Key takeaways

  • Ocrevus can cause side effects ranging from mild (upper respiratory infection, pain, and more) to serious (infusion reactions, severe infections, an increased risk of cancer, and more).
  • Managing side effects of Ocrevus includes preventive measures such as vaccinations and frequent hand washing to reduce the risk of infection, as well as medications to lessen infusion reactions. It’s important to discuss any concerning symptoms with a doctor.
  • While Ocrevus isn’t directly linked to certain side effects like weight gain, hair loss, or joint pain, you should talk with a healthcare professional about any new or worsening symptoms during treatment. They can help diagnose and treat these symptoms.

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

Keep reading to learn about the common, mild, and serious side effects Ocrevus can cause.

* CIS is sometimes the first clinical episode of MS and is often categorized as a type of MS. However, it doesn’t mean you should expect more or that you’ll definitely develop MS.

Some people may experience mild or serious side effects during their Ocrevus treatment. Examples of the more commonly reported side effects of Ocrevus include:

Note: Skin infection was reported only in studies of people with PPMS.

To learn more about the side effects listed here, see the “Side effects explained” section. Other side effects are also possible with Ocrevus.

Examples of mild side effects that have been reported by people receiving Ocrevus to treat MS or CIS include:

  • upper respiratory infection
  • lower respiratory infection
  • herpes infection (Herpes infections occur only in people who’ve been exposed to the herpes virus.)

Additional mild side effects were reported in people receiving Ocrevus for PPMS:

Additional mild side effects were also reported in people receiving Ocrevus for RRMS:

In most cases, these side effects should be temporary, and some may be easily managed. But if you have any symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. Do not stop treatment with Ocrevus unless your doctor recommends it.

Ocrevus may cause mild side effects other than those listed here. See the drug’s prescribing information for more details. To learn more about some of the side effects listed here, see the “Side effects explained” section.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you’d like to notify the FDA about a side effect you’ve had with Ocrevus, visit MedWatch or call 800-FDA-1088.

Serious side effects that have been reported with Ocrevus include:

Note: Herpes and hepatitis B infections occur only in people who’ve been exposed to these viruses. Herpes infections are caused by the herpes zoster, herpes simplex 1, or herpes simplex 2 viruses, while hepatitis B is caused by the hepatitis B virus.

If you develop serious side effects during treatment with Ocrevus, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

To learn more about some of the side effects listed here, see the “Side effects explained” section.

Allergic reaction

An allergic reaction is possible with Ocrevus, but it’s not clear whether this side effect occurred in the drug’s studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin — typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it difficult to breathe

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest over-the-counter (OTC) products to manage your symptoms. These may include an oral antihistamine, such as diphenhydramine (Benadryl), or a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you’ve had a mild allergic reaction to Ocrevus, they’ll decide whether you should continue receiving it.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty 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. If they do, they may have you switch to a different treatment.

Here’s more detail about some of the side effects Ocrevus may cause.

Fatigue

Fatigue is one of the most common symptoms of multiple sclerosis (MS). Ocrevus isn’t known to cause fatigue, except as part of an infusion reaction. To learn more about this, see the “Infusion reactions” section.

What might help

If you have fatigue, it’s important to get plenty of rest. Talk with your doctor about ways to manage fatigue related to MS.

Increased risk of cancer

Ocrevus weakens your immune system. As with other medications that work this way, Ocrevus may slightly increase your risk of developing cancer. In studies, cancers such as breast cancer, though rare, were reported in people receiving Ocrevus.

What might help

For certain cancers, such as breast cancer, taking part in screening programs may help identify any growths or tumors early. For example, current American Cancer Society (ACS) guidelines recommend that females ages 45 years and older have a mammogram (breast X-ray) to check for breast cancer every 1 to 2 years.

If you have any unusual lumps, bumps, pains, or other unexplained symptoms, be sure to tell your doctor right away.

Some general tips to help minimize your risk of cancer include:

  • If you smoke, quit.
  • Maintain a healthy weight.
  • Eat a nutritious diet that contains plenty of fresh fruits and vegetables.
  • Protect your skin from sunburn.

Talk with your doctor about your risk of developing cancer and any screening programs in which you should participate.

Diarrhea

Diarrhea was a fairly common side effect reported in Ocrevus studies by people receiving the drug for PPMS.

