Ocrevus (ocrelizumab) is a prescription drug that’s used to manage certain types of multiple sclerosis. Ocrevus comes as an intravenous (IV) infusion.

Ocrevus is used in adults to treat the following types of multiple sclerosis (MS):

To learn more about Ocrevus’s uses, see the “What is Ocrevus used for?” section below.

Like most drugs, Ocrevus may cause mild or serious side effects. The lists below describe some of the more common side effects that Ocrevus may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Ocrevus. They can suggest ways to help reduce side effects. For more information, you can also see this in-depth article.

Mild side effects

Below are short lists of some of the mild side effects that Ocrevus can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the Ocrevus prescribing information.

Some mild side effects of Ocrevus have been seen mostly in people with relapsing-remitting multiple sclerosis. This is multiple sclerosis (MS) with periods of both remission and relapse. These side effects include:

And some mild side effects of Ocrevus have been seen mostly in people with primary progressive MS (PPMS), a rare form of MS. These side effects include:

Other mild side effects that may occur with Ocrevus include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ocrevus can occur, but they aren’t common. If you have serious side effects from Ocrevus, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that have been reported with the use of Ocrevus include:

* For more information on this side effect, see the “Side effect focus” section below.
† PML was not reported in studies of Ocrevus, but has been reported since the drug was approved.

Side effect focus

Learn more about some of the side effects Ocrevus may cause.

Infusion side effects

You might experience side effects from the infusion process after receiving an Ocrevus dose. This was a common side effect in clinical studies of the drug. Most infusion side effects reported from Ocrevus were mild. But in rare cases, serious reactions can occur.

You may have infusion side effects up to 24 hours after your Ocrevus dose. You’re more likely to experience this side effect after your first few doses of Ocrevus than after later doses.

Infusion side effects can include:

Your doctor will monitor you for infusion side effects for at least 1 hour after your Ocrevus infusion.

What might help

Tell your doctor right away if you have any infusion side effects from Ocrevus. These could be life threatening if untreated.

If you have infusion side effects from Ocrevus, your doctor may slow your Ocrevus infusion. This can help lower your risk of this reaction.

Your doctor may also prescribe other drugs with Ocrevus to help lower your risk of infusion side effects. They’ll give you doses of these drugs about 30 to 60 minutes before each Ocrevus infusion.

You’ll likely be given a corticosteroid, such as methylprednisolone (Medrol), and an antihistamine, such as diphenhydramine (Benadryl). If you have a fever after your Ocrevus injection, you may also be given acetaminophen (Tylenol) or another drug to help lower your temperature.

Upper respiratory infection

Upper respiratory infections (URIs), such as the common cold, might occur after receiving Ocrevus. URIs were a common side effect in clinical studies of the drug.

URIs can cause symptoms such as:

  • cough
  • mucus production
  • runny or stuffy nose
  • sneezing

What might help

Talk with your doctor about any URI symptoms you have while receiving Ocrevus. They can suggest ways to help relieve these side effects.

Home remedies, such as honey and ginger, may help relieve URI symptoms.

Over-the-counter (OTC) medications may also be helpful, but make sure to talk with your doctor before starting any new medications.

Examples of OTC drugs and the symptoms they relieve include:

  • dextromethorphan (Robitussin DM) for cough
  • guaifenesin (Mucinex) for mucus production
  • antihistamines, such as loratadine (Claritin) and cetirizine (Zyrtec), for sneezing or runny nose
  • decongestants, such as oxymetazoline (Afrin) and pseudoephedrine (Sudafed), for stuffy nose

Fatigue

You may have fatigue after receiving your Ocrevus infusion. If you experience fatigue, it will likely be an infusion-related side effect.

Aside from lack of energy, other symptoms of fatigue may include:

  • sore muscles
  • mood changes
  • blurred vision
  • trouble concentrating
  • loss of motivation

What might help

If you have questions about how to manage fatigue while receiving Ocrevus, talk with your doctor. For more information and to learn what might help, see the “Infusion side effects” section above.

Allergic reaction

For some people, Ocrevus can cause an allergic reaction.

But this side effect wasn’t reported in the drug’s studies.

In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

What might help?

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Ocrevus.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Ocrevus, they may have you switch to a different treatment.

Ocrevus is prescribed to treat certain types of multiple sclerosis (MS) in adults, as well as clinically isolated syndrome.

MS is a condition that causes your immune system to attack the protective covering of your brain and spinal cord. This can cause swelling in your brain and spinal cord, which interrupts the communication between your brain and body.

Below are brief descriptions of each condition Ocrevus is used to treat.

  • Clinically isolated syndrome (CIS): With CIS, you experience MS symptoms for at least 24 hours. Although CIS is usually the first sign of MS, it often occurs before an official MS diagnosis.
  • Relapsing-remitting MS: Relapsing-remitting MS has repeated episodes of relapse (worsened MS symptoms) and remission (no MS symptoms).
  • Active secondary progressive MS: Active secondary progressive MS usually starts as relapsing-remitting MS. But over time, your MS symptoms continue to worsen.
  • Primary progressive MS (PPMS): If you have PPMS, you have continued worsening MS symptoms without ever having periods of remission.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and where you receive your infusion.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Ocrevus manufacturer’s website to see if it has support options.

