Zeposia is a brand-name oral capsule that’s prescribed for certain forms of multiple sclerosis (MS) and ulcerative colitis (UC). Zeposia contains the active ingredient ozanimod.

Zeposia is FDA approved to treat the following conditions in adults:

Drug details

The following lists key information about Zeposia.

  • Drug class: sphingosine 1-phosphate receptor modulator
  • Drug form: oral capsule
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2020

Zeposia is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics usually cost less than brand-name drugs.

Zeposia can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Zeposia. These lists do not include all possible side effects.

For more information about the possible side effects of Zeposia, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks and reviews side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Zeposia, you can do so through MedWatch.

Mild side effects

Here is a partial list of mild side effects of Zeposia. To learn about other mild side effects, talk with your doctor or pharmacist, or view Zeposia’s prescribing information.

Mild side effects of Zeposia can include:

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Zeposia aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • temporarily slowed heart rate when you start treatment, which may include symptoms such as:
    • feeling that your heart is beating slowly or skipping beats
    • feeling dizzy or lightheaded
    • shortness of breath
    • fatigue
  • serious infections such as shingles and meningitis, which may include symptoms such as:
    • fever
    • flu-like symptoms
    • cough
    • rash
    • headache with a stiff neck and sensitivity to light
  • progressive multifocal leukoencephalopathy, which is a rare brain infection that may include symptoms such as:
    • worsening weakness on one side of the body
    • clumsiness
    • problems with thinking or memory
    • changes in vision
    • personality changes
  • posterior reversible encephalopathy syndrome, which is a rare brain condition that may include symptoms such as:
    • sudden severe headache
    • sudden confusion
    • sudden vision changes
    • seizures
  • liver damage, which may include signs and symptoms such as:
    • increased liver enzymes
    • pain in the upper right of the abdomen
    • dark urine
    • loss of appetite
    • jaundice
  • high blood pressure, which if very high may include symptoms such as:
    • severe headache
    • dizziness
    • confusion
    • chest pain
  • macular edema (swelling of the back of the eye), which may include symptoms such as:
    • difficulty seeing detail in the center of your vision
    • colors seeming faded or washed out
    • blurry vision
  • increased risk of skin cancer, which may include symptoms such as:
    • new or changed mole or skin growth
    • skin sore that doesn’t heal
    • changes in the skin’s appearance
  • breathing problems, such as shortness of breath
  • severe worsening of multiple sclerosis symptoms after stopping Zeposia
ALLERGIC REACTION

For some people, Zeposia capsule can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Zeposia capsules, your doctor may recommend taking a different medication instead.

The Food and Drug Administration (FDA) approves prescription drugs such as Zeposia to treat certain conditions. Zeposia may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Zeposia for multiple sclerosis

Zeposia is FDA approved to treat relapsing forms of multiple sclerosis (MS) in adults, including:

This drug is also approved to treat clinically isolated syndrome, an episode of MS-like symptoms lasting at least 24 hours. This condition may or may not develop into MS.

In a person who has MS, the immune system mistakenly attacks the protective coating, called the myelin sheath, that surrounds the nerves in the brain and spinal cord. As a result, the nerves become damaged and stop communicating effectively with other parts of the body. This can produce many different symptoms.

Symptoms of MS can vary and can be mild or severe. They can include:

  • numbness or tingling
  • muscle weakness, stiffness, or spasms
  • pain
  • vision changes, such as double vision
  • fatigue
  • problems with thinking or learning
  • bladder or bowel problems
  • mobility problems

Zeposia is a type of MS treatment called disease-modifying therapy (DMT). It helps to prevent relapses of MS symptoms. The drug also helps slow the development of new or worsening brain lesions (areas of nerve damage in the brain that can be seen with an MRI scan). This can help slow the worsening of your condition.

For this purpose, Zeposia may be prescribed by itself or with drugs that treat MS symptoms. Examples of other drugs that may be used with Zeposia include corticosteroids such as prednisone (Rayos).

For more information about MS, see our multiple sclerosis hub.

Zeposia for ulcerative colitis

Zeposia is FDA approved to treat moderate to severe ulcerative colitis (UC) that’s active (causing symptoms) in adults.

