Zeposia (ozanimod)

Reviewed by: HU Medical Review Board | Last review date: February 2022. | Last updated: April 2022

Zeposia (ozanimod) is an oral medication used to treat adults with relapsing forms of MS. The specific forms of MS treated by Zeposia include active secondary progressive disease, relapsing-remitting disease, and clinically isolated syndrome. Unlike some other similar drugs, Zeposia does not require genetic testing before treatment starts. It also does not require significant monitoring after the first dose, like others do.

What are the ingredients in Zeposia?

The active ingredient in Zeposia is ozanimod. This ingredient impacts the way some white blood cells behave in the body.

How does Zeposia work?

Zeposia belongs to a class of drugs called sphingosine 1-phosphate (S1P) receptor modulators. The S1P receptor is a protein on the outside of cells. When Zeposia binds to this protein, it impacts the immune system. Specifically, Zeposia prevents white blood cells called lymphocytes from leaving lymph nodes and getting into the blood stream. These white blood cells play a role in the inflammatory response. It thought that Zeposia may prevent these cells from getting into the central nervous system, where MS-related damage is found, however, no one knows exactly how Zeposia works in MS.

What are the possible side effects of Zeposia?

The most common side effects of Zeposia include:

  • Upper respiratory infection
  • Urinary tract infection
  • Liver function changes
  • High blood pressure or changes in blood pressure when standing up (orthostatic hypotension)
  • Back pain

This is not an exhaustive list of all potential side effects of Zeposia. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Zeposia, contact your doctor or healthcare provider immediately.

Things to know about Zeposia

Before starting Zeposia, make sure your doctor is aware of all medications you are taking and any other health conditions you manage in addition to MS.

Heart-related problems

Zeposia can affect the heart and the way it beats. If you have experienced heart-related problems in the past, such as a heart attack, heart failure, recurrent chest pain, stroke, or heart rhythm changes, tell your doctor before starting Zeposia. Before starting Zeposia, your doctor will order a test called an ECG (electrocardiogram) to make sure your heart is beating regularly.

Risk of infection

Zeposia can also increase a person’s risk of infection. Before starting Zeposia, your doctor will do a blood test to check the number of white blood cells in your body. While taking Zeposia, you may have low levels of lymphocytes. These numbers typically go back to normal within a month after stopping the drug.

Vaccination history

Before starting Zeposia, your doctor will review your vaccination history. Some vaccines cannot be given while a person is taking Zeposia due to their effects on the immune system. Your doctor may recommend that you receive specific vaccines before treatment to help best protect you. Let your doctor know if you take any other medications that impact your immune system. These effects may combine with Zeposia and impact your immune system even more.

Sleep apnea and other medications

People with severe, untreated sleep apnea should not take Zeposia. Zeposia may also interact with other medications, include a type of antidepressant called a monoamine oxidase inhibitor. Tell your doctor about all drugs you are taking or have recently taken before starting Zeposia.

Impact on the liver

Zeposia may also impact a person’s liver. Your doctor may need to test your liver function before starting Zeposia and while you are on the drug. Additionally, Zeposia may increase a person’s blood pressure during treatment.

Impact on vision and respiratory system

Other systems Zeposia may impact include the respiratory system and the eyes. Side effects may include varying respiratory infections. If you have a history of vision problems, or are at a higher risk of having vision changes, your doctor may recommend that you visit an ophthalmologist for an eye check-up before starting Zeposia.

Zeposia and pregnancy

Zeposia may cause harm to an unborn baby. If you or your partner could become pregnant, effective birth control should be used while taking the drug and for 3 months after stopping.

Read the prescribing information to learn more about Zeposia.1,2

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