You can also see this article for details about the cost of Ocrevus treatment.

Ocrevus is prescribed to treat certain types of multiple sclerosis (MS) in adults. MS causes your immune system to attack the protective covering of your brain and spinal cord. This can cause swelling in your brain and spinal cord, which interrupts the communication between your brain and body.

Ocrevus works by lowering the number of B cells (a type of white blood cell) in your body. This lessens the activity of your immune system and relieves your MS symptoms.

If you have questions about how Ocrevus works, talk with your doctor or pharmacist.

Find answers to some commonly asked questions about Ocrevus.

Is Ocrevus a chemotherapy or immunosuppressant drug?

Ocrevus isn’t a type of chemotherapy, but it is an immunosuppressant drug.

Chemotherapy works by destroying cells that grow more rapidly than healthy cells, such as cancer cells. Immunosuppressant drugs work by lessening the activity of your immune system.

Ocrevus is a type of immunosuppressant called a monoclonal antibody. The drug specifically works by lowering the number of B cells (a type of white blood cell) in your body. This can help relieve your multiple sclerosis (MS) symptoms.

Does Ocrevus cause hair loss?

It isn’t likely. Hair loss wasn’t a side effect reported in clinical studies of the drug.

However, other drugs used to treat MS can cause hair loss, such as azathioprine (Imuran) and methotrexate (Trexall).

If you have hair loss while receiving Ocrevus, talk with your doctor. They can help you determine the cause of your hair loss and can suggest ways to prevent it.

Will I have weight gain or weight loss with Ocrevus?

Weight gain and weight loss weren’t side effects reported in clinical studies of Ocrevus. But keep in mind that weight changes can be a symptom of MS.

If you experience weight gain or weight loss while receiving Ocrevus, talk with your doctor. They can suggest healthy ways to manage your weight.

Does Ocrevus increase the risk of cancer, such as breast cancer?

In rare cases, Ocrevus may increase your risk of certain cancers, such as breast cancer. In clinical studies of Ocrevus, some people who took the drug had an increased risk of breast cancer.

Be sure to follow breast cancer screening guidelines while receiving Ocrevus. Tell your doctor right away if you have any breast pain or lumps, or if you have nipple discharge. Your doctor will perform tests to check your condition.

You may wonder how Ocrevus compares to Kesimpta, which is also prescribed to treat certain types of multiple sclerosis (MS). To learn about the similarities and differences between these drugs, see the following chart:

OcrevusKesimpta
Active drugocrelizumabofatumumab
Formliquid solution given as an
intravenous (IV) infusion (an
injection that’s given slowly into your vein over time)		liquid solution given as an injection under your skin
Usestreating the following conditions in adults:
• active secondary progressive MS
• primary progressive MS
• relapsing-remitting MS
• clinically isolated syndrome		treating the following conditions in adults:
• active secondary progressive MS
• relapsing-remitting MS
• clinically isolated syndrome

Ocrevus and Kesimpta generally cause similar side effects, including upper respiratory tract infection and reactions to the injections. These drugs can cause some different side effects, as well.

If you’d like more details about Ocrevus and other similar medications, talk with your doctor. They can recommend the best treatment for you.

Before receiving Ocrevus, it’s important to talk with your doctor about other medical conditions you have. This includes any recent infections you’ve had. You should also tell them if you’ve had any problems receiving Ocrevus in the past. These and other important considerations are discussed below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before receiving Ocrevus, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Ocrevus.

Interactions with drugs or supplements

Ocrevus can interact with several types of drugs. These drugs include:

This list does not contain all types of drugs that may interact with Ocrevus. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with the use of Ocrevus.

Other interactions

Make sure your vaccinations are up to date before receiving Ocrevus. Talk with your doctor about any vaccines you may need.

During treatment with Ocrevus, you should not receive live vaccines. Live vaccines are made from a weakened form of the virus or bacteria the vaccine is meant to protect you from. Ocrevus can weaken your immune system. So receiving live vaccines while being treated with Ocrevus can raise your risk of getting an infection from the vaccine. You should wait at least 4 weeks after having a live vaccine before receiving Ocrevus.

Examples of live vaccines include the intranasal flu (FluMist) and measles, mumps, rubella (MMR) vaccines.

It isn’t known whether it’s safe to have non-live vaccines while receiving Ocrevus. For this reason, you should wait at least 2 weeks after having a non-live vaccine to start Ocrevus treatment, if possible.

Examples of non-live vaccines include the COVID-19 vaccine and flu shots.

Warnings

Ocrevus may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you receive Ocrevus. Factors to consider include those in the list below.

