All About Zeposia

Zeposia price and savings

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. Zeposia is only available from certain specialty pharmacies.

Here are a few things to consider regarding Zeposia’s cost:

• Cost information and savings coupons: You can visit Optum Perks for price estimates of Zeposia. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.
• Savings options: If you have questions about how to pay for your prescription or the annual cost of Zeposia, talk with your doctor or pharmacist. Zeposia’s manufacturer also offers some financial assistance options, including a copay program and help understanding your costs and coverage.

Zeposia side effects

Like most drugs, Zeposia may cause mild or serious side effects. The following lists contain some of the more common side effects Zeposia may cause, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Zeposia. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Zeposia and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that Zeposia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Zeposia’s prescribing information.

Mild side effects of Zeposia that have been reported vary depending on the condition being treated. But they may include:

• infection, such as a urinary tract infection (UTI) or a respiratory infection like a cold
• mildly high blood pressure
• low blood pressure when changing positions
• back pain
• headache

For more information about some of these side effects, see the “Side effect focus” section.

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Zeposia can occur, but they aren’t common. If you have serious side effects from Zeposia, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Zeposia that have been reported include:

• liver problems, such as:
  • high levels of liver enzymes, which may be a sign of liver damage
  • acute liver failure
• slowed heart rate
• lung problems, such as trouble breathing
• severely high blood pressure
• serious infection, such as pneumonia
• cancer, such as skin cancer or breast cancer
• posterior reversible encephalopathy syndrome (a condition that causes swelling in your brain)
• macular edema (swelling and pressure buildup in your eye)
• allergic reaction

For more information about some of these side effects, see the “Side effect focus” section.

Side effect focus

Learn more about some of the side effects Zeposia may cause.

Infections

You may develop an infection while you’re taking Zeposia. Infections were a common side effect in studies of the drug.

Most infections from Zeposia are mild. But some can be serious, and rarely, life threatening.

Mild infections may include a respiratory infection, such as a cold, or a urinary tract infection (UTI). More rare but serious infections that can occur include:

• meningitis, which is an infection of the covering of the brain
• progressive multifocal leukoencephalopathy, which is an infection of the brain

An infection may cause a fever, cough, and vomiting. Other symptoms can include confusion, weakness, and trouble breathing.

What might help

Tell your doctor right away if you develop any symptoms of an infection while taking Zeposia.

They can help determine how serious the infection may be and whether you need treatment.

If you do need treatment, your doctor may recommend an antibiotic or a fever reducer, such as acetaminophen (Tylenol). In more severe cases, your doctor may have you stop taking Zeposia and try a different treatment option.

High blood pressure

Your blood pressure may increase while you’re taking Zeposia. This was a common side effect in studies of the drug.

In most cases, this increase in blood pressure isn’t high enough to cause any serious effects. But in some rare cases, Zeposia may cause high blood pressure that can be serious or even life threatening. In studies, high blood pressure occurred after 3 months of Zeposia treatment. It continued for the rest of treatment.

In severe cases, symptoms of high blood pressure can include:

• headache
• trouble breathing
• confusion
• dizziness

What might help

High blood pressure may not cause noticeable symptoms, so your doctor will likely recommend that you check your blood pressure throughout your Zeposia treatment to make sure it doesn’t get too high.

If you have symptoms of high blood pressure while you’re taking Zeposia, tell your doctor. They may have you take a medication to lower your blood pressure.

Macular edema

Rarely, Zeposia may cause an eye problem called macular edema. With macular edema, fluid collects in your eye and causes swelling and pressure. This can be serious and may affect your vision.

Symptoms of macular edema may include:

• blurry vision
• light sensitivity
• gradual development of a blind spot in your vision
• vision loss

You may be at an increased risk of developing macular edema if you also have diabetes.

What might help

Before you start taking Zeposia, your doctor may recommend that you have your eyes checked by an eye doctor. Your vision will also be monitored throughout your treatment.

If you develop symptoms of macular edema, tell your doctor right away. They can recommend the best treatment option for this condition, which may include laser therapy or medication.

Allergic reaction

Some people may have an allergic reaction to Zeposia.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Zeposia. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Frequently asked questions about Zeposia

Find answers to some commonly asked questions about Zeposia.

Is Zeposia similar to Ocrevus?

Zeposia and Ocrevus (ocrezulimab) can be used for some of the same conditions, but they are very different drugs. Both drugs are used in adults to treat:

• clinically isolated syndrome (CIS)
• relapsing-remitting MS (RRMS)
• active secondary progressive MS (SPMS)

Ocrevus is also approved to treat adults with primary progressive MS (PPMS). Zeposia can also be used to treat ulcerative colitis (UC), which Ocrevus is not approved to treat.

