Section 04 · Monograph
Ocrelizumab + hyaluronidase
Reviewed Nov 2026FDA label
Ocrevus ZunovoAnti-CD20 mAb · SC
- Forms
- SC: 920mg/23,000 units per 23mL vial
- Dose
- 920mg SC every 6 months; premedicate with dexamethasone 20mg + antihistamine
- MOA
- Depletes CD20+ B-cells
Indications
- Relapsing forms of multiple sclerosis and primary progressive multiple sclerosis in adults (subcutaneous formulation)FDA-labeled
Mechanism of Action
- Humanized anti-CD20 monoclonal antibody co-formulated with recombinant human hyaluronidase to allow subcutaneous delivery; depletes CD20+ B cells
Full Dosing
Adult / usual
- 920mg ocrelizumab/23,000 units hyaluronidase as a single 23mL subcutaneous injection into the abdomen over about 10 minutes every 6 months
- Premedicate orally with dexamethasone 20mg (or equivalent corticosteroid) and an antihistamine at least 30 minutes before each injection; consider an antipyretic
- Observe at least 1 hour after the first injection and at least 15 minutes after subsequent injections
Contraindications
- Active hepatitis B virus infection
- History of life-threatening administration reaction to ocrelizumab
- History of hypersensitivity to ocrelizumab, hyaluronidase or any component
Drug Interactions
- Avoid live or live-attenuated vaccines during treatment and until B-cell repletion
- Additive immunosuppression with other immunosuppressive therapies
Adverse Effects
- Injection reactions (local and systemic)
- Infections and hepatitis B reactivation; PML risk
- Reduced immunoglobulins
- Possible increased malignancy risk
Monitoring Parameters
- Hepatitis B screening before treatment
- Immunoglobulin levels periodically
- Infection and injection-reaction monitoring
Pregnancy & Lactation
- Possible neonatal B-cell depletion with in-utero exposure; delay live vaccines in exposed infants
- Unknown whether present in milk