Ocrevus (ocrelizumab) is a brand-name biologic solution that’s prescribed for multiple sclerosis and clinically isolated syndrome. As with other drugs, Ocrevus can cause side effects, such as infusion side effects and certain cancers.
Specifically, Ocrevus is approved to treat the following conditions in adults:
- certain types of multiple sclerosis (MS), including:
- active secondary progressive MS (SPMS)
- clinically isolated syndrome (CIS)
Ocrevus belongs to the monoclonal antibody drug class. It’s given by a healthcare professional as an IV infusion.
Read on to learn about potential common, mild, and serious side effects. For a general overview of Ocrevus, including details about its uses, see this article.
Side effects of Ocrevus can vary depending on which condition the drug is used to treat. These are just a few of the more common side effects reported by people who took Ocrevus in clinical trials.
More common side effects in people taking Ocrevus (regardless of the condition being treated) include:
- increased risk for mild herpes infections, such as oral herpes (cold sores) or shingles
- upper or lower respiratory infections,* such as the common cold or pneumonia
- infusion side effects,* such as redness or swelling at the infusion site
- pain in your arms, back, or legs*
Finally, in people taking Ocrevus for primary progressive MS (PPMS), the following side effects were more common:
- skin infections*
* For more information about this side effect, see “Side effect specifics” below.
† Relapsing forms of MS that Ocrevus is used to treat include active secondary progressive MS (SPMS) and relapsing-remitting MS (RRMS).
Mild side effects can occur with Ocrevus. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Ocrevus’s prescribing information.
- herpes infections, such as oral herpes (cold sores) or shingles
- upper or lower respiratory infections,† such as the common cold or pneumonia
- pain in your arms, back, or legs†
Mild side effects in people taking Ocrevus for primary progressive MS (PPMS) include:
- herpes infections, such as oral herpes or shingles
- swelling in your arms or legs
- upper or lower respiratory infections,† such as the common cold or pneumonia
- skin infections†
These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Ocrevus and want to tell the FDA about it, visit MedWatch.
* Relapsing forms of MS that Ocrevus is used to treat include active secondary progressive MS (SPMS) and relapsing-remitting MS (RRMS).
† For more information about this side effect, see the “Side effect specifics” section below.
Ocrevus may cause serious side effects, although this wasn’t very common in clinical trials. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Ocrevus’s prescribing information.
If you develop serious side effects while taking Ocrevus, call your doctor right away. If the side effects seem life threatening, or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects reported with Ocrevus and their symptoms include:
- Colitis (inflammation of the colon). Symptoms can include:
- abdominal pain or cramping
- blood in your stool
- Increased risk of certain infections, including the herpes infection, if you are exposed to the virus. Symptoms of a serious herpes infection can include:
- skin rash
- changes in vision
- eye redness or pain
- persistent or severe headache
- Progressive multifocal leukoencephalopathy (PML). Symptoms can include:
- general weakness that steadily gets worse
- balance issues
- changes to vision
- memory problems and mental slowness
- Reactivation of existing hepatitis B. Symptoms can include:
- jaundice (yellowing of the skin or the whites of your eyes)
- dark urine or stools that are darker than usual
- fatigue or drowsiness
- nausea or vomiting, including vomiting blood
- pain or swelling in the upper-right side of your abdomen
- Infusion side effects.*
- Allergic reaction.*†
* For more information about this side effect, see the “Side effect specifics” section below.
† An allergic reaction is possible after receiving Ocrevus. But this side effect wasn’t reported in clinical trials.
Learn more about some of the side effects that Ocrevus may cause.
Infusion side effects
Infusion side effects can occur during or up to 24 hours after an Ocrevus infusion. This may also be called an infusion reaction.
Examples of infusion side effects that Ocrevus can cause include:
- trouble breathing
- increased heart rate
- skin itchiness or redness
- mouth pain or swelling
Your doctor or another healthcare professional will monitor you for at least 1 hour after you have an Ocrevus infusion. This is to watch for infusion side effects.
