive your Ocrevus infusion you will be monitored for signs and symptoms of an infusion reaction, and infusion will be interrupted or stopped if any symptoms occur, and appropriate supportive treatment will be administered if necessary.

Tell your healthcare provider or nurse if you get any of these symptoms: itchy skin, trouble breathing, nausea, shortness of breath, rash, throat irritation or pain, headache, fatigue, hives, feeling faint, swelling of the throat, fast heartbeat, tiredness, fever, dizziness, coughing or wheezing or redness on your face (flushing), injection site pain, swelling and redness.

Injection reactions can happen during or up to 24 hours after administration. You must call your healthcare provider right away if you get any of the signs or symptoms listed above after each infusion or injection.

Infection: Infections are a common side effect. Ocrevus increase your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. Serious infections can happen with Ocrevus, which can be life-threatening or cause death. Tell your healthcare provider if you have an infection or have any of the following signs of infection, including fever, chills, or a cough that does not go away or painful urination. Signs of herpes infection include: cold sores, shingles, genital sores, skin rash, pain, and itching. Signs of more serious herpes infection include: changes in vision, eye redness or eye pain, severe or persistent headache, stiff neck, and confusion. Signs of infection can happen during treatment or after you have received your last dose of Ocrevus. Tell your healthcare provider right away if you have an infection. Your healthcare provider should delay your treatment with Ocrevus until your infection is gone.

Hepatitis B virus (HBV) reactivation: Before starting treatment with ocrelizumab, your healthcare provider will do blood tests to check for hepatitis B viral infection. If you have ever had hepatitis B virus infection, the hepatitis B virus may become active again during or after treatment with Ocrevus. Hepatitis B virus becoming active again (called reactivation) may cause serious liver problems including liver failure or death. Your healthcare provider will monitor you if you are at risk for hepatitis B virus reactivation during treatment and after you stop receiving Ocrevus.

Weakened immune system: Ocrevus taken before or after other medicines that weaken the immune system could increase your risk of getting infections.

Progressive Multifocal Leukoencephalopathy (PML): PML is a rare brain infection that usually leads to death or severe disability and has been reported with ocrelizumab. Symptoms of PML get worse over days to weeks. It is important that you call your healthcare provider right away if you have any new or worsening neurologic signs or symptoms that have lasted several days, including problems with:

• thinking

• eyesight

• strength

• balance

• weakness on 1 side of your body

• using your arms or legs

Decreased immunoglobulins: Ocrevus may cause a decrease in some types of immunoglobulins. Your healthcare provider will do blood tests to check your blood immunoglobulin levels.

Before receiving this medicine

Before receiving Ocrevus, tell your healthcare provider about all of your medical conditions, including if you:

• have or think you have an infection. See “Warnings”

• have ever taken, take, or plan to take medicines that affect your immune system, or other treatments for MS. These medicines could increase your risk of getting an infection.

• have ever had hepatitis B or are a carrier of the hepatitis B virus.

• have a history of inflammatory bowel disease or colitis.

• have had a recent vaccination or are scheduled to receive any vaccinations.

You should receive any required ‘live’ or ‘live-attenuated’ vaccines at least 4 weeks before you start treatment with Ocrevus. You should not receive ‘live’ or ‘live-attenuated’ vaccines while you are being treated with Ocrevus and until your healthcare provider tells you that your immune system is no longer weakened.

When possible, you should receive any ‘non-live’ vaccines at least 2 weeks before you start treatment with Ocrevus. If you would like to receive any non-live (inactivated) vaccines, including the seasonal flu vaccine, while you are being treated with Ocrevus talk to your healthcare provider.

Pregnancy 

Tell your healthcare provider if you are pregnant, think that you might be pregnant, or plan to become pregnant. It is not known if this medicine will harm your unborn baby. You should use birth control (contraception) during treatment with this medication and for 6 months after your last infusion. Talk with your healthcare provider about what birth control method is right for you during this time.

There is a pregnancy registry for women who take Ocrevus during pregnancy. If you become pregnant while receiving this medication, tell your healthcare provider right away. Talk to your healthcare provider about registering with the Ocrevus Pregnancy Registry. The purpose of this registry is to collect information about your health and your baby's health. Your healthcare provider can enroll you in this registry by calling 1-833-872-4370 or visiting www.Ocrevuspregnancyregistry.com.

