Ocrevus Zunovo (ocrelizumab/hyaluronidase-ocsq) is a prescription drug that’s used to treat certain forms of multiple sclerosis (MS). Ocrevus Zunovo comes as a solution for injection under the skin. A healthcare professional gives it by infusion.
Ocrevus Zunovo is prescribed for adults to treat the following conditions:
- relapsing forms of multiple sclerosis (MS), which include:
- clinically isolated syndrome (which does not necessarily lead to MS)
- relapsing-remitting MS
- active secondary progressive MS
- primary progressive MS
To learn more about Ocrevus Zunovo’s uses, see the “What is Ocrevus Zunovo used for?” section.
Ocrevus Zunovo basics
Ocrevus Zunovo contains the active ingredients ocrelizumab and hyaluronidase-ocsq.
Ocrevus Zunovo is a biologic medication. A biologic is made from parts of living organisms. It’s available only as a brand-name drug. It isn’t available in a biosimilar form.
Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
Ocrevus Zunovo is used to treat the following conditions in adults:
- relapsing forms of multiple sclerosis (MS), which include:
- clinically isolated syndrome (which does not necessarily lead to MS)
- relapsing-remitting MS
- active secondary progressive MS
- primary progressive MS
MS is an autoimmune condition that affects the central nervous system (CNS). The CNS includes the spinal cord and brain. In people with MS, their immune system causes damage to nerves. This leads to inflammation that causes disruptions in communication signals between the CNS and the rest of the body.
MS may cause symptoms such as:
- loss of coordination
- fatigue (lack of energy)
- muscle weakness
It’s not fully known how Ocrevus Zunovo works to treat MS. But it’s thought that the drug targets certain cells of the immune system that damage nerves. In doing so, Ocrevus Zunovo may help reduce inflammation, and that may help ease symptoms of MS.
Like most drugs, Ocrevus Zunovo may cause mild to serious side effects. The lists below contain some of the more common side effects Ocrevus Zunovo may cause. But they don’t include all side effects possible.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor can tell you more about the potential side effects of Ocrevus Zunovo. They can also suggest ways to help reduce side effects.
Mild side effects
Mild side effects of Ocrevus Zunovo that have been reported include:
- mild reactions around the infusion site, such as pain, swelling, or discolored skin
- mild infection, such as a respiratory tract infection or a herpes-related infection
- cough
- diarrhea
- pain in the back, arms, or legs
- peripheral edema (buildup of fluid in the arms or legs)
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor.
To learn about other mild side effects, talk with your doctor or read Ocrevus Zunovo’s prescribing information (package insert).
Serious side effects
Serious side effects from Ocrevus Zunovo can occur, but they aren’t common. If you have serious side effects from Ocrevus Zunovo, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Ocrevus Zunovo that have been reported include:
- infusion reactions
- serious infection, including progressive multifocal leukoencephalopathy
- depression
- low level of immunoglobulins (a type of protein)
- colitis (inflammation of the colon)
- increased risk of cancer, including breast cancer
ALLERGIC REACTIONFor some people, Ocrevus Zunovo 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.
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. They also can determine whether you should keep receiving Ocrevus Zunovo.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
Your doctor can confirm whether you’ve had a serious allergic reaction to Ocrevus Zunovo. If they do, they may have you switch to a different treatment.
Your doctor will recommend the dosage of Ocrevus Zunovo that’s right for you. Below are commonly used dosages, but your doctor will determine the right dosage for you.
Form and strength
Ocrevus Zunovo comes as a liquid solution that’s given as an injection under your skin.
It’s available in one strength: 920 milligrams (mg) of ocrelizumab and 23,000 units of hyaluronidase per 23 milliliters (mL) of solution. This means 1 mL of solution contains 40 mg ocrelizumab and 1,000 units of hyaluronidase.
Recommended dosage
The recommended dosage of Ocrevus Zunovo is 920 mg ocrelizumab and 23,000 units of hyaluronidase once every 6 months.
How to receive
Your doctor will explain Ocrevus Zunovo administration, how much you’ll be given, and how often. The drug will be given to you by a healthcare professional.
Before each infusion
- Your doctor will assess whether you have any infection. If you do, they may delay your dose until the infection clears.
