Ocrevus (ocrelizumab) is a medication primarily used to treat multiple sclerosis (MS), including relapsing forms and primary progressive MS. It works by targeting CD20-positive B cells, a type of immune cell involved in the abnormal immune response seen in MS. While Ocrevus can be highly effective, there are important contraindications—specific situations or conditions where its use is not advised because it could cause harm or worsen a patient’s health.
The **main contraindication for Ocrevus** is a known **hypersensitivity or allergic reaction to ocrelizumab or any of its components**. If a patient has experienced a severe allergic reaction to Ocrevus before, they should not receive it again, as this could lead to life-threatening reactions.
Another critical contraindication involves **active infections**. Because Ocrevus suppresses certain immune cells, it can increase the risk of infections or worsen existing infections. Patients with **active hepatitis B virus infection** should not start Ocrevus, as the drug can cause reactivation of hepatitis B, which can be severe or fatal. Similarly, patients with other serious infections, including bacterial, viral, or fungal infections, should avoid Ocrevus until these infections are fully treated and resolved.
Patients with **immunodeficiency disorders** or those on other immunosuppressive therapies may also be at increased risk of infections when taking Ocrevus. Therefore, caution is advised, and in some cases, Ocrevus may be contraindicated if the immune system is severely compromised.
Because Ocrevus affects B cells, it can interfere with the body’s ability to respond to vaccines, especially live or live-attenuated vaccines. Therefore, **live vaccines are contraindicated during treatment with Ocrevus and until B-cell levels recover after stopping the drug**. Patients should complete any necessary vaccinations before starting Ocrevus.
Pregnancy is a special consideration. Ocrevus is generally **not recommended during pregnancy** because of potential risks to the fetus. Women who are pregnant or planning to become pregnant should discuss alternative treatments or timing with their healthcare provider.
Patients with a history of **severe infusion-related reactions** to Ocrevus should not receive further infusions. Infusion reactions can include symptoms like rash, difficulty breathing, low blood pressure, or swelling, and can be serious.
In summary, the key contraindications for Ocrevus include:
– Known allergy or hypersensitivity to ocrelizumab or its ingredients
– Active hepatitis B infection or other serious active infections
– Severe immunodeficiency or concurrent use of other strong immunosuppressants without careful evaluation
– Use of live or live-attenuated vaccines during treatment and until immune recovery
– Pregnancy or breastfeeding without medical advice
– History of severe infusion reactions to Ocrevus
Before starting Ocrevus, doctors typically perform screening tests for infections such as hepatitis B and tuberculosis and assess vaccination status to minimize risks. Patients should inform their healthcare providers about any infections, immune system problems, allergies, or pregnancy plans to ensure safe use of Ocrevus.
