Hyaluronidase / Ocrelizumab
Hyaluronidase / Ocrelizumab (Ocrevus Zunovo) is a subcutaneous injection used to treat relapsing forms of multiple sclerosis and primary progressive multiple sclerosis in adults.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Hyaluronidase / Ocrelizumab: Patient Information Guide
A plain-language walkthrough of Hyaluronidase / Ocrelizumab — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Ocrevus Zunovo (hyaluronidase / ocrelizumab) subcutaneous injection is approved for adults with multiple sclerosis (MS). Here are the specific conditions it treats:
- Ocrevus Zunovo treats relapsing forms of MS in adults, including:
- Clinically isolated syndrome (a first episode of MS-like symptoms)
- Relapsing-remitting MS (periods of attacks followed by recovery)
- Active secondary progressive MS (a progressing form that still has relapses)
- Ocrevus Zunovo also treats primary progressive MS (PPMS) in adults — a form where disability steadily worsens from the start without clear relapses
⚙️How it works▾
Ocrelizumab is an antibody that targets a protein called CD20 on B lymphocytes — immune cells that play a role in attacking the myelin (protective coating) around nerves in MS. By binding to these B-cells, ocrelizumab triggers their destruction, which is believed to reduce the immune-driven nerve damage that causes MS symptoms. Hyaluronidase, the second ingredient, temporarily breaks down a substance in the tissue under the skin, creating a pathway that allows the large ocrelizumab molecule to be absorbed efficiently after a subcutaneous injection; this effect reverses on its own within 24 to 48 hours.
💊How it's taken▾
Ocrevus Zunovo is given as a subcutaneous (under-the-skin) injection into the abdomen by a healthcare professional approximately every 6 months — doses must be separated by at least 5 months. Before every dose, you will take premedication by mouth (a steroid and antihistamine, and optionally acetaminophen) at least 30 minutes beforehand to lower the risk of a reaction.
- If a dose is missed, take it as soon as possible and reset the 6-month schedule from that point — do not simply wait for the next scheduled date
- After your first injection, you will be observed for at least one hour; after later injections, for at least 15 minutes
- Ocrevus Zunovo has different dosing instructions than intravenous ocrelizumab — they are not interchangeable without guidance from your prescriber
🤒Side effects — in detail▾
The most commonly reported side effect with Ocrevus Zunovo is injection reactions — experienced by about half of patients after the first dose.
- Local injection reactions: redness, pain, swelling, or itching at the injection site
- Systemic injection reactions: headache and nausea
- Upper respiratory tract infections (colds, sinusitis)
- Lower respiratory tract infections (bronchitis)
- Herpes virus infections (cold sores, shingles, genital herpes)
- Skin infections
- Depression
- Back pain or pain in the extremities
Serious reactions — including life-threatening infections, PML (a rare brain infection), liver injury, and immune-mediated colitis — have been reported. Contact your doctor or seek emergency care if you develop severe or unusual symptoms.
⚠️Warnings & precautions▾
- Serious and fatal infections: Because Ocrevus Zunovo depletes B-cells, it weakens your immune system. Bacterial, viral, fungal, and parasitic infections — including serious herpes infections, respiratory infections, and hepatitis B reactivation — have been reported. Treatment should be delayed if you have an active infection.
- Injection reactions: Nearly half of patients experience a reaction with the first injection. Reactions can occur during or within 24 hours after the injection. Life-threatening reactions require immediately stopping the medication permanently.
- Progressive multifocal leukoencephalopathy (PML): A rare but often fatal or severely disabling brain infection caused by the JC virus has been reported. New neurological symptoms should prompt immediate evaluation and possibly stopping the drug.
- Falling immunoglobulin (antibody) levels: Prolonged use can lower your body's antibody levels, raising the risk of serious infections. Levels are monitored before and during treatment.
- Malignancy: An increased risk of cancer, including breast cancer, may exist with this medication.
- Immune-mediated colitis and liver injury: Inflammation of the colon and clinically significant liver injury have been reported; monitor for new digestive symptoms or signs of liver problems.
- Vaccines: Live or live-attenuated vaccines must not be given during treatment or until B-cells recover. Non-live vaccines may be less effective during treatment.
🔀What it interacts with▾
Ocrevus Zunovo can interact with other medications that affect the immune system, and it can also reduce how well vaccines work.
- Immunosuppressants and immune-modulating drugs: Combining Ocrevus Zunovo with other drugs that suppress immunity increases the risk of serious infections — this includes high-dose corticosteroids and other MS therapies
- Specific MS drugs requiring careful transition: Fingolimod, natalizumab, daclizumab, teriflunomide, and mitoxantrone all have prolonged immune effects; your doctor will factor this in when switching to Ocrevus Zunovo
- Live or live-attenuated vaccines: Not recommended during treatment or until B-cells recover; ideally given at least 4 weeks before starting Ocrevus Zunovo
- Non-live vaccines (flu, tetanus, pneumococcal): Ocrevus Zunovo reduces the immune response to these vaccines, potentially making them less protective
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not use Ocrevus Zunovo if you have an active hepatitis B virus (HBV) infection
- Do not use it if you have had a life-threatening reaction to ocrelizumab in the past
- Do not use it if you have a known severe allergy (hypersensitivity) to ocrelizumab, hyaluronidase, or any ingredient in Ocrevus Zunovo
- Tell your doctor if you are a hepatitis B carrier or have been exposed to hepatitis B in the past — liver specialist consultation may be needed before starting
- Tell your doctor if your immunoglobulin (antibody) levels are low — an immunology consultation may be needed first
- Pregnancy: Based on animal data, this medication may harm a fetus. Women who can become pregnant should use effective contraception during treatment and for 6 months after the last dose
- Breastfeeding: It is unknown whether ocrelizumab passes into human milk; discuss the risks and benefits with your doctor
- Infants born to mothers who used Ocrevus Zunovo during pregnancy should not receive live vaccines until their B-cell counts have recovered
- Children: Safety and effectiveness in pediatric patients have not been established
- Older adults (65+): Not enough data are available to know if older patients respond differently
- Mild kidney or liver impairment: Included in clinical trials without significant pharmacokinetic changes, but discuss your full medical history with your doctor
📡Pharmacodynamics — effects in the body▾
Ocrevus Zunovo works by depleting B lymphocytes — a type of immune cell — in the blood. Within 14 days of an injection, measurable CD19+ B-cell counts drop significantly. After stopping the medication, B-cell counts typically begin to recover; the median time for counts to return to baseline or the lower limit of normal is about 72 weeks after the last dose, and 90% of patients see recovery within 2.5 years. Prolonged treatment is associated with decreasing immunoglobulin (antibody) levels, particularly IgM, and lower IgG levels have been linked to a higher rate of serious infections.
