Ocrevus interactions: Alcohol, medications, and other factors

Before you start treatment with Ocrevus, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Ocrevus interacts with supplements, herbs, or vitamins, see the “Ocrevus and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Ocrevus. Keep in mind that this table doesn’t include all drugs that may interact with Ocrevus. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Ocrevus due to the risk of harm. These are known as contraindications. The contraindications of Ocrevus include:

Having an active HBV infection

Doctors typically will not prescribe Ocrevus for people with an active hepatitis B virus (HBV) infection. This is because Ocrevus weakens your immune system and can make it harder for your body to fight infections.

Your doctor will test you for HBV before you start treatment with Ocrevus. If you receive a positive test result for active HBV infection, your doctor will likely prescribe medication to manage your HBV before you start Ocrevus.

Having had a life threatening reaction to a past infusion of Ocrevus

If you have had a life threatening reaction to a past infusion of Ocrevus, you should not receive any further doses of the drug. Taking the drug again could cause another life threatening reaction. You can talk with your doctor about other treatments that may be better choices for you.

There are no known interactions between Ocrevus and alcohol.

If you have questions about drinking alcohol while taking Ocrevus, talk with your doctor or pharmacist.

Here’s a closer look at certain drug interactions of Ocrevus.

Corticosteroids

Ocrevus can interact with corticosteroids, which are drugs used to treat inflammation. Corticosteroids are used to treat many different conditions. They are commonly prescribed to help manage multiple sclerosis.

Interaction result: Taking Ocrevus with corticosteroids can raise your risk of infection.

Interaction explained: Ocrevus works by weakening part of your immune system. Corticosteroids can also weaken your immune system when taken in high doses or for long periods of time. So taking these drugs together can weaken your immune system further. This can make it harder for your body to fight infections.

Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Ocrevus:

• dexamethasone
• hydrocortisone (Cortef)
• methylprednisolone (Medrol)
• prednisone (Rayos)

Steps you or your doctor may take: If your doctor prescribes a corticosteroid with Ocrevus, they’ll likely monitor you more closely. Tell your doctor right away if you develop any symptoms of infection. These can include:

• fever or chills
• sore throat
• cough
• genital sores
• sore, hot, red, or discolored areas of skin
• skin rash
• pain when urinating

If you have an infection while taking these drugs together, your doctor may prescribe medication to treat the infection. They may also delay your next dose of Ocrevus until the infection has cleared up.

If you have questions about taking Ocrevus with corticosteroids, talk with your doctor or pharmacist.

Immunosuppressive or immune-modulating therapies

Ocrevus can interact with immunosuppressive or immune-modulating therapies, which are drugs that weaken your immune system. They are prescribed for many different conditions, including multiple sclerosis. Ocrevus is an immunosuppressant drug.

Interaction result: Taking Ocrevus with other immunosuppressive or immune-modulating therapies can raise your risk of infection.

Interaction explained: Ocrevus and other immunosuppressive or immune-modulating therapies both work by weakening your immune system. So taking these drugs together can weaken your immune system further. This can make it harder for your body to fight infections. Infections are a common side effect of these medications. For details about Ocrevus’s side effects, see this article.

Examples of immunosuppressive or immune-modulating therapies: Here are some immunosuppressive or immune-modulating therapies that may interact with Ocrevus:

• fingolimod (Gilenya)
• natalizumab (Tysabri)
• teriflunomide (Aubagio)
• mitoxantrone (Novantrone)

Steps you or your doctor may take: Due to the increased risk of infections, your doctor will usually avoid prescribing Ocrevus with other immunosuppressive or immune-modulating therapies for multiple sclerosis.

Some of these therapies can last for a long time in your body. So if you are switching to Ocrevus from another multiple sclerosis therapy, your doctor may want you to wait for a few weeks or months before you start Ocrevus.

If you have questions about taking Ocrevus with or after another immunosuppressant or immune-modulating therapy, talk with your doctor or pharmacist.

Ocrevus may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Ocrevus.

Ocrevus interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Ocrevus interactions with herbs

There are no specific reports of herbs interacting with Ocrevus. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Ocrevus treatment.

Ocrevus interactions with vitamins

There are no specific reports of vitamins interacting with Ocrevus. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Ocrevus.

Ocrevus interactions with food

There were no reports of food interactions with Ocrevus. If you’d like to learn more about eating certain foods during treatment with Ocrevus, talk with your doctor.

Ocrevus interactions with vaccines

Live vaccines

Ocrevus is known to interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.

But Ocrevus works by weakening your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines to avoid during Ocrevus treatment include:

• measles, mumps, rubella (MMR)
• chickenpox
• flu vaccine (nasal spray form)

Before starting Ocrevus, talk with your doctor or pharmacist about any vaccines you may need. If you need any live vaccines, you should receive them at least 4 weeks before you start treatment with Ocrevus.

Inactivated vaccines

Ocrevus can also interact with inactivated (non-live) vaccines. Inactivated vaccines contain proteins or toxins from the bacterium or virus that the vaccine defends against. They can’t cause infection, even if you have a weakened immune system. But if you have a weak immune system, these vaccines can be less effective.

Ocrevus weakens your immune system. So if you get an inactivated vaccine, your immune system may not respond to it as well as usual. This can make the vaccine less effective at preventing the disease it’s meant to protect you from.

Examples of inactivated vaccines include:

• tetanus
• COVID-19
• flu vaccine (injected form)

Before starting Ocrevus, talk with your doctor or pharmacist about any vaccines you may need. If you need any inactivated vaccines, you should receive them at least 2 weeks before starting Ocrevus.

Ocrevus interactions with lab tests

Ocrevus isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

OCREVUS INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Ocrevus. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Ocrevus. The impact of cannabis may affect how well you stick to your Ocrevus treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Ocrevus. Before you take this drug, be sure to talk with your doctor about your health history. Ocrevus may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Ocrevus include:

• Infections: Ocrevus weakens your immune system and can make it harder for your body to fight infections. Before starting treatment with Ocrevus, tell your doctor if you have any ongoing infections or infections that keep coming back. If you have an active infection, you should not receive Ocrevus until the infection has been treated. Before receiving each dose of Ocrevus, be sure to tell your doctor if you have an infection.
• Hepatitis B: Your doctor will test you for hepatitis B virus (HBV) before you start Ocrevus. If you have an active HBV infection, your doctor will likely prescribe medication to manage your HBV before you start Ocrevus. If you have a history of hepatitis B, talk with your doctor before starting treatment with Ocrevus. If you still have HBV in your body, taking Ocrevus could allow the infection to become active again. Your doctor will likely monitor your liver during Ocrevus treatment.
• Allergic reaction: If you’ve had an allergic reaction to Ocrevus or any of its ingredients, your doctor will likely not prescribe Ocrevus. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Ocrevus while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Ocrevus may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Ocrevus. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Ocrevus is safe to use while pregnant. However, the drug may cause the baby to be born with a weakened immune system. Animal studies show that the drug may also cause pregnancy loss and other problems in the baby after the birth. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Ocrevus. They can advise you on the right treatment plan for you. If you take Ocrevus during pregnancy, your newborn baby should not receive live vaccines* until their immune system has recovered. Talk with your doctor about this.

* Live vaccines contain live but weakened pieces of the virus or bacterium they are meant to defend against. For more information, see the section “Ocrevus interactions with vaccines” section above.

You can take certain steps to help prevent interactions with Ocrevus. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Ocrevus label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Ocrevus doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Ocrevus by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.