If you have a baby and you received Ocrevus during your pregnancy, it is important to tell your baby's healthcare provider about receiving this medication so they can decide when your baby should be vaccinated.

Breastfeeding

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. It is not known if Ocrevus passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take this medication.

Who should not receive Ocrevus?

• Do not receive this medication if you have an active hepatitis B virus (HBV) infection.
• Do not receive this medication if you have had a life-threatening allergic reaction to it. Tell your healthcare provider if you have had an allergic reaction to Ocrevus or any of its ingredients in the past. See "What are the ingredients in Ocrevus?" below for a complete list of ingredients.

​​How should I receive Ocrevus?

• Ocrevus is given through a needle placed in your vein (intravenous (IV) infusion) in your arm.
• Before treatment, your healthcare provider will give you a corticosteroid medicine and an antihistamine to help reduce infusion reactions (make them less frequent and less severe). You may also receive other medicines to help reduce infusion reactions. See the Warnings section.
• Your first full dose of Ocrevus will be given as 2 separate infusions, 2 weeks apart. Each infusion will last about 2 hours and 30 minutes.
• Your next doses of this medication will be given as 1 infusion every 6 months. These infusions will last about 2 hours to 3 hours and 30 minutes depending on the infusion rate prescribed by your healthcare provider.

Ocrevus Dosing information

Ocrevus is given by intravenous infusion

Initial Ocrevus dose: 300 mg intravenous infusion, followed two weeks later by a second 300 mg intravenous infusion

Maintenance Ocrevus doses: 600 mg intravenous infusion every 6 months 

General dosing information:

• Must be diluted before administration.
• You will be monitored closely during and for at least one hour after infusion.
• Before your first treatment you should have hepatitis B virus and quantitative serum immunoglobulin screening 
• Pre-medicate with methylprednisolone (or an equivalent corticosteroid) and an antihistamine (e.g., diphenhydramine) before each infusion.

Related/similar drugs

Tecfidera, Betaseron, Briumvi, Rebif, Ocrevus Zunovo, Extavia, Kesimpta, Avonex, Copaxone, Aubagio

Ocrevus J code and billing codes

Ocrevus J code is J2350

Ocrevus is available as Ocrelizumab 300 mg single-dose vial 

NDC code 50242-150-01 (10 digit) or 50242-0150-01 (11 digit)

Multiple sclerosis ICD-10-CM G35

What happens if I miss a dose?

If you miss a dose of Ocrevus, call your healthcare provider and reschedule your appointment to receive your missed dose as soon as possible. Do not wait until your next planned dose. After you receive your missed dose, reschedule your next dose for 6 months after your missed dose. Ocrevus doses must be separated by a minimum of 5 months.

Interactions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider about other immunosuppressive or immune-modulating drugs that you have taken or are currently taking.

Ocrevus Package Insert 

Review the Ocrevus Package Insert for more detailed information about this medicine. Discuss any medical questions you have with your doctor or other health care provider. This is not all the information you need to know about this medicine for safe and effective use, and it does not take the place of talking to your doctor about your treatment.

Storage

• Store Ocrevus vials at 2°C to 8°C (36°F to 46°F) in the outer carton to protect from light.
• Do not freeze or shake
• Use prepared Ocrevus infusion solution immediately. If not used immediately, store up to 24 hours in the refrigerator at 2°C to 8°C (36°F to 46°F) and 8 hours at room temperature up to 25°C (77°F), which includes infusion time. In the event an intravenous infusion cannot be completed the same day, discard the remaining solution.

Keep out of sight and reach of children.

What are the ingredients in Ocrevus?

Active ingredient: ocrelizumab.

Inactive ingredients: glacial acetic acid, polysorbate 20, sodium acetate trihydrate, trehalose dihydrate.

Company

Ocrevus is manufactured by: Genentech, Inc., A Member of the Roche Group, 1 DNA Way, South San Francisco, CA 94080-4990.

Ocrevus and Ocrevus Zunovo are manufactured by: Genentech, Inc., A Member of the Roche Group, 1 DNA Way, South San Francisco, CA 94080-4990.

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