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Ocrelizumab infusion

Updated 2 Feb 2023 | Ocrelizumab


Infusions of ocrelizumab.

Drugs List

  • ocrelizumab 300mg/10ml concentrate for solution for infusion
  • OCREVUS 300mg/10ml concentrate for solution for infusion
  • Therapeutic Indications


    Treatment of Multiple Sclerosis



    Initial dose: 300mg intravenous infusion followed 2 weeks later by second 300mg intravenous infusion.

    Subsequent doses: 600mg intravenous infusion 6 months after initial dose. Repeat every 6 months. Minimum interval between intravenous infusions is 5 months.

    Additional Dosage Information

    Infusion Rate

    Severe infusion-related reaction
    Interrupt infusion immediately. The infusion should only be restarted once all symptoms are resolved. The initial infusion rate at restart should be half of the infusion rate at the time of the onset of the reaction.

    Mild to moderate infusion-related reaction
    Reduce infusion rate to half the rate used at the onset of the reaction. Maintain the reduced rate for at least 30 minutes. If tolerated increase infusion rate to initial rate. Dose reductions are not required.

    Delayed or Missed Doses
    If the ocrelizumab infusion is missed, the dose should be administered as soon as possible. Do not wait until the next planned dose. A 6 month treatment interval (minimum of 5 months) should be maintained between doses for ocrelizumab.


    Acute infection
    Children under 18 years
    Severe immunosuppression
    Hepatitis B
    Malignant neoplasm

    Precautions and Warnings

    History of acute infusion reactions
    History of hepatitis B
    Moderate hepatic impairment
    Moderate renal impairment
    New York Heart Association class III failure
    New York Heart Association class IV failure

    Administration of live vaccines is not recommended
    Consider withholding antihypertensives 12 hours prior to treatment
    Before initiating screen all patients for hepatitis B infection
    Ensure relevant vaccinations administered at least 6 weeks before treatment
    Patients must be premedicated with an antihistamine and corticosteroid
    Premedication with antipyretic recommended
    Treatment to be prescribed under the supervision of a specialist
    Monitor patient for at least 1 hour after administration
    Record name and batch number of administered product
    Reduce infusion rate if mild to moderate infusion reaction occurs
    Monitor for hypersensitivity reactions - risk of severe reactions
    Monitor patient for infusion-associated reactions (IARs)
    Perform neutrophil count in patients with signs and symptoms of infection
    Advise patient to report headaches, seizures, confusion, visual disturbance
    Discontinue if hypersensitivity reactions occur
    Discontinue if Progressive multifocal leukoencephalopathy (PML) develops
    Discontinue permanently if life threatening infusion reactions occur
    Interrupt treatment if severe infusion reaction occurs
    Female: Contraception required during and for 1 year after treatment

    Progressive multifocal leukoencephalopathy syndrome (PML) has been reported in some patients treated with similar agents. If patients present with symptoms indicating PML such as worsening neurological, cognitive or behavioural signs or symptoms, an MRI should be performed. If PML is diagnosed, treatment should be permanently discontinued.

    For neonates and infants born to mothers who have been exposed to ocrevus in utero, consider postponing vaccination with live or live-attenuated vaccines.

    Cases of late onset neutropenia have been reported at least four weeks after the infusion with most of the cases being grade one or two.

    Pregnancy and Lactation


    Use ocrelizumab with caution during pregnancy.

    The manufacturer recommends Ocrelizumab is not used during pregnancy unless the potential benefit to the mother outweighs the potential risk to the foetus.

    Ocrelizumab is a humanised monoclonal antibody. Immunoglobulins are known to cross the placental barrier, however animal studies do not indicate teratogenic effects.

    There is a potential for b-cell depletion in infants exposed to ocrelizumab in utero. Postpone vaccinations with live or attenuated vaccines in infants until b-cell depletion recovered.


    Use ocrelizumab with caution during breastfeeding.

    The manufacturer advises discontinuation of breastfeeding during treatment with ocrelizumab. It is not known if ocrelizumab or its metabolites are excreted in human breast milk. Animal studies have shown excretion of ocrelizumab in milk.

    LactMed suggests that ocrelizumab is a large protein molecule and thus the amount expressed in milk is likely to be low. LactMed suggests any amount of the drug is likely to be destroyed in the infant's gastrointestinal tract, limiting its absorption.

    Side Effects

    Herpes zoster
    Immunoglobulin abnormalities
    Infusion related reaction
    Laryngeal oedema
    Late onset of neutropenia
    Oral herpes
    Oropharyngeal pain
    Progressive multifocal leukoencephalopathy (PML)
    Respiratory tract infection
    Throat irritation
    Upper respiratory tract infection
    Viral infection


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: May 2019

    Reference Sources

    Summary of Product Characteristics: Ocrevus 300mg concentrate for solution for infusion. Roche Products Limited. Revised March 2021.

    Summary of Product Characteristics: Ocrevus 300mg concentrate for solution for infusion (Northern Ireland). Roche Products Limited. Revised March 2021.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed). Ocrelizumab Last revised: 3 December 2018
    Available at:
    Last accessed: 20 May 2019

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