What might help

If you have diarrhea, be sure to drink plenty of fluids to avoid dehydration. Sports drinks or rehydration solutions, such as Pedialyte, can help replace lost fluids and electrolytes. You can also try OTC medications such as loperamide (Imodium). But check with your doctor or pharmacist first to make sure these drugs are suitable for you.

Talk with your doctor if you have diarrhea that’s severe, doesn’t go away in 2 or 3 days, or contains blood. In some cases, severe or bloody diarrhea can be a symptom of a serious condition, such as colitis (inflammation of the colon). Your doctor can examine you for other possible symptoms.

Infections, such as respiratory or skin infections

Ocrevus reduces some of your immune system activity. As a result, it can increase your risk of infection. For example, you may have an increased risk of herpes infection (if you’ve been exposed to the herpes virus).

In studies, infections were commonly reported in people receiving Ocrevus treatment. These include:

  • Upper respiratory infections, such as the common cold or sinusitis. Symptoms may include:
    • sinus pain
    • sneezing
    • runny nose
    • stuffy or blocked nose
  • Lower respiratory infections, such as bronchitis, pneumonia, or the flu. Symptoms may include:
    • fever
    • chills
    • cough
    • sore throat
  • Herpes infections, such as cold sores, shingles, or genital herpes. Symptoms may include:
    • tingling, itching, or burning sensation around your mouth
    • small, painful, fluid-filled sores on your lips, cheeks, chin, or the inside of your nostrils
    • small, painful, fluid-filled sores on or around your genitals
    • skin pain, itchiness, or rash
    • flu-like symptoms, such as fever or sore throat
  • Skin infections, such as cellulitis. Symptoms may include:
    • redness or discoloration
    • swelling
    • warmth
    • tenderness or pain
    • blisters or spots

Most infections reported in studies, including herpes infections, were mild to moderate in severity. But in rare cases, infections can be severe. Since Ocrevus was approved for use, serious cases of herpes infection have been reported by some people receiving this treatment. These include widespread skin or soft tissue infections, as well as herpes infections of the eyes or brain.

What might help

A few tips that may help prevent you from getting an infection are:

  • Wash your hands or use hand sanitizer frequently, especially if you’ve been in a public place.
  • Avoid crowds when possible.
  • Stay away from people who are sick.
  • Do not share face cloths, towels, lip balms, or lipsticks with others.
  • Avoid kissing or sexual contact with someone who has an active herpes infection.
  • Eat a healthy diet that contains plenty of fruit and vegetables.
  • Make sure you’re up to date with immunizations before you start Ocrevus treatment.*

* You should not start Ocrevus treatment until at least 2 weeks after receiving non-live vaccines and at least 4 weeks after receiving live vaccines.

If you have symptoms of an infection during Ocrevus treatment, talk with your doctor or pharmacist. They can determine whether the infection may be treated with OTC medications or home remedies or if you need a prescription drug, such as antibiotics or antivirals.

See your doctor right away if you have an infection that starts to get worse or doesn’t get better after about a week. You should also see your doctor right away if you have symptoms of a more serious herpes infection. These may include:

If you have an active infection, you should not start Ocrevus treatment or have another dose until the infection has cleared up.

Infusion reactions

Infusion reactions were one of the most common side effects reported in studies of Ocrevus. These reactions typically happen during or just after the infusion, but can sometimes occur up to 24 hours later.

You’re more likely to have a reaction with your first infusion than with later infusions. Infusion reactions are usually mild, but they can become serious and require urgent treatment.

Symptoms of an infusion reaction include:

What might help

A healthcare professional will monitor you closely during your infusion and for at least 1 hour afterward. If you have a reaction during this time, they may slow the infusion down or stop it until your symptoms ease. Depending on how severe your symptoms are, you may need medication to treat the reaction.

You should tell your doctor right away about any infusion reaction symptoms you develop in the 24 hours after your infusion.

If you have an infusion reaction, you’ll likely be given medications before your next dose to help prevent another reaction. This is called premedication and may include acetaminophen (Tylenol), a corticosteroid such as methylprednisolone (Medrol), and an antihistamine such as diphenhydramine (Benadryl).

If you have a severe infusion reaction, your doctor may recommend that you stop treatment with Ocrevus.

