From the FDA Drug Label
2.4 Recommended Dosage The recommended dosage of OCREVUS ZUNOVO is 920 mg/23,000 units (920 mg ocrelizumab and 23,000 units of hyaluronidase) administered as a single 23 mL subcutaneous injection in the abdomen over approximately 10 minutes every 6 months.
The recommended dosage protocol for Ocrevus (ocrelizumab) in the treatment of multiple sclerosis is:
- Dose: 920 mg/23,000 units (920 mg ocrelizumab and 23,000 units of hyaluronidase)
- Administration: Single 23 mL subcutaneous injection in the abdomen
- Duration: Over approximately 10 minutes
- Frequency: Every 6 months 1
From the Research
Ocrevus (ocrelizumab) should be administered as an intravenous infusion with an initial dosing of two 300 mg infusions given two weeks apart, followed by 600 mg infusions every six months thereafter, with the option to infuse the 600 mg dose over a shorter duration of approximately 2 hours, as supported by recent studies 2, 3. The first dose is split to reduce infusion-related reactions, which are most common during the initial infusion. Before each infusion, patients should receive premedication with methylprednisolone (or equivalent corticosteroid) 100 mg intravenously about 30 minutes prior, as well as an antihistamine (such as diphenhydramine) to further reduce infusion reaction risk 4. Acetaminophen may also be given as premedication. During administration, the infusion should start slowly (30 ml/hour) and gradually increase if well-tolerated, with the entire infusion typically taking 3.5-4 hours, but can be reduced to 2 hours for subsequent doses 2, 3. Patients should be monitored during and for at least one hour after infusion completion. Ocrevus works by targeting CD20-positive B cells, which are involved in the autoimmune process of multiple sclerosis, reducing inflammation and slowing disease progression. Laboratory testing, including hepatitis B screening, should be completed before initiating therapy, and live vaccines should be administered at least 4 weeks before starting treatment. Some studies suggest that a single 600 mg dose for the first infusion may be relatively safe with some protocol modifications 5, but the standard split-dose regimen is still widely recommended. The most recent and highest quality studies support the safety and efficacy of ocrelizumab in patients with multiple sclerosis, with a favorable risk-benefit profile 6.
Key considerations for the administration of Ocrevus include:
- Initial dosing: two 300 mg infusions given two weeks apart
- Subsequent dosing: 600 mg infusions every six months
- Infusion duration: approximately 2 hours for 600 mg doses, with the option for shorter infusion times
- Premedication: methylprednisolone, antihistamine, and acetaminophen as needed
- Monitoring: during and after infusion completion.
Overall, the recommended dosage protocol for Ocrevus is supported by recent clinical trials and should be followed to minimize infusion-related reactions and optimize treatment outcomes for patients with multiple sclerosis.