If you have a certain autoimmune condition, your doctor might suggest Zeposia as a treatment option.

Zeposia is a prescription drug that’s used to treat certain kinds of the following conditions in adults:

The active ingredient in Zeposia is ozanimod. An active ingredient is what makes a drug work. Zeposia comes as a capsule that you swallow.

Zeposia is part of a group of drugs called immune modulators. This means it works with your immune system.

This article describes the dosages of Zeposia, as well as its strengths and how to take the drug. To learn more about Zeposia, see this in-depth article.

Note: This chart highlights the basics of Zeposia’s dosage. Be sure to read on for more detail. And keep in mind that this article covers Zeposia’s standard dosage schedule, which is provided by the drug’s manufacturer. But always follow the dosing instructions your doctor prescribes.

Zeposia formZeposia strengths in milligrams (mg)Starting dosage (days 1 to 4)Increased dosage (days 5 to 7)Maintenance dosage (day 8 on)
capsules• 0.23 mg
• 0.46 mg
• 0.92 mg
0.23 mg once daily0.46 mg once daily0.92 mg once daily

Read about Zeposia’s recommended dosages in this section.

What is Zeposia’s form?

Zeposia comes as a capsule that you swallow.

What strengths does Zeposia come in?

Zeposia comes in the following strengths:

  • 0.23 milligrams (mg)
  • 0.46 mg
  • 0.92 mg

The two lower dosages come together in a color-coded blister pack called a starter pack. The starter pack is part of a starter kit for Zeposia. For more information, see the “Frequently asked questions” section below.

What are the usual dosages of Zeposia?

Your Zeposia dosage will usually be increased over a week when you start taking the drug. You’ll get a starter kit to make it easier to keep track of your dosage for the first week. For more information about the starter kit, see the “Frequently asked questions” section below.

The information below describes dosages that are commonly prescribed or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for relapsing-remitting MS and active secondary progressive MS

Zeposia is prescribed to treat relapsing forms of multiple sclerosis (MS), specifically relapsing-remitting MS and active secondary progressive MS.

Relapsing-remitting MS gets worse for a period of time, and then it gets better for a period of time. With secondary progressive MS, the disease continues to get worse.

The dosage of Zeposia for both of these kinds of MS is the same. You’ll begin by taking 0.23 mg once per day for 4 days. Then your dose of Zeposia will increase to 0.46 mg, which you’ll take once daily for the next 3 days. Your dose will increase once more to 0.92 mg. This is your maintenance dose, which you’ll take once daily for the rest of treatment.

Dosage for clinically isolated syndrome

Clinically isolated syndrome (CIS) is a set of symptoms that you experience on one occasion. These symptoms can last 24 hours or longer. CIS is sometimes the first sign of MS.

For CIS, you’ll start with a 0.23-mg dose of Zeposia, which you’ll take once daily for 4 days. You’ll then take a dose of 0.46 mg once daily for the next 3 days. Finally, your doctor will prescribe a maintenance dose of 0.92 mg, which you’ll take once daily for the rest of treatment.

Dosage for ulcerative colitis

Ulcerative colitis (UC) is an inflammatory condition that affects the intestines.

If you take Zeposia for UC, your starter dose will be 0.23 mg. You’ll take this dose once daily for the first 4 days. Then you’ll take a higher dose of 0.46 mg once daily for the next 3 days. After that, your doctor will prescribe 0.92 mg as your maintenance dose. You’ll take this dose once daily for the rest of treatment.

Is Zeposia taken long term?

Yes, Zeposia is typically taken as a long-term treatment. If you and your doctor determine that Zeposia is safe and effective for you, it’s likely that you’ll take it long term.

Dosage adjustments

If you get a serious infection, your doctor may temporarily stop Zeposia treatment. They might also recommend switching to a different medication if this happens. Your immune system may not function as it usually does for 3 months after you stop taking Zeposia. So your doctor may keep track of any infections you develop during that time.

Zeposia can cause serious side effects in some people who take it. Examples include heart problems and liver problems. If you have a serious side effect from Zeposia, your doctor may pause your treatment. Or they may prescribe a different medication for your condition.

If you miss a dose of Zeposia during the first 2 weeks of treatment, let your doctor know right away. You’ll likely have to follow the same dosage instructions as at the beginning of treatment. And your daily dose will slowly increase until you’re back to taking the maintenance dose.

If you miss a dose of Zeposia after you’ve been taking it for more than 2 weeks, take the dose as soon as you remember. But if it’s almost time for your next dose, wait to take the dose at your next regularly scheduled time. Do not take two doses at once.