  • Active infection: Before starting Ocrevus treatment, tell your doctor about any infections you have. Your body won’t be able to fight an infection as well as before once you start receiving Ocrevus. So your doctor will want to make sure your infection is treated before you receive Ocrevus.
  • Hepatitis B: Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). Make sure to tell your doctor if you have hepatitis B or have had it in the past. Before starting Ocrevus, your doctor will test you for HBV. If you have an active hepatitis B infection, your doctor will treat it before starting Ocrevus or recommend another treatment for your multiple sclerosis (MS). This is because the drug can lower your body’s ability to fight an active hepatitis B infection, which could lead to serious liver damage.
  • Allergic reaction: If you’ve had an allergic reaction to Ocrevus or any of its ingredients, you should not receive Ocrevus. Ask your doctor what other medications are better options for you.
  • Recent live vaccination: You should not start Ocrevus treatment if you’ve had a live vaccine in the past 4 weeks. Ocrevus can weaken your immune system. And receiving live vaccines while receiving Ocrevus can raise your risk of getting an infection from the vaccine. For more information, see the “What should be considered before receiving Ocrevus?” section above.
  • Inflammatory bowel disease (IBD) or colitis: Rarely, treatment with Ocrevus can cause colitis (inflammation of the colon). If you have existing IBD or colitis, talk with your doctor. Receiving Ocrevus infusions could worsen symptoms of your condition. Your doctor will let you know whether Ocrevus is safe to receive with your condition.

Use with alcohol

There aren’t any known issues with drinking alcohol while receiving Ocrevus.

Talk with your doctor about the amount of alcohol that’s safe for you to drink while receiving Ocrevus.

Pregnancy and breastfeeding

It’s not known whether it’s safe for you to receive Ocrevus during pregnancy or while breastfeeding. If you’re pregnant, breastfeeding, or planning to become pregnant or breastfeed while receiving Ocrevus, talk with your doctor. They can discuss other treatment options with you.

Your doctor will recommend the dosage of Ocrevus that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Form and strength

Ocrevus comes as a liquid solution inside a single-dose vial. It comes in one strength: 30 milligrams (mg) of the active ingredient per milliliter (mL) of solution.

Each single-dose vial contains 300 mg of Ocrevus in 10 mL of solution.

Recommended dosage

Your first two doses of Ocrevus will be starter doses. Your first starter dose will be a 300-mg infusion given over at least 2.5 hours. Your second starter dose will be the same and will be given 2 weeks later.

After receiving two starter doses, you’ll get one infusion of Ocrevus every 6 months. Each infusion will be 600 mg. Your Ocrevus infusion will likely take either 2 hours or 3.5 hours. But it could take longer, depending on how well your body tolerates your first few doses.

You can refer to this article for more information about the common dosages of Ocrevus.

Receiving Ocrevus

A healthcare professional will give you each dose of Ocrevus as an intravenous (IV) infusion. (This is an injection that’s given slowly into a vein over time.)

You won’t give yourself doses of Ocrevus. However, you may be able to receive your Ocrevus infusions at home. Talk with your doctor about whether it’s best to receive your infusions in a doctor’s office, clinic, infusion center, or at home.

Receiving Ocrevus with other drugs

To help lower your risk of side effects from Ocrevus, your doctor may prescribe other drugs along with it. They’ll give you doses of these drugs about 30 to 60 minutes before each Ocrevus infusion.

You’ll likely be given a corticosteroid, such as methylprednisolone (Medrol), and an antihistamine, such as diphenhydramine (Benadryl). These medications help lower your risk of infusion side effects.

If you have a fever after your Ocrevus injection, you may also be given acetaminophen (Tylenol) or another drug to help lower your temperature.

Questions about receiving Ocrevus

The following are answers to some common questions about receiving Ocrevus.

  • What if I miss a dose of Ocrevus? If you miss an appointment to receive your Ocrevus infusion, call your doctor right away to reschedule. After getting your missed dose, you’ll have to wait at least 5 months before getting your next infusion. Your doctor will adjust your dosing schedule if needed.
  • Will I need to use Ocrevus long term? Yes, you’ll probably use Ocrevus long term. But talk with your doctor about how long you should use the drug.
  • How long does Ocrevus take to work? Ocrevus starts working right away after you receive your first dose. But it may take several doses before your symptoms start to ease.
Questions for your doctor

You may have questions about Ocrevus and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will Ocrevus affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

If you have questions about receiving Ocrevus for multiple sclerosis (MS), talk with your doctor or pharmacist.

You may want to ask your doctor about other treatments for MS, such as rituximab (Rituxan) or alemtuzumab (Lemtrada). Below is a list of articles you might find helpful:

Here are a few other questions you may want to ask your doctor about Ocrevus:

  • Can I receive my Ocrevus infusions at home?
  • How long will Ocrevus stay in my system?
  • Should I use other MS treatments while receiving Ocrevus?
  • What should I expect after getting an Ocrevus infusion?

To learn more about Ocrevus, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

Should I get the COVID-19 vaccine if I’m receiving Ocrevus to treat my multiple sclerosis (MS)?

Anonymous

A:

Yes, if possible.

It’s recommended that you receive the COVID-19 vaccine at least 2 weeks before you start Ocrevus. But if you’re already receiving Ocrevus, you can still get the COVID-19 vaccine. Although it hasn’t been studied, it’s possible that Ocrevus may decrease how well the COVID-19 vaccine works. Your doctor can tell you more.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline 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.

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