Medication Safety Updates

We are following the COVID-19 situation closely. Currently, we do not have enough information to advise you specifically about the risks of more severe infection in patients with MS who are on specific MS therapies, but we are in constant communication with our extensive network of physician colleagues around the world to gather as much information as we can quickly. When reliable information becomes available, we will post it here. In the interim, please find the most up-to-date information available on our COVID-19 and MS resource page.

ALERT: Case of Progressive Multifocal Leukoencephalopathy (PML) reported in Ocrelizumab (Ocrevus®) treated patient without prior immune suppressing therapy.
In September 2019, a 78 year old patient, who had been treated with Ocrelizumab for 2 years, was diagnosed with PML. This was the first PML case reported in relation to Ocrelizumab in which the patient had no exposure to any other immune suppressing medication prior to starting Ocrelizumab.

For this patient, their age and a low lymphocyte count (CD4+ and CD8+ T-cells) prior to starting Ocrelizumab which persisted while on treatment, were identified as possible risk factors for PML.

PML has been reported in patients taking other B-cell depleting medications and is a known risk with Ocrelizumab. Talk to your MS physician about your personal risk for PML, and any other concerns or questions.

ALERT: Regarding FDA warning pertaining to patients taking Biotin or other compounded medicines from Reliable Rexall Pharmacy
It has come to our attention that the FDA has issued the following warning regarding medicines compounded by Reliable Rexall in San Francisco. If you or a family member are taking any medicines (Biotin, 4AP etc) compounded at Reliable Rexall please discontinue taking this medicine immediately and contact our clinic for guidance.

Link to FDA Drug Safety website

If you are a patient obtaining medications through a compounding pharmacy, please ensure that this compounding pharmacy has received PCAB Accreditation.

There have been a few cases of the brain infection PML (progressive multifocal leukoencephalopathy) reported in patients treated with Gilenya and Tecfidera.
The FDA recommends that patients taking Tecfidera have a blood test within 6 months before starting Tecfidera and additional regular blood tests (at least annually) to check their lymphocyte (white blood cell) count and more frequent ones if clinically indicated. The standard practice at the UCSF MS Center has been to check these counts every 6 months. At present this appears to be single case, however, the MS Center is monitoring the situation closely and is available to patients for further information and support at (415)353-2635.