Your doctor may recommend that you take Zeposia if you have ulcerative colitis (UC) or certain forms of multiple sclerosis (MS).

Specifically, this drug can be used in adults to treat:

To read more about these conditions, see “Is Zeposia used for MS?” and “Is Zeposia used for IBD?” below.

Zeposia basics

Zeposia comes as a capsule that you’ll take by mouth. The active ingredient in Zeposia is ozanimod.

At this time, Zeposia is only available in the brand-name form. There are no generic forms of this medication currently available.

Read on to learn more about Zeposia, including its cost, side effects and what it’s used for.

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.) To find current prices for Zeposia in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription or the annual cost of Zeposia, talk with your doctor or pharmacist. You can also visit the Zeposia manufacturer’s website to see if they have support options.

You can also check out this article to learn more about saving money on prescriptions.

Like most drugs, Zeposia may cause mild or serious side effects. The lists below describe some of the more common side effects that Zeposia may cause. These lists 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.

Mild side effects

Here’s a short 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:

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.

* For more information about this side effect, see the “Side effect focus” section below.

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:

* For more information about this side effect, see the “Side effect focus” section below.

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:

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.

Symptoms of high blood pressure can include:

  • headache
  • trouble breathing
  • confusion
  • dizziness

What might help

Your doctor may 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.

Find answers to some commonly asked questions about Zeposia.

Is Zeposia similar to Ocrevus?

Somewhat, but these drugs are different from each other.

Both Zeposia and ocrezulimab (Ocrevus) are used in adults to treat:

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.

Although these medications can be used for some of the same conditions, Zeposia and Ocrevus are very different drugs.

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. They can help determine what the best treatment option may be for your condition.

How does Zeposia work?

Zeposia’s mechanism of action (how it works) 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.

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 (UC), which is a form of inflammatory bowel disease (IBD). To learn more about this, see the “Is Zeposia used for IBD?” section below.

If you have a type of inflammatory bowel disease (IBD) called ulcerative colitis (UC), your doctor may recommend Zeposia. This drug 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:

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 “Is Zeposia used for MS?” section above.

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

Form

Zeposia comes as a capsule that you take by mouth.

Recommended dosage

You’ll take your dose of Zeposia once daily.

When you first start taking Zeposia, you’ll start with a low dose. Your doctor will slowly increase your dose over the next week until you’re taking the recommended dose for your condition. This is done so that your body can adjust to the new medication gradually.

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 re-start 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.

To learn more about how Zeposia and Gilenya are alike and different, see this article. Also, check with your doctor about which drug is right for you.

If you’d like to learn how Zeposia compares with Tecfidera, see this article. Ask your doctor which medication is better for your condition.

Your doctor will explain how you should take Zeposia. Be sure to follow your doctor’s instructions.

Taking Zeposia

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

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.
Questions for your doctor

You may have questions about Zeposia and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Zeposia affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

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:

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 live virus or bacteria.) Zeposia may weaken your immune system, 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 those in the list below.

  • Active infections. If you have an infection that’s currently causing symptoms, your doctor will recommend treating your infection before you start Zeposia. This medication can make active infections worse if they’re not treated first. Be sure to tell your doctor about any infections you have before starting Zeposia.
  • Irregular heartbeat. Zeposia can make certain heart conditions, including an irregular heartbeat, worse. If you have an irregular heartbeat, tell your doctor before you start Zeposia. In some cases, they may recommend more frequent monitoring of your heart health during Zeposia treatment. Or they may recommend a different treatment option for your condition.
  • Breathing problems, including sleep apnea. Zeposia may cause certain lung or breathing problems to occur. If you already have breathing problems, Zeposia may make your condition worse. Tell your doctor about any breathing problems you have before starting Zeposia. They can help determine if Zeposia is a safe option for you.
  • Heart attack, stroke, heart failure, or unstable angina. If you’ve had a heart attack, stroke, heart failure or unstable angina (chest pain) in the past 6 months, you should not take Zeposia. Zeposia may make certain heart conditions worse and can increase your risk of heart problems. Talk with your doctor about the best treatment option for you if you’ve recently experienced any of these conditions.
  • Recent vaccination. Tell your doctor about any vaccines you’ve received recently. Zeposia may make vaccines less effective. Your doctor may recommend waiting before starting Zeposia so that the vaccine can begin working before your treatment.
  • Slowed heart rate. If you have a slowed heart rate, tell your doctor before you start Zeposia. This medication can make your heart rate even slower, which may make your condition worse. Your doctor may recommend more frequent monitoring of your heart health during Zeposia treatment. Or they may recommend a different treatment option for your condition.
  • High blood pressure. Zeposia may increase your blood pressure. If you already have high blood pressure, Zeposia can increase your blood pressure even more, which may become dangerous. Tell your doctor if you have high blood pressure so that they can help you determine if Zeposia may be a safe treatment option for you.
  • Liver problems. Zeposia may cause increases in your liver enzymes, which may be a sign of liver damage. If you already have liver problems, taking Zeposia can make your condition worse. Your doctor may recommend more frequent monitoring during your Zeposia treatment. Or they may recommend a different drug for your condition.
  • Eye problems, especially uveitis. Zeposia can increase your risk of eye problems, such as macular edema. If you already have uveitis or another eye condition, Zeposia can make your condition worse. Tell your doctor about any eye conditions you have before starting Zeposia. They’ll recommend the best treatment option for you.
  • Allergic reaction. If you’ve had an allergic reaction to Zeposia or any of its ingredients, you shouldn’t take Zeposia. Ask your doctor what other medications are better options for you.
  • Diabetes. Tell your doctor if you have diabetes before you start taking Zeposia. The drug may increase your risk of developing certain eye conditions related to diabetes. Your doctor may recommend more frequent monitoring of your eye health than usual while you’re taking Zeposia. They may also recommend that you monitor your blood sugar levels more often.

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.

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

What to do in case you take too much Zeposia

Call your doctor if you think you’ve taken too much Zeposia. You can also call 800-222-1222 to reach the American Association of Poison Control 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.

Your doctor may recommend that you take Zeposia if you have:

Before you start Zeposia, you should discuss the medication with your doctor. Be sure to talk about any other medical conditions you have and other medications you take. This will help you and your doctor determine if Zeposia is a good treatment option for you.

Here are some other questions you may want to discuss with your doctor before you start taking Zeposia.

  • If I have side effects from Zeposia, can my doctor lower my dose?
  • What should I do if I become pregnant while I’m taking Zeposia?
  • What’s the best way to treat side effects from this medication?

If you’d like to learn more about other treatment options for MS or CIS, see this article about MS drugs. You may also wish to compare treatment options for MS, using this chart. To get updates on MS and its treatments, sign up for Healthline’s newsletter.

If you have UC, you may want to learn more about treatment or read about new treatment options. To get updates on IBD, sign up for Healthline’s newsletter.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.