🔬Pharmacokinetics — how your body processes it▾
After a subcutaneous injection of Ocrevus Zunovo, ocrelizumab reaches peak blood levels in about 4 days and has an estimated bioavailability of 81%, meaning the body absorbs most of the dose. The terminal elimination half-life — the time it takes for blood levels to fall by half — is approximately 20 days, and the drug is cleared primarily through natural protein breakdown (catabolism) rather than kidney or liver metabolism. Pharmacokinetic studies showed that the subcutaneous dose of Ocrevus Zunovo and the intravenous ocrelizumab dose produced exposures that were not clinically meaningfully different. Mild kidney or mild liver impairment did not significantly change how the body handles ocrelizumab.
📦How to store it▾
Store OCREVUS ZUNOVO vials refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton to protect from light. Do not freeze or shake. refrigerator.
📄 Written from Hyaluronidase / Ocrelizumab’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Hyaluronidase / Ocrelizumab — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly is Ocrevus Zunovo and why has my doctor prescribed it for my MS? ▾
How is this injection given, and do I do it myself at home? ▾
What side effects should I expect, and which ones mean I need to call someone right away? ▾
Will I need any vaccines or blood tests before or during treatment? ▾
Is this medication safe to take if I'm pregnant or thinking about becoming pregnant? ▾
Are there other medications I need to be careful about while taking Ocrevus Zunovo? ▾
Is Hyaluronidase / Ocrelizumab available over the counter? ▾
When was Hyaluronidase / Ocrelizumab first available? ▾
💬 Answers drafted from Hyaluronidase / Ocrelizumab’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Hyaluronidase / Ocrelizumab comes
Hyaluronidase / Ocrelizumab is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Ocrevus Zunovo subcutaneous injection is used to treat relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults
- Ocrevus Zunovo subcutaneous injection is used to treat primary progressive MS in adults
- Ocrevus Zunovo is administered by a healthcare professional as a subcutaneous injection into the abdomen (not within 2 inches of the navel) only — not self-injected at home
- Ocrevus Zunovo is given over approximately 10 minutes every 6 months; doses must be separated by at least 5 months
- Before each Ocrevus Zunovo injection, take premedication (a steroid and antihistamine, and optionally a fever reducer) at least 30 minutes beforehand to reduce reaction risk
- After the first Ocrevus Zunovo injection, remain monitored for at least one hour; after subsequent injections, for at least 15 minutes
📊 Hyaluronidase / Ocrelizumab across the U.S. market
How Hyaluronidase / Ocrelizumab appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
📈 How widely Hyaluronidase / Ocrelizumab is used
A general measure of how commonly Hyaluronidase / Ocrelizumab is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Hyaluronidase / Ocrelizumab is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Hyaluronidase / Ocrelizumab prescribed? Of the 1,596 medications we measure, Hyaluronidase / Ocrelizumab ranks #1,575 by Medicaid prescriptions — more than 1% of them.
Utilization by Hyaluronidase / Ocrelizumab product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
23 ML hyaluronidase-ocsq 1000 UNT/ML / ocrelizumab-ocsq 40 MG/ML Injection
Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2693458
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Hyaluronidase / Ocrelizumab, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 2 listed Hyaluronidase / Ocrelizumab NDCs with Medicaid activity.
🔍 Compare Hyaluronidase / Ocrelizumab products
A representative set of FDA-listed product records for Hyaluronidase / Ocrelizumab — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| OCRELIZUMAB 920 mg/23 mL; HYALURONIDASE (HUMAN RECOMBINANT) 23000 U/23 mL | Subcutaneous | Genentech, Inc. | BLA | View NDC → |
| OCRELIZUMAB 23000 U/23 mL; HYALURONIDASE (HUMAN RECOMBINANT) 920 mg/23 mL | Subcutaneous | Genentech, Inc. | BLA | View NDC → |
Showing 2 of 2 products — FDA National Drug Code Directory. See every product, package size and price: browse all 2 Hyaluronidase / Ocrelizumab NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Hyaluronidase / Ocrelizumab — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Hyaluronidase / Ocrelizumab in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Hyaluronidase / Ocrelizumab went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.
RxCUI 2693453 1 dose form · 1 strength
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Dose form (SCDF) Injection RxCUI 2693455In current FDA listingsClinical drug / strength (SCD) 23 ML hyaluronidase-ocsq 1000 UNT/ML / ocrelizumab-ocsq 40 MG/MLRxCUI 2693458
Look up RxCUI 2693453 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Hyaluronidase / Ocrelizumab is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Hyaluronidase / Ocrelizumab belongs to the CD20-directed Cytolytic Antibody class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Genentech, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.