Ocrevus (ocrelizumab) has potential interactions with other medications and some vaccines. These interactions could affect how well the drug works or cause harmful effects.
Ocrevus is used in adults to treat:
- primary progressive multiple sclerosis (MS)
- relapsing-remitting MS
- active secondary progressive MS
- clinically isolated syndrome (which is often the first sign of MS)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ocrevus’s possible interactions. For a detailed overview of this drug, check out this in-depth Ocrevus article.
Before you receive Ocrevus, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
To learn whether Ocrevus interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Ocrevus?” section.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Ocrevus. Keep in mind this table does not include all drugs that may interact with Ocrevus. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| corticosteroids | • dexamethasone (Hemady) • methylprednisolone (Medrol) • prednisone | may increase the risk of infection |
| interferons | • interferon beta-1a (Avonex, Rebif) • interferon beta-1b (Betaseron) • peginterferon beta-1a (Plegridy) | may increase the risk of infection |
| certain other monoclonal antibodies | • alemtuzumab (Lemtrada) • belimumab (Benlysta) • natalizumab (Tysabri) • ofatumumab (Arzerra, Kesimpta) • rituximab (Rituxan) | may increase the risk of infection |
| other disease-modifying therapies | • dimethyl fumarate (Tecfidera) • glatiramer (Copaxone, Glatopa) • monomethyl fumarate (Bafiertam) • ozanimod (Zeposia) • teriflunomide (Aubagio) | may increase the risk of infection |
Certain health conditions or other factors could raise your risk of harm if you take Ocrevus. In such cases, your doctor may not prescribe Ocrevus for you. These are known as contraindications. The following list includes contraindications of Ocrevus.
If you have an active hepatitis B infection: If you have a hepatitis B infection, your doctor likely won’t prescribe Ocrevus for you until the infection is treated. This is because the drug could lower the ability of your immune system to fight against the hepatitis B virus. Talk with your doctor about when it’s safe to start Ocrevus treatment.
If you’ve had a life threatening infusion reaction to Ocrevus: If you’ve had an infusion reaction with Ocrevus that was life threatening, your doctor likely won’t prescribe the drug for you. This is because receiving the drug could cause another life threatening reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start using Ocrevus, talk with your doctor if any of the factors mentioned here apply to you. Your doctor can determine whether Ocrevus is safe for you.
Ocrevus is not known to interact with alcohol. It’s likely safe to drink alcohol during your Ocrevus treatment.
If you have questions about consuming alcohol during Ocrevus treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Ocrevus.
Interaction with corticosteroids
Ocrevus may interact with corticosteroids, which are prescribed for many conditions. This includes multiple sclerosis, which Ocrevus is also used to treat.
Using Ocrevus with high or long-term doses of corticosteroids can increase your risk of infections. Both drugs may lower the activity of your immune system. As a result, your immune system may not be able to fight infection as well as it should.
Here are some corticosteroids that may interact with Ocrevus:
- dexamethasone (Hemady)
- methylprednisolone (Medrol)
- prednisone
What you can do
Your doctor may give you a corticosteroid shortly before your Ocrevus infusion. This will lower the risk of infusion side effects with Ocrevus. Your doctor can also tell you more about the potential risk of infection when taking these medications together.
If you take a corticosteroid while receiving Ocrevus, tell your doctor right away if you have any symptoms of infection. These may include fever, chills, or body aches. Your doctor will advise you on what to do if you have an infection.
If you have questions about taking a corticosteroid with Ocrevus, talk with your doctor or pharmacist.
Interaction with interferons
Ocrevus may interact with a group of drugs called interferons. Like Ocrevus, some interferons are used to treat multiple sclerosis.
When used individually, Ocrevus and interferons may lower the activity of your immune system and raise your risk of infection. Using these drugs together may increase this risk even further.
Here are some interferons that may interact with Ocrevus:
- interferon beta-1a (Avonex, Rebif)
- interferon beta-1b (Betaseron)
- peginterferon beta-1a (Plegridy)
What you can do
Before using Ocrevus, tell your doctor if you take an interferon drug. They can recommend the right treatment options for your condition.
If you use Ocrevus and an interferon drug together, tell your doctor right away if you have symptoms of infection. Examples include fever, chills, and body aches. They’ll advise you on what to do if you develop an infection.
If you have questions about using Ocrevus with an interferon drug, talk with your doctor or pharmacist.
Interaction with other disease-modifying therapies
Ocrevus may interact with other disease-modifying therapies (DMTs) for multiple sclerosis.
Using Ocrevus with a DMT can increase your risk of infection. These drugs may lower the activity of your immune system. Taking them together could prevent your immune system from fighting infection as well as it should.
