Ocrelizumab (intravenous route)


    Brand Name

    US Brand Name

    Ocrevus


    Description

    Ocrelizumab injection is used to treat the relapsing forms (including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease) or primary progressive forms of multiple sclerosis (MS). This medicine will not cure MS, but it may slow some of the disabling effects and decrease the number of relapses of the disease.

    This medicine is to be given only by or under the direct supervision of your doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of ocrelizumab injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies on the relationship of age to the effects of ocrelizumab injection have not been performed in the geriatric population. However, geriatric-specific problems that would limit the usefulness of ocrelizumab injection in the elderly are not expected.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Adenovirus Vaccine Type 4, Live
    • Adenovirus Vaccine Type 7, Live
    • Bacillus of Calmette and Guerin Vaccine, Live
    • Cholera Vaccine, Live
    • Dengue Tetravalent Vaccine, Live
    • Influenza Virus Vaccine, Live
    • Measles Virus Vaccine, Live
    • Mumps Virus Vaccine, Live
    • Poliovirus Vaccine, Live
    • Rotavirus Vaccine, Live
    • Rubella Virus Vaccine, Live
    • Smallpox Vaccine
    • Typhoid Vaccine, Live
    • Varicella Virus Vaccine, Live
    • Yellow Fever Vaccine
    • Zoster Vaccine, Live

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Cancer or
    • Weak immune system—Use with caution. May increase risk for more serious side effects.
    • Hepatitis B infection, active or
    • Infusion reaction, history of—Should not be used in patients with this condition.
    • Hepatitis B infection, history of—Use with caution. May make this condition worse.
    • Infection (eg, bacterial, fungal, parasitic, viral), active—Should be treated first before receiving this medicine.

    Proper Use

    A nurse or other trained health professional will give you this medicine in a medical facility. It is given through an IV catheter that is placed into one of your veins.

    You will receive your first dose of this medicine in 2 doses, given at least 2 weeks apart. Each infusion is given for at least 2 hours and 30 minutes. You will receive your next doses as 1 infusion every 6 months. These infusions are given for at least 2 hours or 3 hours and 30 minutes. Your doctor will decide how long you will receive the infusion.

    Your doctor may give you other medicines (eg, allergy medicine, fever medicine, steroid) before each infusion of this medicine to prevent unwanted effects. Your doctor may also want you to stay for at least 1 hour after infusion to check for unwanted effects.

    This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

    Missed Dose

    This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.


    Precautions

    It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.

    This medicine may cause a rare but serious type of an allergic reaction called an infusion reaction. This can be life-threatening and requires immediate medical attention. Tell your doctor right away if you start to have a cough, difficulty with swallowing, sore throat, dizziness, headache, nausea, fast heartbeat, trouble breathing, chest tightness, swelling in your face or hands, fever, chills, skin itching, redness, rash, or hives, lightheadedness or faintness, or unusual tiredness or weakness while you are receiving this medicine.

    Receiving this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for 6 months after the last dose. If you think you have become pregnant while receiving this medicine, tell your doctor right away.

    This medicine may increase your risk of developing serious infections (eg, bacterial, fungal, parasitic, viral). Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.

    Check with your doctor right away if you have ear congestion, chills, cough, chest tightness, fever, sneezing, sore throat, body aches or pain, headache, loss of voice, runny or stuffy nose, unusual tiredness or weakness, or trouble breathing. These could be symptoms of a lung infection.

    This medicine may increase your risk for herpes infection. Tell your doctor right away if you have a fever, blistering, burning, crusting, irritation, itching, reddening, stinging, or swelling of the skin, painful cold sores, or blisters on the lips, nose, eyes, genitals, or trunk of the body, skin rash, pain, or itching, changes in vision, confusion, eye pain or redness, headache, or stiff neck.

    Check with your doctor if you have weakness on one side of the body, clumsiness, blurred vision, changes in thinking, memory problems, confusion, or personality changes. These could be symptoms of a serious and rare brain infection called progressive multifocal leukoencephalopathy (PML).

    This medicine may cause hepatitis B virus reactivation. Tell your doctor right away if you have any symptoms of liver problems, such as yellow skin or eyes, dark brown-colored urine, right-sided stomach pain, fever, or severe tiredness.

    While you are being treated with ocrelizumab, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. You may receive live or live-attenuated vaccines at least 4 weeks or non-live vaccines at least 2 weeks before starting this medicine. Ocrelizumab may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

    Using this medicine may increase your risk of getting cancer (eg, breast cancer). Talk to your doctor if you have concerns about this risk.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Back pain
    • bloating or swelling of the face, arms, hands, lower legs, or feet
    • blurred vision
    • body aches or pain
    • chest tightness
    • chills
    • confusion
    • cough
    • difficulty with breathing
    • dizziness
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • ear congestion
    • fast, pounding, or irregular heartbeat or pulse
    • feeling of warmth
    • fever
    • headache
    • hives, itching, or skin rash
    • loss of voice
    • nausea
    • pain, redness, swelling, tenderness, or warmth on the skin
    • rapid weight gain
    • redness of the face, neck, arms, and occasionally, upper chest
    • runny or stuffy nose
    • sneezing
    • sore throat
    • sweating
    • tingling of the hands or feet
    • unusual tiredness or weakness
    • unusual weight gain or loss
    • vomiting

    Less common

    • Burning or stinging of the skin
    • painful blisters on the trunk of the body
    • painful cold sores or blisters on the lips, nose, eyes, or genitals

    Incidence not known

    • Eye pain or redness
    • mental changes
    • stiff neck

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Diarrhea
    • discouragement
    • feeling sad or empty
    • irritability
    • lack of appetite
    • loss of interest or pleasure
    • trouble concentrating
    • trouble sleeping

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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