In a person who has UC, the immune system mistakenly attacks the lining of the colon (large intestine). This causes inflammation and ulcers (small sores) in the lining of your colon.

Symptoms of UC can include:

  • diarrhea, which may contain blood or mucus
  • constant urge to pass stool
  • abdominal pain
  • fatigue
  • loss of appetite
  • dehydration
  • weight loss
  • anemia (low level of red blood cells)

You’ll typically have periods when the disease is active and your symptoms flare up (get worse). You’ll typically also have periods when the disease goes into remission and your symptoms improve or go away.

Zeposia is used to induce remission of UC (reduce active symptoms) and help maintain remission (prevent symptom flare-ups).

For this purpose, Zeposia may be prescribed by itself or with drugs that treat UC symptoms. Examples of other drugs that may be used with Zeposia include corticosteroids such as budesonide (Entocort EC), and aminosalicylates, such as mesalamine (Lialda).

For more information about UC, see our ulcerative colitis hub.

Zeposia and children

Zeposia is not approved by the FDA for any uses in children under ages 18 years old. It’s not known whether the drug is safe or effective in this age group.

As with all medications, the cost of Zeposia can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance: If you need financial support to pay for Zeposia, or if you need help understanding your insurance coverage, help is available.

A program called Zeposia 360 Support is available for Zeposia. For more information and to find out if you’re eligible for support options, such as a copay card, call 833-937-6742 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Generic version: Zeposia is not available in a generic form. A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics tend to cost less than brand-name drugs.

Here are answers to some frequently asked questions about Zeposia.

Does Zeposia cause weight gain?

No, Zeposia is not known to cause weight gain. This side effect was not reported in clinical trials of Zeposia.

Keep in mind that some other drugs you may take to treat multiple sclerosis (MS) or ulcerative colitis (UC) can sometimes cause weight gain. For example, corticosteroids can have this effect.

If you have unexpected weight gain while taking Zeposia, talk with your doctor. This information will help them determine the possible cause and suggest ways to manage it.

How does Zeposia compare with Rinvoq, Velsipity, and Xeljanz for UC?

Zeposia, Rinvoq, Velsipity, and Xeljanz are all immunomodulators that are used to treat UC. They help to induce remission of UC (reduce active symptoms) and maintain remission (prevent symptom flare-ups). Zeposia is also approved to treat certain forms of MS, while Rinvoq and Xeljanz are also approved to treat other autoimmune conditions, such as certain forms of arthritis. These drugs have some similarities and some differences.

Zeposia contains the active drug ozanimod. It comes as an oral capsule that you typically take once per day.

Velsipity contains the active drug etrasimod. It belongs to the same class of drugs as Zeposia (sphingosine 1-phosphate receptor modulators), so it works in the same way as Zeposia. The side effects of Velsipity are mainly similar to those of Zeposia, including headache and infections. However, Zeposia may cause upper respiratory infection, whereas clinical trials of Velsipity did not report this side effect. Velsipity comes as an oral tablet that’s usually taken once per day.

Rinvoq contains the active drug upadacitinib, and Xeljanz contains the active drug tofacitinib. These drugs belong to a different drug class than Zeposia, called Janus kinase (JAK) inhibitors. Some of the side effects of Rinvoq and Xeljanz, such as infections, are similar to those of Zeposia. But these drugs can also cause some that are different, such as blood clots and heart attack.

Rinvoq comes as an oral extended-release tablet and oral solution. (“Extended release” means the drug is slowly released into your body over a long period of time.) Xeljanz comes as an oral tablet, extended-release tablet, and oral solution. Both are usually taken once or twice per day.

For more information about how these drugs compare, talk with your doctor or pharmacist.

When you start taking Zeposia, your doctor will gradually increase your dosage over the first week of treatment. This allows your body to get used to the medication. It reduces the risk of the medication slowing your heart rate.

The following information describes Zeposia dosages that are commonly used or recommended. However, if you have liver problems, your doctor may prescribe a different dosage for you. Be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosing schedule to fit your needs.

