Zeposia

Generic name: Ozanimod
Dosage form: oral capsule (0.23 mg; 0.46 mg; 0.92 mg)
Drug class: Selective immunosuppressants

Usage of Zeposia

Zeposia (ozanimod) capsules are used to treat adults with types relapsing forms of multiple sclerosis (MS) and moderately to severely active ulcerative colitis (UC). Zeposia helps to reduce the relapse rate and the number and size of brain lesions in multiple sclerosis. For ulcerative colitis, Zeposia is used to reduce symptoms, and it can also help achieve and maintain remission.

Zeposia is FDA-approved to treat adults with moderately to severely active ulcerative colitis and also FDA-approved to treat relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.

Multiple sclerosis and ulcerative colitis are both autoimmune disorders where the immune cells (lymphocytes) are thought to incorrectly start attacking your healthy tissue, thinking that it is a foreign substance. In multiple sclerosis, the immune system attacks and damages the myelin sheath that covers the nerves in the brain and spinal cord (CNS). This disrupts the brain from sending signals to the rest of the body and causes symptoms including numbness and tingling in the face, arms, feet, and legs, balance issues and trouble walking, vision problems, bowel and bladder problems, fatigue, and problems thinking and concentrating.

In ulcerative colitis, the immune system attacks and causes inflammation in the lining of the colon which causes the symptoms of abdominal pain, rectal bleeding, bowel urgency, diarrhea, and tiredness. 

Zeposia side effects

Get emergency medical help if you have signs of an allergic reaction to Zeposia: hives, rash; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • slow heartbeats, chest pain, shortness of breath, or feel like your heart is skipping beats;
  • a light-headed feeling, like you might pass out;
  • cough, new or worsening shortness of breath;
  • sudden confusion, severe headache, vision loss, or a seizure;
  • pounding in your neck or ears;
  • liver problems - nausea, vomiting, upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
  • changes in vision - blurred vision, increased sensitivity to light, seeing an unusual color in your vision, or having a blind spot or shadows in the center of your vision; or
  • symptoms of infection - fever, flu symptoms, feeling very tired, cough, rash, painful and frequent urination, neck stiffness, increased sensitivity to light.
  • Common Zeposia side effects may include

  • headache, back pain;
  • urination problems;
  • high or low blood pressure;
  • abnormal liver function tests; or
  • cold symptoms such as stuffy nose, sneezing, sore throat.
  • This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    Before taking Zeposia

    You should not use Zeposia if you are allergic to the active ingredient ozanimod or any of the inactive ingredients. To check for a complete list of ingredients, click here: Zeposia ingredients. 

    You should not use Zeposia if you have certain serious heart conditions, especially:

  • recent (within the past 6 months) heart failure, heart attack, stroke, "mini-stroke" or TIA, chest pain (unstable angina), or other serious heart problem;
  • "AV block" or sick sinus syndrome (unless you have a pacemaker); or
  • severe untreated sleep apnea (breathing stops during sleep).
  • Some heart rhythm medications can cause unwanted or dangerous effects when used with this medicine. Your doctor may change your treatment plan if you also use amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, or sotalol.

    Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. Wait at least 14 days after stopping an MAO inhibitor before you take Zeposia.

    You should not receive live vaccines during treatment with Zeposia, for at least 1 month before starting treatment, and for 3 months after you stop treatment. Vaccines may not work as well when given during treatment with Zeposia.

    Tell your doctor if you have received any vaccine within the past 30 days or if you are scheduled to receive a vaccine.

    Tell your doctor if you have a fever or infection, or if you have ever had:

  • a weak immune system (caused by disease or by using certain medicine);
  • a very slow heart rate;
  • heart rhythm problems, long QT syndrome;
  • a heart attack, stroke, or chest pain;
  • high blood pressure;
  • sleep apnea or other breathing problems;
  • diabetes;
  • liver disease; or
  • an eye condition called uveitis.
  • Before taking this medicine, you should have a complete blood count, a cardiac evaluation, liver function tests, and a ophthalmic assessment. Your doctor will check your current or prior medication, your vaccination history, and whether you have a confirmed history of chickenpox.

    Pregnancy

    Zeposia may harm an unborn baby. Tell your doctor if you are planning a pregnancy or are pregnant. Use effective birth control while using this medicine and for at least 3 months after your last dose.

    If you become pregnant while taking Zeposia pregnant, talk to your healthcare provider about registering with the Pregnancy Registry. The purpose of this registry is to collect information about your health and your baby's health.

    Breastfeeding

    It is not known if Zeposia passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you taking this medicine.

    Relate drugs

    How to use Zeposia

    Usual Adult Dose for Multiple Sclerosis

    Dose titration regimen

  • Day 1 to day 4: 0.23 mg capsule once a day.
  • Day 5 to day 7: 0.46 mg capsule once daily.
  • Day 8 and thereafter: 0.92 mg capsule once a day.
  • Maintenance dose:

  •  0.92 mg capsule once daily starting on Day 8.
  • Uses:

  • For the treatment of relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive. 
  • Usual Adult Dose for Ulcerative Colitis

    Dose titration regimen

  • Days 1 to day 4: 0.23 mg capsule once a day.
  • Days 5 to day 7: 0.46 mg capsule once daily.
  • Day 8 and thereafter: 0.92 mg capsule once a day.
  • Maintenance dose

  • 0.92 mg capsule once daily starting on Day 8.
  • Uses:

  • For the treatment of moderately to severely active ulcerative colitis.
  • Warnings

    Infections: You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, flu symptoms, feeling very tired, cough, rash, painful and frequent urination, neck stiffness, increased sensitivity to light. Your risk of infection could last for 3 months after you stop taking this medicine.

    Heart rate: This medicine can slow your heart rate when you start taking it. Tell your doctor if you have slow heartbeats, chest pain, shortness of breath, or feeling like your heart is skipping beats.

    Progressive multifocal leukoencephalopathy (PML): Zeposia can increase your risk for PML, which is a rare brain infection that usually leads to death or severe disability. PML is more likely to happen in people with weakened immune systems but has happened in people who do not have weakened immune systems. Symptoms of PML get worse over days to weeks. Call your doctor right away if you have any new or worsening symptoms of PML that have lasted several days, including weakness on one side of your body, loss of coordination in your arms or legs, decreased strength, problems with balance, changes in your vision, changes in your thinking or memory, confusion or changes in your personality.

    What other drugs will affect Zeposia

    Zeposia can cause a serious heart problem and your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

    Tell your doctor about all your other medicines, especially:

  • alemtuzumab, clopidogrel, eltrombopag, gemfibrozil, rifampin;
  • an antidepressant;
  • drugs that weaken the immune system such as cancer medicine, steroids, and medicines to prevent organ transplant rejection;
  • heart rhythm medicine;
  • medicine to treat Parkinson's disease; or
  • opioid pain medicine
  • MAO inhibitors such as  isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. 
  • amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, or sotalol.
  • Zeposia can have long lasting effects on your body, especially on your immune system. For at least 4 weeks after your last dose, tell any doctor who treats you that you have used this medicine.

    This list is not complete and many other medications may also interact with Zeposia so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. To check for interactions with Zeposia click on the link below.

    Disclaimer

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