Zeposia is a capsule that you take by mouth once daily. In comparison, Ocrevus is a solution that’s injected into a vein every 6 months. These medications work in different ways to treat MS, so they may cause some different side effects.

If you’re interested in learning more about how Zeposia and Ocrevus compare, talk with your doctor.

What is Zeposia’s mechanism of action (how does it work)?

Zeposia’s mechanism of action isn’t entirely known. But Zeposia reduces the number of certain immune system cells called lymphocytes in certain areas of your body. It’s possible that it may block these cells from getting into your brain, spinal cord, and intestines.

MS and UC are both conditions in which your immune system is overactive. So decreasing the number of lymphocytes in certain areas of your body may decrease symptoms of these conditions.

If you have more questions about how Zeposia may work to treat your MS or UC, talk with your doctor or pharmacist.

What’s the efficacy of Zeposia?

Zeposia is an effective treatment option for MS and for UC.

In studies, people with MS who took Zeposia had fewer relapses (periods of few or no symptoms) and decreased disease progression (the rate at which the condition gets worse) than people who took a different MS drug.

People with UC experienced a decrease in symptoms (such as rectal bleeding) when taking Zeposia in studies.

For more information about the effectiveness of Zeposia, including study details, see the drug’s prescribing information. If you have other questions about Zeposia’s efficacy, talk with your doctor or pharmacist.

Zeposia for MS

If you have certain types of multiple sclerosis (MS), your doctor may recommend Zeposia. MS is an autoimmune condition that affects the myelin sheath (the covering that protects your nerves).

Autoimmune conditions occur when your immune system attacks your body. With MS, your immune system attacks your myelin sheath. This may cause symptoms such as:

• fatigue (low energy)
• trouble walking
• vision changes
• weakness
• dizziness

There are many different forms of MS. Zeposia can be used in adults to treat:

• Clinically isolated syndrome (CIS): With CIS, you have one or more MS-like symptoms. CIS might be the first sign of MS, and it may or may not lead to MS.
• Relapsing-remitting MS (RRMS): With RRMS, your symptoms may relapse (worsen) and remit (get better) for periods of time.
• Active secondary progressive MS (SPMS): This typically develops after RRMS. With active SPMS, your condition continues to worsen over time. You may have fewer periods of remission (times when your symptoms get better).

It’s not known exactly how Zeposia works to treat MS. The drug is thought to decrease the number of immune system cells in your brain and spinal cord. This may decrease the damage that your immune system does to your myelin sheath.

Zeposia is also used to treat ulcerative colitis (see the following “Zeposia for IBD” section for details).

Zeposia for IBD

If you have a type of inflammatory bowel disease (IBD) called ulcerative colitis (UC), your doctor may recommend Zeposia. (Zeposia is not approved to treat the other common type of IBD, called Crohn’s disease.)

UC is a condition that causes swelling and ulcers (sores) in your large intestine. It’s an autoimmune condition, meaning it occurs because your immune system attacks your body. With UC, your immune system attacks the inner lining of your large intestine.

Symptoms of UC may include:

• diarrhea
• weight loss
• blood in your stool
• nausea
• belly pain

It’s not known exactly how Zeposia may work to treat UC. The drug is thought to reduce the number of immune system cells that are attacking your large intestine. This can decrease your UC symptoms.

Zeposia is also used to treat multiple sclerosis (MS) and clinically isolated syndrome (CIS). To learn more about this, see the “Zeposia for MS” section.

Zeposia dosage

Your doctor will recommend the dosage of Zeposia that’s right for you. This section describes commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Zeposia comes as a capsule that you take by mouth in the following strengths: 0.23 milligrams (mg), 0.46 mg, and 0.92 mg.

Recommended dosage

During the first 7 days of treatment, your doctor will have you gradually increase your Zeposia dose as shown in the following table. This is done so that your body can adjust to the new medication gradually.

The recommended maintenance (ongoing) dosage is 0.92 mg of Zeposia per day.

If you have liver problems, your doctor may prescribe 0.92 mg every other day instead.

Questions about Zeposia’s dosage

Below are answers to a few common questions about Zeposia’s dosage.

• What if I miss a dose of Zeposia? If you miss a dose of Zeposia within your first 2 weeks of treatment, talk with your doctor. Since your dose of Zeposia is slowly increased within the first week, your doctor will likely recommend that you restart treatment with the starting dose. But if you miss your dose of Zeposia after your first 2 weeks of treatment, skip the missed dose and take your next dose at the usual time. If you missed a dose of Zeposia and you aren’t sure when to take your next dose, talk with your doctor or pharmacist.
• Will I need to use Zeposia long term? If Zeposia works for you, your doctor will likely recommend that you take it long term.
• How long does Zeposia take to work? Zeposia will begin working after you take your first dose of medication. But it may take time for you to notice that Zeposia is working. It’s important that you continue to take Zeposia each day so that the medication can work to decrease your symptoms.