- You’ll receive oral medication (usually dexamethasone) and an antihistamine (such as desloratadine). You’ll receive these at least 30 minutes prior to your Ocrevus Zunovo dose. These two medications will help reduce your risk of reaction to the infusion. Your doctor also may give you an antipyretic that reduces fever (such as acetaminophen).
With each infusion
Ocrevus Zunovo is available as a liquid solution that’s given by subcutaneous infusion (an injection under your skin over a period of time).
- You’ll receive infusions at your doctor’s office or a clinic.
- A healthcare professional will administer the injection into your abdomen. The infusion will last approximately 10 minutes.
- A healthcare professional will monitor you closely during injections to ensure that you don’t have an infusion reaction. In this way, if you have a severe reaction, they can take appropriate medical action.
- For your first dose, they’ll monitor you for at least 1 hour after the injection.
- For later doses, they’ll monitor you for at least 15 minutes after the injection.
Questions about receiving Ocrevus Zunovo
Below are some common questions about receiving Ocrevus Zunovo.
- What if I miss an infusion appointment for Ocrevus Zunovo? If you miss an appointment for your dose of Ocrevus Zunovo, call your doctor’s office right away to reschedule it. Once you receive the missed dose, you’ll receive the next dose 6 months from this new date.
- Will I need to receive Ocrevus Zunovo long term? Ocrevus Zunovo is typically received as a long-term treatment. You and your doctor can determine whether it’s safe and effective for your condition. If you agree that it is, you’ll likely receive it long term.
- How long does Ocrevus Zunovo take to work? Ocrevus Zunovo begins to work after you receive your first dose. Your doctor will order tests throughout your treatment to check whether Ocrevus Zunovo is working for your condition.
Consider the important information below before starting treatment with Ocrevus Zunovo.
Interactions
Receiving a drug while taking certain medications, vaccines, foods, and other things could affect how the drug works. These effects are called interactions.
Before starting Ocrevus Zunovo treatment, talk with your doctor. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
Drug interactions
Medications that can interact with Ocrevus Zunovo appear in the table below. This table does not contain all drugs that may interact with Ocrevus Zunovo.
| Drug group or drug name | Drug examples |
|---|---|
| other immune-modulating or immunosuppressive therapies (treatments that work on the immune system), including certain uses of corticosteroids | • fingolimod (Gilenya, Tascenso ODT) • mitoxantrone • natalizumab (Tysabri) • teriflunomide (Aubagio) • prednisone (Rayos) • methylprednisolone (Medrol) |
| live and non-live vaccines | • live vaccines, such as the chickenpox vaccine (Varivax) or the measles, mumps, and rubella (MMR) vaccine • non-live vaccines, such as the flu vaccine (Fluzone, others) or the shingles vaccine (Shingrix) (Learn more about vaccine interactions and timing of vaccinations in the “Other interactions” section below.) |
If you have questions about drug interactions that may affect you, ask your doctor.
Ocrevus Zunovo and alcohol
Alcohol is not known to interact with Ocrevus Zunovo. But alcohol can affect the immune system, which makes it harder for the body to fight infection and recover from illness. Because of this, your doctor may recommend that you limit the amount of alcohol you drink.
Other interactions
Ocrevus Zunovo can interact with other substances, such as:
- Lab tests: Ocrevus Zunovo may decrease levels of immunoglobulins (a type of protein) in the body. It may also decrease levels of neutrophils (a type of white blood cell). So in certain blood tests, your immunoglobulins and neutrophils could appear to be low. Be sure to tell the doctor ordering the test that you use Ocrevus Zunovo.
- Vaccines: You should not receive certain vaccines during your Ocrevus Zunovo treatment. This is because getting certain vaccines during Ocrevus Zunovo treatment can weaken the vaccines. But you may be able to receive certain vaccines prior to starting treatment with Ocrevus Zunovo. If so, you may need to wait 2 or 4 weeks after receiving them before starting treatment with Ocrevus Zunovo. If you need to receive a vaccine, talk with your doctor first to make sure it’s safe. (See examples of vaccines that can interact with Ocrevus Zunovo in the table above.)
Pregnancy and breastfeeding
It’s not known whether it’s safe to receive Ocrevus Zunovo during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding or planning either, talk with your doctor before starting Ocrevus Zunovo treatment.
Birth control
In pregnant people receiving drugs similar to Ocrevus Zunovo, some reports included their infants having weakened immune systems. Due to this risk, your doctor may suggest that you use birth control during treatment with Ocrevus Zunovo.