Drug forms and strengths

Zeposia comes as an oral capsule. It’s available in three strengths, 0.23 milligrams (mg), 0.46 mg, and 0.92 mg.

Dosage for multiple sclerosis and clinically isolated syndrome

The usual recommended dosing schedule is described here:

  • Days 1 to 4: 0.23 mg once per day
  • Days 5 to 7: 0.46 mg once per day
  • Days 8 and beyond: 0.92 mg once per day

For starting treatment, you’ll receive a 7-day starter pack (also called a starter kit) containing the lower-strength doses of Zeposia. After that, your doctor will prescribe a 30-day supply of the 0.92-mg strength capsules.

Dosage for ulcerative colitis

The usual recommended dosing schedule for ulcerative colitis (UC) is the same as for multiple sclerosis (MS). This is described in the section preceding this one.

About taking Zeposia

Here you’ll find information about key dosage issues.

  • When to take: You should take Zeposia once per day. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Zeposia work effectively.
  • If you miss a dose: If you miss a dose in your first 2 weeks of treatment, talk with your doctor. You’ll need to restart treatment with a new starter pack. If you miss a dose after your first 2 weeks of treatment, just take your next dose as scheduled. Do not take a double dose or any extra doses to make up for a missed dose.
  • Taking Zeposia with food: You can take Zeposia with or without food.
  • Crushing, splitting, or chewing Zeposia: Zeposia is meant to be swallowed whole. The manufacturer doesn’t state whether the capsules can be crushed, split, opened, or chewed. If you have difficulty swallowing the capsules, talk with your doctor or pharmacist.
  • Length of use: Zeposia is meant to be used as a long-term treatment. If you and your doctor determine that Zeposia is safe and effective for you, you’ll likely take it long term.
  • Length of time to work: Zeposia starts working as soon as you start taking it. If you take it for UC, you may notice your symptoms start to get better within a few weeks. But if you take it for MS, you may not notice it working. With MS, the drug helps prevent symptom flare-ups and slow the worsening of your condition.

Overdose

Do not use more Zeposia than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Zeposia

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Zeposia is used to treat ulcerative colitis (UC) and certain forms of multiple sclerosis (MS). It’s also used for clinically isolated syndrome (an episode of MS-like symptoms lasting at least 24 hours that may or may not develop into MS).

What happens with MS and UC

With MS, your immune system mistakenly attacks the protective coating around the nerves in your brain and spinal cord. As a result, the nerves become damaged and stop communicating effectively with other parts of the body. This can cause many different symptoms, such as pain, tingling, numbness, muscle weakness, and vision changes.

With UC, your immune system mistakenly attacks the lining of your colon (large intestine). This causes inflammation and ulcers (small sores) in your colon. It leads to symptoms such as diarrhea and abdominal pain.

When your immune system attacks your nerves or colon, white blood cells called lymphocytes are likely involved. These blood cells help fight infection.

What Zeposia does

Doctors don’t fully understand how Zeposia works in treating MS and UC. However, the drug attaches to proteins called sphingosine 1-phosphate receptors. It’s thought that this action helps to block lymphocytes from moving out of your lymph nodes into your blood circulation.

In UC, Zeposia reduces the number of lymphocytes that can attack your colon. This reduces active symptoms of UC and helps prevent future flare-ups of your condition.

In MS, Zeposia reduces the number of lymphocytes that can attack the nerves in your brain and spinal cord. This can help prevent flare-ups of MS symptoms and slow worsening of your condition.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zeposia, talk with your doctor. They can tell you about other medications that may work well for you.

The following drugs are alternatives to Zeposia for multiple sclerosis:

The following drugs are alternatives to Zeposia for ulcerative colitis:

You may wonder how Zeposia compares with other medications that are prescribed for similar uses. Here we look briefly at how Zeposia compares with Gilenya.

Zeposia contains the active ingredient ozanimod, while Gilenya contains the active ingredient fingolimod. These drugs are used to treat certain forms of multiple sclerosis (MS). They’re also used to treat clinically isolated syndrome (an episode of MS-like symptoms lasting at least 24 hours that may or may not develop into MS). In addition, Zeposia is used to treat ulcerative colitis, but Gilenya is not approved for this use.

