medicationszeposiaZeposia dosage

Zeposia Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Zeposia (ozanimod) is a sphingosine 1-phosphate receptor modulator that is a product of Bristol-Myers Squibb. It is FDA-approved to treat adults with active ulcerative colitis (UC) and relapsing forms of multiple sclerosis (MS). Zeposia has immunosuppressive effects that help keep your immune system from attacking healthy cells and tissues in your central nervous system (CNS) and colon.

How does Zeposia work?

It is not known how Zeposia works to treat multiple sclerosis and ulcerative colitis. Zeposia binds to S1P receptors 1 and 5 which block the release of lymphocytes from your lymph nodes to your spinal cord, brain, and colon. Reducing the number of lymphocytes in these areas is thought to help relieve symptoms of multiple sclerosis and ulcerative colitis.

Zeposia dosage forms and strengths

Zeposia is available as a capsule in the following strengths:

  • 0.23 mg
  • 0.46 mg
  • 0.92 mg

Zeposia dosage

Zeposia treatment for multiple sclerosis or ulcerative colitis begins with a 7-day starter pack. Once you have been titrated up, you will stay on the maintenance dose if it is effective and well tolerated.

Dose Titration Regimen:

  • Days 1-4: 0.23mg once daily
  • Days 5-7: 0.46mg once daily
  • Day 8 and thereafter: 0.92mg once daily

Zeposia dosage restrictions

  • There is no dosage adjustment necessary in patients with renal impairment.
  • The use of Zeposia is not recommended in patients with hepatic impairment.

How to take Zeposia

  • Read the Full Prescribing Information and Medication Guide that comes with this medication.
  • Take Zeposia exactly as your healthcare provider prescribes it to you. Do not change your dose or stop taking this medication without talking to them first.
  • If you miss 1 or more doses of Zeposia during the first 14 days of treatment, you will need to restart a 7-day starter pack. If you miss a dose of Zeposia after the first 14 days of treatment, skip the missed dose and take the next one at its regular time the following day.
  • Swallow Zeposia capsules whole once a day. They can be taken with or without food.
  • You should avoid foods that are high in tyramine as they can cause a severe increase in your blood pressure.

Zeposia dosage FAQs

What are some side effects of Zeposia?

Some common adverse reactions to Zeposia in clinical trials include:

  • Increased risk of infections including upper respiratory infections and urinary tract infections
  • Increased liver enzymes or transaminases
  • Low blood pressure when you stand up (orthostatic hypotension)
  • Back pain
  • Hypertension (high blood pressure)
  • Headache
  • Fatigue
  • Herpes infection

Zeposia can sometimes cause more serious side effects, including:

  • Serious hypersensitivity reactions (hives, angioedema, and breathing problems)
  • Increased risk of serious infections, especially if taken with or after anti-neoplastic, non-corticosteroid immunosuppressive, or biologic therapy
  • Bradyarrhythmia (slow heart rate) and torsades de pointes
  • Severe headache
  • Liver injury or impairment
  • Progressive multifocal leukoencephalopathy (PML)
  • Posterior reversible encephalopathy syndrome (PRES)

Contact your doctor for medical advice about any side effects or worsening symptoms you experience while taking Zeposia. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Zeposia?

Concomitant use of Zeposia with other medications can change how they work or increase the frequency and severity of side effects. Make sure your healthcare professional is aware of all the prescription and over-the-counter medications, vitamins, and herbal supplements you take, including:

  • Strong CYP2C8 inhibitors such as clopidogrel
  • Strong CYP2C8 Inducers such as rifampin
  • MAO inhibitors such as selegiline and linezolid
  • Class III antiarrhythmics such as amiodarone and sotalol
  • Methadone
  • Atenolol
  • Verapamil

Are there any contraindications or precautions with Zeposia?

Zeposia is contraindicated in patients who have had an allergic reaction to Zeposia or any of the inactive ingredients in its formulation. You should avoid this medication if you have an active infection, had serious heart problems such as a heart attack, stroke, or heart failure in the past 6 months, or are currently taking a monoamine oxidase inhibitor (MAOI).

You should use Zeposia with caution if you have severe liver problems, macular edema, arrhythmias, severe untreated sleep apnea, or atrioventricular (AV) block and sick sinus syndrome, unless you have a functioning pacemaker.

Is it safe to use Zeposia while pregnant or breastfeeding?

It is not known how Zeposia affects pregnant women or their fetuses. Animal studies with Zeposia showed adverse effects on the unborn baby. There is a pregnancy exposure registry that monitors outcomes with Zeposia use in pregnant women. You can register yourself at www.zeposiapregnancyregistry.com or by calling 1-877-301-9314. There is no data on whether Zeposia is found in breast milk or the effects it may have on the fetus. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What foods should I avoid with Zeposia?

You should avoid foods that are high in tyramine which include cheeses, beer, wines, kimchi, sausage, soy sauce, and sauerkraut as they can significantly increase your blood pressure.

Can I take vaccines with Zeposia?

You should not receive a live attenuated vaccine one month before starting Zeposia, during treatment, and for three months after discontinuation of this medication. Your healthcare provider may test you for antibodies to varicella-zoster virus (VZV) and have you receive a VZV, which is also called the chickenpox vaccine before you start Zeposia.

What tests do you need before starting Zeposia?

You may have a few routine tests performed before taking your first dose of Zeposia. These may include a baseline complete blood count (CBC), liver function tests, electrocardiogram (ECG), and an eye exam if you have a history of uveitis or macular edema.

What is the maximum dose of Zeposia?

The maximum dose of Zeposia is 0.92mg once a day.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.