Ocrelizumab
Multiple sclerosis disease-modifying therapies
Multiple sclerosis disease-modifying therapies
An anti-CD20 antibody infused every 6 months that depletes B cells; used in relapsing and primary progressive multiple sclerosis.
Quick facts
- Group
- Multiple sclerosis disease-modifying therapies
- Target
- CD20 on B lymphocytes
- Used for
- Relapsing forms of multiple sclerosis
- Key effects
- Infusion reactions · Swelling or pain in the hands
- Monitor
- Vital signs and symptoms during · Signs of infection
- ATC
- L04AG08
No doses: the clinician sets them by the current guideline.
Mechanism of action
Ocrelizumab is a humanized monoclonal antibody against CD20, a surface protein of mature B lymphocytes. Binding leads to depletion of circulating B cells. In multiple sclerosis, B cells act as antigen-presenting cells that drive the immune attack on myelin, not only as antibody producers; removing them reduces relapses and slows progression.
- Ocrelizumab binds CD20 on B cells
- Circulating B cells are depleted
- Less antigen presentation to myelin-reactive T cells
- Fewer relapses and slower disability
Indications
- Relapsing forms of multiple sclerosis Multiple sclerosis →
- Primary progressive multiple sclerosis Multiple sclerosis →
Adverse effects
Common
- Infusion reactions (itching, rash, throat irritation, flushing, fever, headache, fast heartbeat)
- Swelling or pain in the hands, arms, legs or feet
Contraindications
- Active hepatitis B infection
- Allergy to ocrelizumab
Key interactions
- Vaccines
- Some are given at least 4 weeks and others at least 2 weeks before starting; during treatment vaccines are given only with the doctor's approval
What is monitored
- Hepatitis B screening before the first infusion
- Vital signs and symptoms during and for at least 1 hour after each infusion
- Signs of infection, new neurological symptoms and bowel symptoms
- Breast cancer screening as recommended
Administration and safety
- Slow intravenous infusion by trained staff; premedication is often given to reduce reactions
- After a reaction the doctor may pause, stop or change the treatment
- Observation for at least 1 hour after the infusion
Pregnancy and breastfeeding
Effective contraception is used during treatment and for 6 months after the last dose; a baby exposed in pregnancy may need some vaccines delayed.
Nursing care
- Ask about infections, hepatitis B, inflammatory bowel disease and recent vaccines before each infusion
- Watch for rash, itching, throat swelling, breathing difficulty, fever and fast heartbeat during and after the infusion
- Teach to report reactions that start up to 24 hours later
Pharmacokinetics
- Absorption
- Intravenous infusion
- Elimination
- Long-acting; given every 6 months after two initial infusions two weeks apart
Test yourself
Think of the answer, then tap the question to see it.
What does ocrelizumab target?
CD20 on B lymphocytes.
Which form of MS, besides relapsing MS, is ocrelizumab approved for?
Primary progressive multiple sclerosis.
Which viral infection is screened for before the first infusion?
Hepatitis B.
Connections
← Back to the class: Multiple sclerosis disease-modifying therapies
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Ocrelizumab Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.