Both drugs come as an oral capsule that you typically take once per day.

Zeposia and Gilenya are disease modifying therapies (DMTs) for MS. They help prevent relapses (symptom flare-ups) and slow the worsening of your condition. They belong to the same class of drugs, called sphingosine 1-phosphate receptor modulators, so they work in the same way.

This also means the side effects of Gilenya are similar to those of Zeposia. Examples include headache and infections. However, Gilenya may cause side effects that differ from Zeposia, such as arm or leg pain.

To find out more about how Zeposia and Gilenya compare, talk with your doctor or pharmacist.

You may wonder how Zeposia compares with other medications that are prescribed for similar uses. Here we look briefly at how Zeposia compares with Entyvio.

Zeposia contains the active ingredient ozanimod, while Entyvio contains the active ingredient vedolizumab. These drugs are used to treat ulcerative colitis (UC). Both drugs help induce remission of UC (reduce active symptoms) and maintain remission (prevent symptom flare-ups).

Zeposia is also used to treat certain forms of multiple sclerosis and clinically isolated syndrome, while Entyvio is also used to treat Crohn’s disease.

Zeposia comes as an oral capsule that you typically take once per day. Entyvio comes as an injection. A healthcare professional may administer Entyvio by intravenous (IV) infusion once every 8 weeks. Or a person may give themselves a subcutaneous injection at home once every 2 weeks.

These drugs belong to different drug classes: Zeposia is a sphingosine 1-phosphate receptor modulator, while Entyvio is an integrin receptor antagonist. So these drugs work in different ways. They can also cause some similar and some different side effects.

Examples of Entyvio side effects that are similar to those of Zeposia include headache, infections, and nose or throat irritation. Side effects of Entyvio that differ include injection site reactions, such as rash and itchy skin.

To find out more about how Zeposia and Entyvio compare, talk with your doctor or pharmacist.

Zeposia can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Before taking Zeposia, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

For more information about Zeposia and interactions, talk with your doctor or pharmacist.

Interactions with medications, foods, and supplements

Here is a list of medications, supplements, and foods that can interact with Zeposia. This list does not contain all drugs that may interact with Zeposia. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Medications that can interact with Zeposia include:

No foods have been reported to interact with Zeposia.

Lab tests or vaccines that can interact with Zeposia include:

Zeposia may also make non-live vaccines, such as the COVID-19 vaccine, less effective.

Alcohol interaction

It may not be safe to consume alcohol while taking Zeposia. Drinking alcohol may increase the risk or severity of certain Zeposia side effects, such as headache, nausea, and liver problems. If you have questions about the safety of drinking alcohol while taking Zeposia, talk with your doctor or pharmacist.

If you can become pregnant, consider the following information about pregnancy, fertility, birth control, and breastfeeding.

Zeposia and pregnancy

Zeposia should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor will likely suggest birth control options to use during treatment with Zeposia. Also, you should avoid becoming pregnant until at least 3 months after stopping Zeposia treatment.

If you become pregnant while using Zeposia for multiple sclerosis (MS), consider taking part in the drug’s MS pregnancy registry. A pregnancy registry helps gather information on how certain drugs can affect pregnancy. To learn more, call 833-244-4083, visit this site, or talk with your doctor.

Your doctor can tell you whether there is a pregnancy registry for people using Zeposia for ulcerative colitis during pregnancy.

Zeposia and birth control

It’s not known whether Zeposia is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zeposia.

Note: Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

For females using Zeposia

If you’re able to become pregnant, you should use birth control while taking Zeposia and for at least 3 months after your last dose.

For males using Zeposia

The manufacturer of Zeposia doesn’t provide birth control recommendations for males. If you have a sexual partner who’s able to become pregnant, ask your doctor for birth control recommendations while you’re taking Zeposia.

Zeposia and breastfeeding

It’s not known whether Zeposia should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Before taking Zeposia, discuss your health history with your doctor. Zeposia may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Note: For more information about the potential negative effects of Zeposia, see the “Zeposia side effects” section.

Disclaimer: Medical News Today 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.

Zeposia images

VIEW GALLERY1