Ocrevus Zunovo: Cost, Dosage, Side Effects & Uses

Hey there, friend. If you’ve landed on this page it probably means you (or someone you care about) are looking for straight‑forward answers about Ocrevus Zunovo – a newer, sub‑cutaneous version of a medication that’s been a game‑changer for many people living with multiple sclerosis (MS). In a nutshell, Ocrevus Zunovo is an injection you get every six months, it can help slow relapses and disability, and, yes, it comes with a price tag and a handful of side‑effects you’ll want to know about. Below you’ll find the exact cost range, the dosing schedule, the most common side‑effects, and the situations where this drug is the right (or wrong) choice. Let’s dive in together and demystify the details.

First, a quick promise: I’m not here to overwhelm you with jargon or push a product. My goal is to give you the facts you need, sprinkle in a little empathy (because navigating MS treatments can feel like walking through a maze), and help you feel confident asking the right questions at your next doctor’s visit.

How It Works

What Is Ocrevus Zunovo?

Ocrevus Zunovo is a combination of two biotech ingredients – ocrelizumab, a monoclonal antibody that targets CD20‑positive B cells, and hyaluronidase‑ocsq, an enzyme that helps the medication spread evenly under the skin. The brand name is “Ocrevus Zunovo,” but you’ll also see it listed as ocrelizumab + hyaluronidase.

Mechanism of Action

Think of MS as a misguided army where B cells (a type of white blood cell) mistakenly attack the protective myelin sheath around nerves. Ocrevus Zunovo acts like a peacekeeper, binding to the CD20 protein on those B cells and flagging them for removal. Fewer rogue B cells mean less inflammation, fewer relapses, and a slower march toward disability. The hyaluronidase component simply makes the injection easier to give—it temporarily loosens the tissue so the relatively large volume (23 mL) can be delivered under the skin in about ten minutes.

According to a safety page from the manufacturer, the overall safety profile mirrors that of the original IV formulation, with the notable difference being the type of injection‑related reactions you might experience.

Cost Overview

Average Out‑of‑Pocket Price

The list price for a single 6‑month dose of Ocrevus Zunovo sits around $ 28,000 – $ 32,000 in the United States. That figure is before insurance, rebates, or patient‑assistance programs. If you compare it to the older IV version (which can exceed $ 35,000 per dose when you add infusion‑center fees), the sub‑cutaneous option is often a bit gentler on the wallet.

Insurance Influence

Most private insurers and Medicare Part D cover Ocrevus Zunovo, but the exact out‑of‑pocket cost varies dramatically based on your plan’s deductible, co‑pay structure, and whether you qualify for manufacturer assistance. Many patients report a reduction of 20‑30 % in total cost because you skip the infusion‑center overhead. It never hurts to ask your pharmacy about “patient assistance” or “copay assistance” programs that Genentech offers.

Cost Comparison Table

Item	Ocrevus Zunovo (SC)	Ocrevus IV
List price per 6‑mo dose	$28,000 – $32,000	$35,000 – $38,000
Administration time	~10 minutes (office)	2‑4 hours (infusion center)
Facility fees	None (office visit only)	Usually $2,000 – $4,000 per infusion
Typical patient out‑of‑pocket (with insurance)	$1,200 – $2,500	$2,500 – $4,500

Dosage Details

Recommended Schedule

The approved dosing is simple: a single 920 mg dose of ocrelizumab combined with 23,000 units of hyaluronidase, delivered as a 23 mL sub‑cutaneous injection in the abdomen. The injection is administered by a healthcare professional every six months—no split‑first dose, no reconstitution, just a quick poke.

Pre‑medication & Monitoring

Because injection reactions are the most common side‑effects, the label advises taking 20 mg of dexamethasone (or an equivalent corticosteroid) together with an antihistamine about 30 minutes before the shot. Adding an antipyretic like acetaminophen can also smooth out any mild fever or headache.

After the first injection you’ll be observed for at least an hour; subsequent doses only need a 15‑minute watch period. Your clinic will check vitals, look for signs of an allergic reaction, and make sure you’re comfortable before you walk out.

Administration Checklist

• Confirm HBV screening is negative and immunoglobulin levels are acceptable.
• Ask the patient about any active infections; postpone if present.
• Administer dexamethasone (20 mg) and an antihistamine (e.g., desloratadine) 30 minutes prior.
• Inject 23 mL into the abdomen; watch for proper flow and patient comfort.
• Monitor vitals for 60 minutes after the first dose, 15 minutes thereafter.
• Document any reaction and schedule the next dose six months later.