The following are some commonly asked questions about Ocrevus side effects and their answers.

Does Ocrevus have an effect on my teeth?

The prescribing information for Ocrevus does not note any dental side effects. But some research suggests that ocrelizumab (the active ingredient in Ocrevus) and similar drugs have occasionally caused dental disorders.

Side effects reported from drugs similar to Ocrevus include receding gum lines, tooth loss, and dental pain.

Talk with your doctor if you think Ocrevus is affecting your teeth. They can help you select an alternate treatment.

Also, keep in mind that MS can affect dental health. This condition can cause nerve damage, muscle weakness, loss of muscular coordination, and pain, to name a few symptoms. These factors can make it difficult to maintain oral health. In turn, inadequate oral health can lead to symptoms such as dry mouth, inflamed or bleeding gums, and plaque.

Your medical care team should include a dentist and related healthcare professionals. They can help detect difficulties concerning your oral health and treat related symptoms.

Could I experience weight gain during my Ocrevus treatment?

It’s not likely. Weight gain wasn’t reported by people who received Ocrevus for MS in the drug’s studies.

Some people who received Ocrevus for PPMS reported swelling in their arms or legs, and this can sometimes cause weight gain. If you have swelling with Ocrevus, talk with your doctor. They may prescribe medication to help ease this side effect.

Some people with MS gain weight if their symptoms make it harder to exercise or move around as usual. But other things could also cause weight gain.

Talk with your doctor if you experience unwanted weight gain during Ocrevus treatment. They can help you figure out what might be causing it and what might help.

Does Ocrevus cause hair loss?

It’s not known whether Ocrevus causes hair loss. This side effect wasn’t reported in the drug’s studies.

Hair loss can be a side effect of certain other medications used to treat MS. But other things could cause hair loss. Talk with your doctor if you have hair loss during Ocrevus treatment. They can help you figure out the possible cause and how to manage it.

Are there any long-term side effects of Ocrevus?

Ocrevus works by reducing some of your immune system activity. As a result, this medication can increase your risk of infection. You’ll have an increased risk of infection as long as you continue Ocrevus treatment. This side effect may last for longer than a year after stopping treatment.

You should take extra care to avoid infection during and after treatment with Ocrevus. To read more about this, see the “Side effects explained” section.

How long do side effects from Ocrevus typically last?

Most side effects of Ocrevus tend to go away on their own within a few days to a couple of weeks. But if you get an infection or infusion reaction, it may sometimes need treatment with medication. To read more about this, see the “Side effects explained” section.

Talk with your doctor or pharmacist if you have symptoms of an infection or infusion reaction during treatment with Ocrevus. Also talk with them if you have any side effects that last longer than a few days or are severe.

Does Ocrevus cause any eye-related side effects?

It’s unlikely. Eye-related side effects weren’t reported in the drug’s studies.

However, herpes infections have been reported in people undergoing treatment with Ocrevus. And these infections can sometimes affect the eyes. While rare, herpes eye infections have been reported with Ocrevus since this drug came on the market. (Herpes infections occur only in people who’ve been exposed to the herpes virus.)

See your doctor right away if you have symptoms of a herpes eye infection during treatment with Ocrevus. These may include eye pain or redness, as well as changes in vision.

If you have a herpes eye infection during Ocrevus treatment, your doctor will likely prescribe antiviral medication to treat it. They may also delay your next dose of Ocrevus until the infection has cleared up.

Can joint pain occur from Ocrevus treatment?

Joint pain wasn’t reported by people receiving Ocrevus in the drug’s studies. But some people with relapsing forms of MS had back, leg, or arm pain with Ocrevus treatment.

While Ocrevus and MS don’t specifically affect your joints, MS can sometimes cause symptoms that lead to joint pain. For example, weakened muscles, stiff or painful limbs, and balance problems can affect your joints.

If you have joint pain during treatment with Ocrevus, talk with your doctor. They can help you figure out the possible cause and suggest ways to manage it.

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 start Ocrevus treatment. Factors to consider include the following:

  • current or recurring infection
  • hepatitis B
  • liver damage
  • if you’ve recently had or need to receive any vaccines
  • previous allergic reaction to Ocrevus or any of its ingredients
  • pregnancy
  • breastfeeding

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 other 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.