If you need help remembering to take your dose of Zeposia on time, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Below are answers to some frequently asked questions about Zeposia.

What is first-dose observation? Does Zeposia treatment require this?

First-dose observation means that a healthcare professional will monitor your body’s reaction when you take a medication for the first time. This may include making sure your blood pressure, heart rate, and breathing are normal.

Zeposia does not require first-dose observation. But you’ll likely need to have tests before you start Zeposia treatment to make sure it’s safe to take the drug. Your doctor may order tests that check the following:

Should I take my daily Zeposia capsule with food?

You can take your daily Zeposia dose with food or without food.

There are certain foods that you should try to avoid while taking Zeposia. These foods have a substance called tyramine. Tyramine can increase your blood pressure, and so can Zeposia. As a result, eating foods containing tyramine during Zeposia treatment increases your risk of high blood pressure.

Foods that have a lot of tyramine include pickled foods, aged cheeses, and cured meats. For more info about foods that contain tyramine, see this article.

If you have questions about eating certain foods while taking Zeposia, talk with your doctor.

What is a 7-day starter pack?

The 7-day starter pack is part of the starter kit you’ll get when you begin taking Zeposia. The Zeposia capsules are color coded and labeled. This is to help you remember to take the right strength of medication each day. The starter pack contains four 0.23-mg capsules and three 0.46-mg capsules.

You’ll only use the starter kit at the beginning of Zeposia treatment or if you need to restart treatment. After you’re taking the maintenance dosage regularly, your capsules will come in a bottle.

If you have any questions about the Zeposia starter pack or kit, ask your doctor.

The dosage of Zeposia you’re prescribed may depend on several factors. These include:

  • the kind and severity of the condition you’re taking Zeposia to treat
  • how long you have been taking Zeposia
  • your body’s reaction to the drug, such as getting an infection
  • other conditions you may have (see “Dosage adjustments” under “What is Zeposia’s dosage?”)

Zeposia is a capsule that you take by mouth. You’ll swallow it whole. If you have trouble swallowing capsules, see this article for tips on how to take this form of medication.

You should try to take Zeposia at the same time every day. And you can take Zeposia with food or without food. But it’s recommended that you don’t eat certain foods during Zeposia treatment. For more information, see the “Frequently asked questions” section above.

When you start taking Zeposia, you’ll increase your daily dose of this drug over the first 7 days. This helps lower your risk of side effects as your body gets used to the drug.

Before you start taking Zeposia, your doctor will likely order tests to check certain bodily functions. For examples of these tests, see the “Frequently asked questions” section above.

For information on Zeposia expiration, storage, and disposal, see this article.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies may provide medication labels that:

  • have large print or use braille
  • feature a code that you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Zeposia in an easy-open container. Your pharmacist may also have some tips that can help make it simpler to open the drug’s container.

Don’t 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 right away 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, call 911 or your local emergency number immediately or go to the nearest emergency room.

The sections above describe the usual dosages provided by the drug manufacturer. If your doctor recommends Zeposia for you, they will prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Zeposia without your doctor’s recommendation. Only take Zeposia exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • If I miss a dose in the second week of taking Zeposia, do I need a new starter kit?
  • If I start taking another drug that works on the immune system, will you change my dose of Zeposia?
  • Would a lower dose of Zeposia make me less likely to have eye problems as a side effect?

For more tips on managing your condition and treatment updates, subscribe to Healthline’s multiple sclerosis (MS) or inflammatory bowel disease (IBD) newsletters.

And if you’re looking for a supportive group of people with the same chronic condition as you have, consider joining a Bezzy community. You’ll find an MS community and an IBD community that you can sign up for through the Bezzy homepage.


Can I get vaccines while I’m taking the lower dosage of Zeposia?



Zeposia is an immune modulator. This means it works with your immune system. So your immune system might respond differently to vaccines while you’re taking this drug, even at its lowest dosage. Talk with your doctor about whether Zeposia might affect the effectiveness of any vaccines you’re planning to get.

The manufacturer of Zeposia recommends avoiding live vaccines while taking Zeposia and for 3 months after stopping treatment. A live vaccine contains a weakened version of the virus or bacteria it’s meant to protect against. Examples of live vaccines include the varicella-zoster vaccine and the measles, mumps, rubella vaccine.

But you may be able to continue getting other vaccines, such as the flu shot or the COVID-19 vaccine. This is because these vaccines are not live vaccines.

Talk with your doctor about vaccinations to get before you start treatment with Zeposia.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.