Ocrevus (ocrelizumab)
An approved treatment for Multiple Sclerosis.
The same compound appears under different names depending on the context. Here is how to identify Ocrelizumab wherever you encounter it, plus the key facts at a glance.
- Generic name
- Ocrelizumab
- Brand name
- Ocrevus
- Drug class
- Monoclonal antibody (anti-CD20)
- Manufacturer
- Genentech / Roche
- How it's taken
- Given as intravenous infusions.
The first drug approved for both relapsing and primary progressive MS. Given as an IV infusion every 6 months, it depletes B cells that drive MS inflammation and progression.
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Where Ocrelizumab fits
First therapy approved for both relapsing MS and primary progressive MS. The IV form is approved for adults with relapsing forms of MS or primary progressive MS, and for children 10 and older who weigh at least 25 kg with relapsing-remitting MS only. Considered a high-efficacy option, often used in patients with active or aggressive disease.
How Ocrelizumab works
Ocrelizumab attaches to B cells (immune cells) and kills them. This reduces the inflammation in your brain and spinal cord caused by your immune system attacking these areas. Fewer B cells means less nerve damage and fewer relapses.
Mechanism: Humanized anti-CD20 monoclonal antibody that depletes B lymphocytes via antibody-dependent cellular cytolysis and complement-mediated lysis
Side effects and safety
Infusion reactions are common (34-40% of patients), causing itching, rash, throat irritation, or fever, especially with the first dose. Serious infections can occur because the drug weakens the immune system. Tell your doctor immediately about fever, chills, or signs of infection. You will be tested for hepatitis B before starting, and Ocrevus cannot be used if you have active hepatitis B. The label also warns about PML (a rare, serious brain infection), liver injury (liver blood tests are done before starting), lower antibody (immunoglobulin) levels, immune-mediated colitis (tell your doctor about new or lasting diarrhea), and a possible higher risk of cancer, including breast cancer.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Ocrelizumab
Given as intravenous infusions. The initial dose is 300 mg, followed by another 300 mg 2 weeks later. After that, you get a 600 mg infusion every 6 months. Each 600 mg infusion takes about 3.5 hours, or about 2 hours for people who have not had a serious infusion reaction before. Children 10 and older who weigh 25 to under 35 kg get lower doses (150 mg, then another 150 mg 2 weeks later, then 300 mg every 6 months).
Availability and cost
Only available as the brand-name product.
Anti-CD20 monoclonal antibody requiring twice-yearly IV infusions. High-efficacy biologic therapy for both relapsing and primary progressive MS forms.
Help paying for Ocrevus
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Copay help
Eligible commercially insured patients may pay as little as $0 per treatment; up to $20,000 per calendar year for drug costs.
For: private insurance · source - Infusion cost help
Help with infusion (administration) costs, as little as $0; up to $1,500 in year one and $1,000 each year after. Not in MA or RI.
For: private insurance · source - Free medicine program
Genentech Patient Foundation gives free OCREVUS to eligible patients, e.g. uninsured or not covered with household income under $150,000 (more for households over 4).
For: no insurance, underinsured · source - Insurance and case manager help
Patient Navigators explain insurance coverage, find financial help and work with your doctor and specialty pharmacy.
For: private insurance, Medicare, Medicaid, no insurance · source
Good to know: Covers OCREVUS and OCREVUS ZUNOVO. Copay programs exclude Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD and TRICARE. The free-drug program is run by the separate Genentech Patient Foundation; insured patients whose out-of-pocket maximum exceeds 7.5% of household income may also qualify. Hours: 6AM-5PM PT, Mon-Fri.
- From a charity · TotalAssist (formerly PAN Foundation)Multiple Sclerosis fundOpen
Pays for: Out-of-pocket costs for approved medications, up to $8,000 per year. Requires Medicare, Medicaid or TRICARE.
- From a charity · The Assistance FundMultiple Sclerosis fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Clinical trial results
In 2 relapsing MS trials (OPERA I and II), ocrelizumab lowered the yearly relapse rate by 46% and 47% compared with interferon beta-1a (Rebif) and slowed disability progression. In primary progressive MS (ORATORIO), it lowered the risk of 12-week confirmed disability progression by 24% compared with placebo. It was the first drug approved for primary progressive MS.
Development history
Developed by Roche and Genentech, ocrelizumab received FDA approval on March 28, 2017. It was a major milestone as the first FDA-approved treatment for primary progressive MS, where few options previously existed. A 10-minute under-the-skin version, Ocrevus Zunovo, was approved on September 13, 2024, and in May 2026 the IV form was approved for relapsing-remitting MS in children 10 and older who weigh at least 25 kg.