Females able to become pregnant should use birth control throughout treatment with Ocrevus Zunovo. They also should use it for 6 months after their last dose. (In this article, we use the term “female” to refer to someone’s sex assigned at birth. For more information, see this article about the difference between sex and gender.)
Warnings
Ocrevus Zunovo can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors also may affect whether Ocrevus Zunovo is a good treatment option for you.
Talk with your doctor about your health history before you start treatment with Ocrevus Zunovo. Be sure to tell them if any of the following factors apply to you:
- current infection
- hepatitis B
- colitis (inflammation of the colon) or inflammatory bowel disease (IBD)
- past allergic reaction to Ocrevus Zunovo
- pregnancy
- breastfeeding
- recent vaccination or scheduled vaccination
How does Ocrevus Zunovo compare vs. Ocrevus?
Ocrevus Zunovo contains two active ingredients: ocrelizumab and hyaluronidase-ocsq. Ocrevus contains one active ingredient, which is ocrelizumab. Both drugs are biologic medications, which are made from parts of living organisms. In Ocrevus Zunovo, hyaluronidase-ocsq helps improve the absorption and distribution of ocrelizumab.
Both drugs are prescribed for adults to treat the following conditions:
- relapsing forms of multiple sclerosis (MS), which include:
- clinically isolated syndrome (which does not necessarily lead to MS)
- relapsing-remitting MS
- active secondary progressive MS
- primary progressive MS
Each drug has different forms. Ocrevus Zunovo is available as a liquid solution that’s given by subcutaneous infusion (an injection under your skin over a period of time). A healthcare professional gives you the infusion once every 6 months.
On the other hand, Ocrevus is available as a liquid solution that’s given by intravenous infusion (an injection into your vein over a period of time). A healthcare professional gives you Ocrevus infusions. After the first dose, you’ll receive another 2 weeks later. After that, doses are given every 6 months.
For both drugs, you’ll receive medications before each infusion to help prevent an allergic reaction. Also, you typically receive both drugs as a long-term treatment.
The dosages of both drugs are as follows:
- Ocrevus Zunovo: 920 milligrams (mg) of ocrelizumab and 23,000 units of hyaluronidase once every 6 months
- Ocrevus:
- initial dose of 300 mg
- 2 weeks later, another dose of 300 mg
- then 600 mg every 6 months
Side effects of Ocrevus Zunovo and Ocrevus are very similar. See the “What are Ocrevus Zunovo’s side effects?” section for more details about Ocrevus Zunovo side effects.
Likewise, interactions that Ocrevus Zunovo has with immune-modulating or immunosuppressive therapies and vaccines are the same for Ocrevus. (See the table in the “What should be considered before starting treatment with Ocrevus Zunovo?” section.)
As with Ocrevus Zunovo treatment, you should not receive certain vaccines during your Ocrevus treatment. Your doctor can provide more details.
It’s not known whether it’s safe to receive Ocrevus Zunovo or Ocrevus during pregnancy or while breastfeeding. Your doctor can provide more information on this before starting treatment.
If you’d like more information on how these two drugs compare, talk with your doctor.
What is a J-code? Does Ocrevus Zunovo have an assigned J-code?
A J-code is a healthcare code that identifies injectable, nonoral medications. It’s used in billing to help process Medicare and private insurance reimbursements. The codes help ensure accurate billing for drugs that healthcare professionals administer.
J-codes are often submitted for billing along with Current Procedural Terminology (CPT) codes. A CPT code identifies the procedure involved with drug administration.
The J-code for Ocrevus Zunovo is J2351. Coverage varies by payer, which is the party providing the reimbursement. Your healthcare professional will verify specific billing requirements with your insurer.
Whether or not you have health insurance, cost may be a factor when you’re considering Ocrevus Zunovo. What you’ll pay for Ocrevus Zunovo may depend on several things, including your treatment plan.
You can consider a few things regarding cost:
- Biosimilar form: Ocrevus Zunovo is not available in biosimilar form. Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
- Savings program: If you have questions about how to pay for Ocrevus Zunovo, talk with your doctor. A program called Ocrevus Connects may also be available.
Other drugs are available that can treat your condition. The following drugs are similar to Ocrevus Zunovo:
If you’d like to explore an alternative to Ocrevus Zunovo, talk with your doctor. They can tell you about other medications that might work well for you.
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.