Ozanimod

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Zeposia; Zeposia 7-Day Starter Pack; Zeposia Starter Kit

Brand Names: Canada

Zeposia; Zeposia Initiation Pack

What is this drug used for?

• It is used to treat MS (multiple sclerosis).
• It is used to treat ulcerative colitis.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have ever had any of these health problems: Certain types of abnormal heartbeats (heart block, sick sinus syndrome, long QT on ECG), chest pain (angina), heart attack, heart failure, transient ischemic attack (TIA), or stroke.
• If you have liver disease.
• If you have sleep apnea.
• If you have an infection.
• If you have had a vaccine in the past month.
• If you are taking or have recently taken any drugs that can cause a slow heartbeat, a certain type of abnormal heartbeat (prolonged QT interval), or suppress your immune system. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
• If you are getting any kind of light therapy, talk with your doctor.
• If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
• If you are taking any of these drugs: Linezolid or methylene blue.
• If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for infections, MS (multiple sclerosis), drugs that affect the immune system, and others. There are many drugs that must not be taken with this drug.
• If you have taken alemtuzumab.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

For all patients taking this drug:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
• Have your blood work and heart function checked as you have been told by your doctor. You will also need to have eye and skin exams.
• Your doctor may order an MRI scan before you start this drug.
• You may have more chance of getting an infection while taking this drug and for 3 months after stopping it. Some infections have been severe. Rarely, this has been deadly. Wash hands often. Stay away from people with infections, colds, or flu.
• Talk with your doctor before getting any vaccines while taking this drug and for 3 months after stopping it. Use with this drug may either raise the chance of an infection or make the vaccine not work as well.
• If you have not had chickenpox or a chickenpox vaccine, talk with your doctor.
• High blood pressure has happened with this drug. Have your blood pressure checked as you have been told by your doctor.
• Too much of some foods and drinks, like some cheeses and red wine, may cause sudden, severe high blood pressure when you are taking this drug. Talk with your doctor about your risk for this effect. Get a list of foods and drinks that can cause this effect. Limit these foods and drinks as your doctor has told you.
• Do not stop taking this drug without calling the doctor who ordered it for you.
• A raised risk of skin cancer has happened with this type of drug. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen with a high SPF and wear clothing that protects you from the sun.
• Other types of cancer like breast, cervical, rectal, and others have happened with this drug. If you have had cancer in the past or if you have questions, talk with the doctor.
• If you are 65 or older, use this drug with care. You could have more side effects.
• This drug may cause harm to the unborn baby if you take it while you are pregnant.
• If you may become pregnant, use birth control while taking this drug and for 3 months after your last dose. If you get pregnant, call your doctor right away.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

For patients taking this drug to treat MS (multiple sclerosis):

• When this drug is stopped, MS signs can come back and may be worse than before or during treatment. If you stop this drug and your MS signs get worse, call your doctor right away.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
• Signs of meningitis like headache with fever, stiff neck, upset stomach, confusion, or if lights bother the eyes.
• Signs of herpes infections like cold sores, shingles, genital sores, severe headache, confusion, change in eyesight, eye redness, or eye pain.
• Signs of skin cancer like a new wart, lump, or other skin growth; a sore that bleeds or does not heal; a shiny, white, pink, red, or skin-colored bump that bleeds or does not heal; or a change in the color or size of a mole.
• Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Shortness of breath.
• Trouble breathing that is new or worse.
• Passing urine more often.
• Swelling in the arms or legs.
• Slow or abnormal heartbeat may happen with this drug, especially after your first dose. People with certain heart problems will need to be watched closely for some time after the first dose of this drug. Before starting this drug, tell your doctor about all your other drugs and health problems. Call your doctor right away if you feel confused or have dizziness, slow or abnormal heartbeat, tiredness, or chest pain.
• An eye problem called macular edema has happened with this drug. The risk may be higher if you have diabetes or have had uveitis. Over a long period of time (like 6 months), macular edema can lead to lasting loss of eyesight. Call your doctor right away if light bothers your eyes or if you have abnormal colors in your eyesight; blurriness, shadows, or a blind spot in the middle of your eyesight; or any other changes in eyesight.
• A very bad and sometimes deadly brain problem called posterior reversible encephalopathy syndrome (PRES) has happened with this drug. Call your doctor right away if you have signs like feeling confused, lowered alertness, change in eyesight, loss of eyesight, seizures, or very bad headache.
• A severe brain problem called progressive multifocal leukoencephalopathy (PML) may happen with this drug. This may be more likely the longer you take this drug. Signs can get worse even months after you stop this drug. PML may cause disability or can be deadly. Tell your doctor right away if you have signs like confusion, memory problems, depression, change in the way you act, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.
• Liver problems have happened with this drug. Sometimes, this has been severe and a liver transplant was needed. Tell your doctor right away if you have any signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Signs of a common cold.
• Back pain.
• Headache.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Swallow whole. Do not chew, open, or crush.
• Take with or without food.
• It is important that you do not miss or skip a dose of this drug during treatment.

What do I do if I miss a dose?

• If you miss 1 day of this drug within the first 2 weeks of taking it, call your doctor to find out how to restart.
• If you miss a dose of this drug after the first 2 weeks of taking it, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

• Store at room temperature in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-10-09

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