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Common questions about Ocrelizumab
▸What is Ocrelizumab (Ocrevus)?
The first drug approved for both relapsing and primary progressive MS. Given as an IV infusion every 6 months, it depletes B cells that drive MS inflammation and progression.
▸How does Ocrelizumab work?
Ocrelizumab attaches to B cells (immune cells) and kills them. This reduces the inflammation in your brain and spinal cord caused by your immune system attacking these areas. Fewer B cells means less nerve damage and fewer relapses.
▸What are the side effects of Ocrelizumab?
Infusion reactions are common (34-40% of patients), causing itching, rash, throat irritation, or fever, especially with the first dose. Serious infections can occur because the drug weakens the immune system. Tell your doctor immediately about fever, chills, or signs of infection. You will be tested for hepatitis B before starting, and Ocrevus cannot be used if you have active hepatitis B. The label also warns about PML (a rare, serious brain infection), liver injury (liver blood tests are done before starting), lower antibody (immunoglobulin) levels, immune-mediated colitis (tell your doctor about new or lasting diarrhea), and a possible higher risk of cancer, including breast cancer.
▸How is Ocrelizumab taken?
Given as intravenous infusions. The initial dose is 300 mg, followed by another 300 mg 2 weeks later. After that, you get a 600 mg infusion every 6 months. Each 600 mg infusion takes about 3.5 hours, or about 2 hours for people who have not had a serious infusion reaction before. Children 10 and older who weigh 25 to under 35 kg get lower doses (150 mg, then another 150 mg 2 weeks later, then 300 mg every 6 months).
▸Is Ocrelizumab FDA approved?
Yes, Ocrelizumab (Ocrevus) is FDA approved (2017) for the treatment of Multiple Sclerosis.
▸Why is ocrelizumab important for primary progressive MS?
Ocrelizumab was the first drug ever approved for primary progressive MS (PPMS), a form of the disease that affects about 10-15% of MS patients and previously had no approved treatments. The ORATORIO trial showed it reduced disability progression by 24% compared to placebo in PPMS patients. While the benefit in PPMS is more modest than in relapsing MS, having any approved option was a major milestone for this patient population.
▸How do infusion reactions with ocrelizumab work?
Infusion-related reactions occur in 34-40% of patients, most commonly with the first infusion. Symptoms can include itching, rash, throat irritation, flushing, fever, nausea, and headache. Reactions are usually mild to moderate and are managed by slowing or temporarily stopping the infusion and giving additional medications. Premedication with a corticosteroid, antihistamine, and acetaminophen is given before each infusion to reduce the risk. Reactions tend to decrease with subsequent infusions.
▸How does ocrelizumab compare to ofatumumab?
Both target CD20 on B cells and achieve similar levels of B-cell depletion. The main practical difference is administration: ocrelizumab requires IV infusions every 6 months at an infusion center, while ofatumumab is a self-administered subcutaneous injection given monthly at home. Ocrelizumab has approval for both relapsing and primary progressive MS, while ofatumumab is approved only for relapsing forms. Cost and insurance coverage may also differ.
▸Can I get vaccinated while on ocrelizumab?
Vaccine responses are reduced in patients taking ocrelizumab because the drug depletes B cells, which are essential for generating antibodies after vaccination. Live or live-attenuated vaccines should be avoided entirely. Inactivated vaccines can be given but may produce a weaker response. The label says to give any live or live-attenuated vaccines at least 4 weeks before starting ocrelizumab, and non-live vaccines at least 2 weeks before when possible. If vaccination during treatment is necessary, timing it 3-4 months after the last infusion (when B cells begin to recover) may improve the response.
▸How long can patients stay on ocrelizumab?
Ocrelizumab is intended for long-term use, and patients in open-label extension studies have been treated continuously for over 8 years. Long-term safety data has been generally reassuring, though prolonged B-cell depletion does raise ongoing infection risk. Your neurologist will monitor immunoglobulin levels and infection frequency over time to determine if continued treatment is appropriate.
▸Is there a subcutaneous version of ocrelizumab?
Yes. The FDA approved Ocrevus Zunovo (ocrelizumab and hyaluronidase) on September 13, 2024. It is given by a healthcare professional as an injection under the skin of the belly that takes about 10 minutes, every 6 months, for adults with relapsing or primary progressive MS. It is not approved for children.