What you can do
If you notice symptoms of infusion side effects after an Ocrevus infusion, talk with your doctor right away. Even mild reactions can become serious quickly and may require urgent treatment.
If you experience side effects during an infusion, your infusion may be slowed down or stopped. Depending on how severe your reaction is, your next infusion may be given more slowly, over a longer period. You may also be given other medications before your next infusion to reduce the risk of a reaction. These medications may include Medrol (methylprednisolone) and Tylenol (acetaminophen).
If you have a very severe reaction, your doctor may have you permanently stop Ocrevus treatment and switch to a different medication.
Taking Ocrevus may increase your risk for cancer, including breast cancer. People who took the drug in clinical trials had a higher rate of cancer development than people who took a placebo or a similar drug. (A placebo is a treatment with no active drug.)
What you can do
Based on your risk factors for cancer, your doctor will recommend how often you should be screened for cancer throughout Ocrevus treatment.
Symptoms of cancer vary, depending on the type of cancer. For example, symptoms of breast cancer may include:
- a lump in your breast
- discharge from your nipple
- pain in your breast or nipple
Talk with your doctor about symptoms of cancer that you may need to monitor for while taking Ocrevus.
Upper and lower respiratory infections
Upper and lower respiratory infections are two of the most common side effects reported by people taking Ocrevus in clinical trials. Upper respiratory infections (such as the common cold) were more common than lower respiratory infections (such as pneumonia).
Symptoms of a respiratory infection can include:
Most people who had an upper or lower respiratory infection while taking Ocrevus had mild cases. But in rare cases, these infections can be severe.
What you can do
If you have an active infection before starting Ocrevus, the infection will need to be treated, or you’ll have to wait until it resolves before starting Ocrevus. This includes an upper or lower respiratory infection.
If you develop symptoms of an infection while taking Ocrevus, call your doctor. They’ll likely want to evaluate your symptoms further. If they diagnose an infection, they may prescribe antibiotics to treat it. They may also recommend treatments for any symptoms you’re experiencing.
A simple but effective way to help prevent infection includes washing your hands. You should do this regularly, especially during Ocrevus treatment. For tips on how to properly wash your hands, check out this article.
Skin infections are a possible side effect of Ocrevus. In clinical trials, they were more common when the drug was taken to treat primary progressive multiple sclerosis (PPMS) than when it was used for relapsing forms* of multiple sclerosis (MS) or for clinically isolated syndrome (CIS). But, skin infections may occur in people taking the drug for any type of MS.
Symptoms of a skin infection can include:
- skin that’s warmer than usual
Most people who experienced skin infections while taking Ocrevus had mild cases. But in rare cases, these infections can be severe.
What you can do
If you have symptoms of a skin infection while taking Ocrevus, call your doctor. They may want to examine you. If you do have a skin infection, your doctor may prescribe antibiotics or other treatments.
A simple but effective way to help prevent infection includes handwashing. You should do this regularly. For tips on how to properly wash your hands, check out this article.
Pain in your arms, back, or legs
It’s possible to experience pain in your arms, back, or legs while taking Ocrevus. This was a mild side effect that was somewhat common among people taking the drug in clinical trials.
It’s important to note that pain in your arms, back, or legs can also be a symptom of MS.
What you can do
Call your doctor if you develop any pain in your back, legs, or arms while taking Ocrevus. They may want to see you to help determine the cause of your pain, and they may recommend treatment. The doctor may also have you try a medication other than Ocrevus for your condition.
Symptoms of a reaction can be mild or serious and can include:
- swelling under your skin, typically in your lips, eyelids, feet, or hands
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should continue Ocrevus treatment. But if your symptoms are serious, and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Ocrevus may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
Is weight gain a side effect of Ocrevus?
No, weight gain hasn’t been reported as a side effect in people taking Ocrevus.
However, in clinical trials, some people taking Ocrevus for primary progressive multiple sclerosis (PPMS) reported swelling in their arms and legs. Sometimes, this swelling can cause weight gain. If you experience swelling while taking Ocrevus, talk with your doctor. They may recommend a medication to help treat this side effect.
