Anti-CD20 monoclonal antibody
Ocrelizumab
Brand names: Ocrevus
Adult dose
Dose: 600mg IV; first dose split 300mg + 300mg 2 weeks apart, then 600mg every 6 months
Route: IV
Frequency: q6m
Clinical pearls
- Relapsing-remitting and primary progressive MS
- Screen HBV/JCV before starting; vaccinate before treatment
Contraindications
- Active HBV
- Active severe infection
- Hypersensitivity
Side effects
- Infusion reactions
- Increased infection risk (esp. URTI, HSV)
- Hypogammaglobulinaemia
- Malignancy risk (esp. breast cancer signal)
- PML (rare)
Interactions
- Live vaccines
- Other immunosuppressants
Monitoring
- IgG
- FBC
- HBV
- Infection signs
Reference: BNF; NICE TA533/TA585; SmPC; https://bnf.nice.org.uk/drugs/ocrelizumab/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Revised Original International Autoimmune Hepatitis Score (IAIHG) · Autoimmune Liver Disease
- Ho Index for Predicting Response to Medical Therapy in IBD · Inflammatory Bowel Disease
- Rh(D) Immune Globulin Dosage for Maternal-Fetal Haemorrhage · Haematology in Pregnancy
- AREDS Classification of Age-related Macular Degeneration · Macular Degeneration
- Diabetic Macular Oedema (DMO) Classification · Diabetic Retinopathy
- Retinopathy of Prematurity — International Classification (ICROP3) · Paediatric Retina
Drugs
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS