For individuals managing multiple sclerosis (MS) or primary progressive MS (PPMS), an Ocrevus (ocrelizumab) infusion is a critical part of their treatment plan. The semi-annual intravenous (IV) therapy has been shown to reduce disease progression. To ensure the process is as smooth and comfortable as possible, patients must adhere to a specific protocol of medical checks and personal preparations. This guide covers essential steps to take in the days leading up to and on the day of your infusion.
Medical Preparations and Health Checks
Prior to each infusion, your healthcare team will need to ensure you are in the best possible health to receive the medication. This involves several key steps that focus on preventing adverse reactions and complications.
Pre-Infusion Screening and Testing
Before starting Ocrevus, your doctor will perform several assessments to establish a baseline and ensure suitability for treatment. This includes checking for hepatitis B (HBV) and assessing quantitative serum immunoglobulin levels. For subsequent infusions, your healthcare team will perform a review of your current medical history and check your vital signs. Keeping your medical history up-to-date is crucial for safe treatment.
Infection Checks
Because Ocrevus can weaken the immune system, it's vital to ensure you do not have an active infection before your treatment. Common symptoms to report include sore throat, fever, cough, or any skin infections. Your infusion will be delayed if an active infection is present, as administering the medication could increase the risk of serious complications. Always be honest and thorough when discussing your health with your provider.
Vaccination Timing
Live-attenuated and live vaccines are not recommended during Ocrevus treatment, as the weakened immune system can increase the risk of infection. Non-live (inactivated) vaccines, such as the seasonal flu shot, should ideally be administered at least two weeks before your Ocrevus infusion, if possible. Discuss any upcoming vaccination plans with your doctor well in advance.
Pre-Medication Protocols
To minimize the risk of infusion-related reactions—such as flushing, headache, and fever—your healthcare team will administer pre-medications before the Ocrevus infusion begins.
- Corticosteroid: You will receive an intravenous corticosteroid approximately 30 minutes prior to the infusion. This helps reduce the frequency and severity of potential reactions.
- Antihistamine: An antihistamine is typically administered 30-60 minutes before the infusion to further decrease the chance of an allergic-like reaction.
- Antipyretic (Optional): Your provider may also consider giving you an antipyretic, such as acetaminophen, to help manage fever or headache symptoms.
Infusion Day Logistics
Preparing for the day of your infusion can help make the hours-long process more relaxing.
What to Wear
Comfort is key for your infusion. Opt for loose-fitting clothing, like sweats or soft pants, and wear a short-sleeved shirt with an easily removable, oversized hoodie or sweater. Infusion centers can sometimes feel cool, so dressing in layers and bringing a cozy blanket or socks can be helpful. Wear clothes that allow easy access to your arm for the IV placement and blood pressure readings.
Hydration and Nutrition
Proper hydration can significantly improve your infusion experience. Stay well-hydrated in the days leading up to your appointment by drinking plenty of water, as this helps make IV access easier and can reduce side effects. Avoid alcohol and excessive caffeine the day before, as they can cause dehydration. Eating a light meal before your infusion can help stabilize your blood sugar and prevent nausea.
Arranging Transport
Since pre-medications like antihistamines can cause drowsiness, it's highly recommended to have someone drive you to and from your appointment. This ensures your safety and allows you to rest immediately after the infusion if you feel tired.
A Comparison of First vs. Subsequent Infusion Preparation
While many preparation steps remain consistent, there are subtle differences between your first and follow-up infusions.
| Aspect | First Infusion | Subsequent Infusions |
|---|---|---|
| Hepatitis B & Immunoglobulin Tests | Required pre-screening before initiation. | Generally not required unless clinically indicated. |
| Dose Schedule | Split into two infusions, typically two weeks apart. | Administered as a single, full dose every six months. |
| Pre-medications | Standard pre-medications are mandatory to prevent reactions. | Required, but the specific medications may be adjusted based on previous reactions. |
| Observation Time | Initial infusion often requires a longer observation period. | Standard observation time, which may be shorter depending on your history. |
| Infusion Reactions | Higher incidence of infusion reactions is reported. | Tend to be less frequent and severe over time. |
What to Bring for Comfort and Entertainment
Your infusion can last several hours, so bringing items to keep you comfortable and occupied is a great strategy.
- Entertainment: A tablet, laptop, book, or magazines can help pass the time. Don't forget your headphones to listen to music or a podcast.
- Charging Cables: Always bring a portable charger or a power cord for your electronic devices.
- Snacks and Drinks: Pack your own snacks and a water bottle, as the provided refreshments may not suit your preferences. Confirm the infusion center's food policy beforehand.
- Comfort Items: A cozy blanket, a neck pillow, or a hot pack can help you relax during the infusion.
- Documentation: Your insurance card, ID, and a list of all your current medications should be readily available for check-in.
- Questions: Prepare a list of any questions you have for your healthcare team.
Conclusion
Preparing effectively for an Ocrevus infusion is a multi-step process that involves careful medical, logistical, and personal planning. By communicating clearly with your healthcare team about your health status and adhering to prescribed pre-medications, you can minimize potential risks and infusion-related reactions. Taking proactive steps for comfort and entertainment will make the experience more manageable. The key is to prioritize your health, stay informed, and arrive at your appointment well-rested and hydrated. For more information, consider exploring resources from the Multiple Sclerosis Association of America (MSAA) at https://mymsaa.org/.
