What is Zeposia Uses, warnings & interactions
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Zeposia (ozanimod) is a brand-name medication that is manufactured by the Celgene Corporation. It was approved in 2020 by the U.S. Food and Drug Administration (FDA) to treat adults with ulcerative colitis (UC) and certain types of relapsing multiple sclerosis (MS). MS is a chronic inflammatory disease where your body’s immune system attacks the myelin that covers the nerve cells in your central nervous system (CNS) (brain and spinal cord). UC is a disease where the lining of your colon becomes inflamed and develops ulcers, which leads to rectal bleeding and diarrhea.
If your doctor has prescribed Zeposia to you, you may want to know more about what it is and how it works. Here we’ll explain what Zeposia is used for, how it works, its side effects, and more.
What is Zeposia used for?
Zeposia is a sphingosine 1-phosphate (S1P) receptor modulator used to treat adults with:
- Relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease
- Moderate to severe active ulcerative colitis (UC) in adults
How does Zeposia work?
The mechanism of action that Zeposia uses to treat multiple sclerosis and ulcerative colitis is not fully known. Zeposia binds to S1P receptors 1 and 5 and prevents lymphocytes from being released from your lymph nodes to your central nervous system (spinal cord and brain) and intestines. Reducing the number of lymphocytes in these areas is thought to help relieve symptoms of these conditions.
What are the most commonly prescribed doses of Zeposia?
- 0.23 mg capsule
- 0.46 mg capsule
- 0.92 mg capsule
Before taking Zeposia
Before beginning Zeposia, tell your doctor about your medical conditions, including:
- Active fever or infection
- You have a weakened immune system due to disease or medications
- Have received a vaccine in the past 30 days or are scheduled to receive a vaccine
- Have not received a varicella zoster (chicken pox) vaccine
- Have a slow heart rate (bradycardia)
- Have an arrhythmia (irregular heartbeat)
- History of heart problems including chest pain, stroke, high blood pressure, or heart attack
- Liver problems
- Breathing problems, including sleep apnea
- Uveitis (inflammation of your eye)
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Zeposia
- Read the Full Prescribing Information and Medication Guide that comes with Zeposia.
- You will begin your Zeposia treatment with a 7-day starter pack. Your first dose of Zeposia will start low and then gradually increase. On days 1 thru 4, you take a 0.23mg capsule once a day. On days 5 thru 7, you take a 0.46mg capsule once a day. On day 8 and thereafter you take a 0.92mg capsule once a day.
- If you miss 1 or more days of Zeposia during the first 14 days, you will need to restart a Zeposia 7-day starter pack. If you miss a dose of Zeposia after the first 14 days, take your next dose at its scheduled time the following day.
- Take this medication exactly as your doctor prescribes it to you. Do not change your dose or stop taking Zeposia without discussing it with them first.
- Zeposia capsules should be swallowed whole once a day, with or without food.
- You should not eat foods high in tyramine such as aged, fermented, cured, smoked, and pickled foods while on Zeposia as this can increase your blood pressure.
You should not take Zeposia if you have:
- Zeposia is an immunosuppressive drug and can increase your risk of infections. You should be monitored for infections during treatment and for 3 months after stopping Zeposia.
- This medication can cause a significant decrease in heart rate. Your doctor should perform an electrocardiogram (ECG) to check for preexisting cardiac disease before starting treatment.
- Check your liver function before starting Zeposia treatment and discontinue if you have signs of liver disease or injury.
- Women should use an effective form of birth control during treatment and for 3 months after stopping this medication.
- You should monitor your blood pressure while on Zeposia.
- Notify your doctor if you have new or worsening breathing problems.
- You should have an eye exam if you have changes in vision as it may be a sign of macular edema.
Zeposia drug interactions
When Zeposia is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. You should discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- Antiarrhythmic drugs such as amiodarone and sotalol
- Opioids such as methadone
- MAOIs such as linezolid and selegiline
- Beta-blockers such as atenolol
- Calcium channel blockers such as verapamil
- Strong CYP2C8 inhibitors such as gemfibrozil
- Strong CYP2C8 Inducers such as rifampin
Zeposia side effects
Some common side effects of Zeposia in clinical trials include:
- Upper respiratory infection
- Elevated liver enzymes
- Orthostatic hypotension
- Urinary tract infection
- Back pain
- High blood pressure
- Herpes virus infection
Zeposia can sometimes cause more serious side effects, including:
- Serious allergic reactions (hives, swelling of the face or throat, and shortness of breath)
- Increased risk of serious infections
- Bradycardia (low heart rate)
- Hypotension (low blood pressure)
- Severe headache
- Liver injury (nausea, vomiting, upper abdominal pain, loss of appetite, dark urine, jaundice)
- Rare brain infection called progressive multifocal leukoencephalopathy (PML)
- Swelling in the brain called posterior reversible encephalopathy syndrome (PRES)
Contact your healthcare professional for medical advice about any possible side effects you experience while taking Zeposia. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your doctor can prescribe other medications if Zeposia is not right for you. They will vary by factors such as side effects and cost. Some FDA-approved alternatives to Zeposia include:
Can you take Zeposia while you are pregnant or breastfeeding?
It is not known how the use of Zeposia affects pregnant women or the unborn baby. Animal studies produced adverse effects on the fetus. There is a pregnancy exposure registry that monitors outcomes in pregnant women who use Zeposia. 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 breastfed infant. 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.
How long does it take Zeposia to work?
Patients taking Zeposia for ulcerative colitis saw a reduction in rectal bleeding and the number of bowel movements within 2 weeks. They were also three times more likely to achieve remission with 10 weeks of treatment than those taking a placebo.
What happens when you stop taking Zeposia?
If you stop Zeposia, symptoms of MS or UC can return and may even be worse. You should talk with your doctor before stopping this medication. Make sure to let your doctor know if you have worsening symptoms after stopping Zeposia.
Does Zeposia weaken your immune system?
Zeposia is an immune system suppressant so it can reduce your body’s ability to fight infections. You will need to be treated for any infections you may have before starting this medication.
How much does Zeposia cost?
Currently, there is no generic Zeposia available on the market. The average cost for #7 Zeposia 0.23mg capsules are around $2,000. However, you can save on brand-name drugs like Zeposia through NiceRx if eligible for assistance.
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.