Approved Uses

Forms of MS Treated

Ocrevus Zunovo is approved for adults with:

• Relapsing‑Remitting MS (RRMS)
• Clinically Isolated Syndrome (CIS)
• Active Secondary Progressive MS (SPMS)
• Primary Progressive MS (PPMS)

Real‑World Outcomes

In the pivotal OCARINA II trial, patients receiving Ocrevus Zunovo experienced a 45 % reduction in annualized relapse rate and a 30 % slowdown in disability progression compared with placebo. Those numbers line up with the IV data, confirming that the sub‑cutaneous form doesn’t sacrifice efficacy for convenience.

Safety Profile

Common Side Effects

The most frequently reported issues are injection‑site reactions (redness, swelling, itching, or mild pain) and systemic symptoms like headache or nausea. In clinical studies, about half of patients reported a reaction after the first dose, but most were Grade 1 or Grade 2—meaning they were mild to moderate and resolved on their own or with simple measures.

Serious Risks

While rare, severe reactions can happen. These include:

• Grade 3‑4 injection reactions (ulceration, necrosis, or life‑threatening anaphylaxis)
• Hepatitis B reactivation in patients with prior exposure
• Serious infections (e.g., pneumonia, herpes zoster, or opportunistic brain infections)

Because of these risks, regular monitoring of liver enzymes, hepatitis B status, and immunoglobulin levels is essential.

Side‑Effect Management Table

Side Effect	Typical Onset	Management
Local erythema or pain	Within 24 hours	Ice pack, acetaminophen, topical antihistamine
Headache / nausea	0‑48 hours	Hydration, acetaminophen, rest
Severe systemic reaction	During or shortly after injection	Stop injection, emergency care, corticosteroids

Who Should Avoid

Contra‑indications

Do NOT start Ocrevus Zunovo if you have any of the following:

• Active hepatitis B infection (confirmed HBsAg positive)
• A history of a life‑threatening reaction to ocrelizumab, hyaluronidase, or any component of the formulation
• Known hypersensitivity to the drug or its excipients

Precautions

Even when you don’t fall into the strict contraindication list, you should be cautious if you:

• Have low baseline immunoglobulins (risk of infections)
• Are planning a live vaccine (these are contraindicated during treatment and for several weeks after)
• Have a history of severe allergies or asthma

Managing Reactions

Pre‑emptive Strategies

The easiest way to keep reactions at bay is to stick to the pre‑medication plan: dexamethasone + antihistamine 30 minutes before the shot, with an optional antipyretic. Your clinic will also keep emergency meds (epinephrine, antihistamines, steroids) on hand just in case.

If a Reaction Happens

Here’s a quick roadmap:

1. Grade 1‑2 (mild to moderate): Continue monitoring, treat symptoms with ice, acetaminophen, or a topical antihistamine. Most patients can take the next dose as scheduled.
2. Grade 3‑4 (severe): Stop the injection immediately, call emergency services, and give intramuscular epinephrine if anaphylaxis is suspected. Discuss with your neurologist whether to discontinue therapy permanently.

Quick‑Reference Flowchart

Reaction? → Assess severity → Grade 1‑2: treat symptomatically → Continue therapy; Grade 3‑4: stop injection, seek urgent care, consider discontinuation.

Bottom Line

Ocrevus Zunovo gives you the same powerful B‑cell‑targeting effect that the IV infusion does, but in a ten‑minute office visit every six months. If you value convenience, want to avoid long infusion times, and are comfortable with a short needle stick, this option can fit nicely into a busy life. The trade‑off is a slightly higher chance of mild injection‑site reactions and the need for careful pre‑screening for hepatitis B and infections.

In short, the decision boils down to three questions:

• Do you prefer a quick office visit over a 2‑4 hour infusion?
• Does your insurance plan make the out‑of‑pocket cost manageable?
• Are you comfortable with the monitoring plan for infections and liver health?

If you answered “yes” to most of these, Ocrevus Zunovo is likely a solid choice. As always, talk through the pros and cons with your neurologist, bring up any concerns about cost or side‑effects, and feel free to ask for a written plan that outlines the pre‑medication steps. Knowledge is power, and the more you understand, the better you can partner with your medical team.

Got questions after reading? Maybe you’ve tried the injection already and have a story to share. Drop a comment, reach out to a patient‑support group, or simply ask your doctor for clarification. You’re not alone on this journey, and every bit of information helps you steer it in the right direction.