Here are some DMTs that may interact with Ocrevus:
- dimethyl fumarate (Tecfidera)
- glatiramer (Copaxone, Glatopa)
- monomethyl fumarate (Bafiertam)
- ozanimod (Zeposia)
- teriflunomide (Aubagio)
What you can do
Before using Ocrevus, tell your doctor if you take another DMT for multiple sclerosis. They can recommend the right treatment options for your condition.
If you use Ocrevus with another DMT, tell your doctor about any symptoms of infection you may have. These include fever, chills, and body aches. Your doctor can recommend what to do if you develop an infection.
If you have questions about using Ocrevus with another DMT, talk with your doctor or pharmacist.
Ocrevus may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.
Here are additional interactions that may occur with Ocrevus. Note that this is not a full list of all other possible interactions with Ocrevus.
Does Ocrevus interact with supplements?
Before you start receiving Ocrevus, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ocrevus and herbs
There are currently no reports of Ocrevus interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while receiving Ocrevus.
Ocrevus and vitamins
There are currently no reports of Ocrevus interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while receiving Ocrevus.
Does Ocrevus interact with food?
There are currently no reports of Ocrevus interacting with food. If you have questions about eating certain foods during your treatment with Ocrevus, talk with your doctor.
Does Ocrevus interact with vaccines?
It may not be safe to receive vaccines during your Ocrevus treatment. Possible interactions with live vaccines and non-live vaccines are described below.
Live vaccines
Live vaccines are made from weakened versions of the bacteria or virus they’re meant to protect against. Examples of live vaccines include chickenpox, measles, mumps, rubella (MMR), and the nasal spray flu vaccine.
Getting a live vaccine during Ocrevus treatment may increase your risk of getting the infection it’s meant to protect against.
Before starting Ocrevus treatment, talk with your doctor about any vaccines you may need. If you receive a live vaccine, you’ll wait at least 4 weeks to start Ocrevus treatment.
Non-live vaccines
Non-live vaccines are made from similar or inactivated parts of the bacteria or virus they’re meant to protect against. Examples of non-live vaccines include shingles, tetanus, and the injectable flu vaccine.
It’s possible that non-live vaccines may not work as well if you receive them during Ocrevus treatment. Your doctor may advise you to delay the start of Ocrevus treatment for at least 2 weeks after receiving a non-live vaccine.
Does Ocrevus interact with lab tests?
There are currently no reports of Ocrevus interacting with lab tests. If you have questions about having certain lab tests during your treatment with Ocrevus, talk with the healthcare professional ordering the test.
Does Ocrevus interact with cannabis or CBD?There are currently no reports of Ocrevus interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Ocrevus.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ocrevus. Before you receive Ocrevus, talk with your doctor about your health history. They’ll determine whether Ocrevus is right for you.
Health conditions or other factors that might interact with Ocrevus include:
Hepatitis B: Your doctor will likely order a hepatitis B test before prescribing Ocrevus for you. If the test shows you have the hepatitis B virus, your doctor can recommend whether Ocrevus is a safe treatment option.
If you have a hepatitis B infection, your doctor likely won’t prescribe Ocrevus for you until the infection is treated. For details, see the “When should I avoid Ocrevus?” section above.
Past infusion reaction: If you’ve had an infusion reaction with Ocrevus that was life threatening, your doctor likely won’t prescribe the drug for you. For details, see the “When should I avoid Ocrevus?” section above.
Infection: Treatment with Ocrevus may lead to new or worsened infections. Before receiving Ocrevus, tell your doctor if you have an infection. They’ll likely treat it before you start Ocrevus treatment.
Inflammatory bowel disease (IBD) or colitis: Before starting Ocrevus treatment, tell your doctor if you have IBD or colitis (inflammation of the colon). Treatment with the drug may worsen symptoms of your condition. Your doctor can recommend whether Ocrevus is a safe treatment option.
Pregnancy: It’s not known whether Ocrevus is safe to receive during pregnancy. If you’re pregnant or may become pregnant, talk with your doctor before receiving Ocrevus.
Breastfeeding: It’s not known whether it’s safe to receive Ocrevus while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Ocrevus or any of its ingredients, your doctor will likely not prescribe Ocrevus. This is because receiving the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.
Taking certain steps can help you avoid interactions with Ocrevus. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
list of medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Ocrevus treatment
It’s also important to understand Ocrevus’s
If you did not get paperwork with Ocrevus, ask your pharmacist to print a copy for you. If you have trouble reading or understanding this information, your doctor or pharmacist can help.
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.