Overdose

Do not take more Zeposia than your doctor prescribes. Taking more than this can lead to serious side effects.

Call your doctor if you think you’ve taken too much Zeposia. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

How to take Zeposia

Your doctor will explain how you should take Zeposia. Be sure to follow their instructions.

Zeposia comes as a capsule that’s taken by mouth once daily. You can take your dose of Zeposia with or without food.

Due to the increased risk of skin cancer with Zeposia, you should limit your exposure to sunlight and ultraviolet (UV) light. You can do this by avoiding direct sunlight, wearing protective clothing, and using high-SPF sunscreen.

Questions about taking Zeposia

Below are answers to a few common questions about how to take Zeposia.

• Can Zeposia be chewed, crushed, or split? No. You should not chew, crush, or split Zeposia capsules. They should be swallowed whole.
• Should I take Zeposia with food? Zeposia can be taken with or without food.

Factors to consider when taking Zeposia

Before you start treatment with Zeposia, you should discuss your medical conditions as well as the medications you take with your doctor. Zeposia may not be a good treatment option for people with certain conditions, or people taking medications that may interact with Zeposia.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Zeposia, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, tell them about any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Zeposia.

Interactions with drugs or supplements

Zeposia can interact with several types of drugs. These drugs include:

• immunosuppressant drugs (drugs that reduce immune system activity)
• certain cancer treatments
• pain medications, such as opioids
• drugs that block an enzyme (a type of protein) called CYP2C8, such as the triglyceride-lowering drug gemfibrozil
• drugs that cause an enzyme called CYP2C8 to work more quickly than usual in the body, such as the antibiotic rifampin
• drugs that are used for heart conditions, or that may decrease your heart rate
• certain depression medications, especially monoamine oxidase inhibitors (MAOIs)

This list does not contain all types of drugs that may interact with Zeposia. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Zeposia.

Other interactions

Zeposia can also interact with foods or beverages that contain a protein called tyramine. This interaction may cause a dangerous increase in your blood pressure.

Some foods and beverages that may contain tyramine include:

• pickled foods
• alcoholic drinks such as wine or beer
• certain cheeses
• some processed meats

Your doctor will likely recommend that you do not eat or drink foods or beverages containing tyramine while you’re taking Zeposia.

You should also avoid live vaccines while you’re taking Zeposia. (Live vaccines contain a small amount of weakened virus or bacteria.) Zeposia may reduce your immune system activity, which can cause live vaccines to make you sick.

Examples of live vaccines include the measles, mumps, and rubella (MMR) vaccine and the chickenpox vaccine. Talk with your doctor about any live vaccines you might need before you start Zeposia.

Warnings

Zeposia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Zeposia. Factors to consider include:

• any infection that’s currently causing symptoms
• irregular heartbeat or a slowed heart rate
• breathing problems, including sleep apnea
• history of heart attack, stroke, heart failure, or unstable angina (chest pain), especially in the past 6 months
• recent vaccinations you’ve had
• high blood pressure
• liver problems
• eye problems, especially uveitis
• diabetes
• any risk factors for skin cancer, such as a personal or family history
• allergic reaction to Zeposia or any of its ingredients
• alcohol use (see below)
• pregnancy or breastfeeding (see below)

Before starting Zeposia, your doctor will recommend having your heart, eye, and liver function assessed, as well as your skin and your blood cell counts.

Zeposia and alcohol

Alcohol may cause damage to your liver. Since Zeposia can also cause liver problems, your doctor may recommend avoiding alcohol or limiting alcohol while you’re taking this medication.

Zeposia can also interact with certain alcoholic drinks, like wine or beer. In some cases, wine or beer may contain a protein called tyramine. This interaction may cause a dangerous increase in your blood pressure.

If you drink alcohol, talk with your doctor about how much, if any, is safe for you to drink while you’re taking Zeposia.

Pregnancy and breastfeeding

It’s not known if Zeposia may be safe to take during pregnancy. The drug has a possible risk of problems with fetal development (commonly known as birth defects).

Because of this risk, if you’re able to become pregnant, you should use an effective form of birth control throughout treatment with Zeposia. And you should continue to use birth control for at least 3 months after stopping Zeposia.

It also isn’t known if Zeposia is safe to use during breastfeeding.

If you’re pregnant, breastfeeding, or planning to be either, talk with your doctor before starting Zeposia.

If you do take Zeposia during pregnancy, you could consider joining the Zeposia pregnancy registry. Pregnancy registries help gather information about how certain drugs affect pregnancy.