If you’re concerned about weight gain that isn’t due to swelling, talk with your doctor. They can recommend ways to maintain a weight that’s healthy for you.
Can Ocrevus cause hair loss?
If you have additional questions about Ocrevus and possible effects on your hair, including hair loss, talk with your doctor.
Should I expect joint pain during Ocrevus treatment?
It’s possible that joint pain may occur with Ocrevus.
Joint pain wasn’t reported as a side effect of the drug in clinical trials. However, there have been reports of pain in people taking Ocrevus since the drug was approved. This includes pain in areas that contain joints, such as the arms and legs. For more information about pain with Ocrevus, see the “Side effect specifics” section above.
If you’re having joint pain with Ocrevus, talk with your doctor.
How long do side effects from Ocrevus last?
Most side effects from Ocrevus are mild and go away after a few days. If you experience side effects that don’t go away, call your doctor. They can determine whether Ocrevus is safe or whether you should try a different medication.
Be sure to talk with your doctor about your health history before receiving Ocrevus. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:
Active infection. If you currently have an infection, your doctor will likely treat it before you start Ocrevus treatment. This is because Ocrevus may weaken your immune system. And this can affect how well your body is able to fight infections. Make sure to tell your doctor if you have an infection before you start Ocrevus treatment.
Recent live vaccines. After receiving a live vaccine, wait at least 4 weeks before you start Ocrevus treatment. Live vaccines contain a small amount of weakened live virus or bacteria. Examples include the chickenpox vaccine and the measles, mumps, and rubella vaccine. Ocrevus may weaken your immune system, and live vaccines can cause infection in people with weakened immune systems.
Hepatitis B. If you have a history of hepatitis B, talk with your doctor before starting Ocrevus treatment. If you test positive for hepatitis B, you’ll need treatment before you start Ocrevus. This is because Ocrevus can cause reactivation of existing hepatitis B. And this can lead to serious side effects, such as liver problems. While you receive Ocrevus, your doctor may monitor you more closely if you have a history of hepatitis B.
Allergic reaction. You should not receive Ocrevus treatment if you’ve ever had an allergic reaction to this medication or any of its ingredients. Talk with your doctor about which other treatments are better choices for you.
Alcohol with Ocrevus
There aren’t any known interactions between Ocrevus and alcohol.
If you have questions about drinking alcohol during Ocrevus treatment, talk with your doctor.
Pregnancy and breastfeeding while taking Ocrevus
Below is information about pregnancy and breastfeeding during Ocrevus treatment.
Pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before you start Ocrevus treatment. They’ll likely recommend a treatment other than Ocrevus for you. This is because it isn’t known if Ocrevus is safe to receive during pregnancy.
If you’re pregnant and receiving Ocrevus, you can join a pregnancy registry. This tracks the health of babies born to people who used medications such as Ocrevus during their pregnancy. You can find more information about the registry here.
Breastfeeding. It isn’t known if Ocrevus passes into human breast milk or if the drug may affect a breastfed child. If you’re breastfeeding, talk with your doctor about the best way to feed your child while you’re being treated for multiple sclerosis (MS) or clinically isolated syndrome (CIS).
Side effects from Ocrevus can occur, although they aren’t common. In most cases, side effects that do occur are mild and go away with time.
If you’d like to learn more about Ocrevus, speak with your doctor or pharmacist. They can help answer any questions you have about side effects from this treatment.
Besides talking with your doctor, you can do some research on your own. These articles might help:
- More information about Ocrevus. For details about other aspects of Ocrevus, refer to this article.
- Drug comparison. Learn how Ocrevus compares with Lemtrada and Rituxan.
- Dosage. For information about the dosage of Ocrevus, view this article.
- Cost. To find out about the cost of Ocrevus, see this article.
- A look at MS. For details about multiple sclerosis (MS), refer to our MS hub.
Disclaimer: Medical News Today 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.