Frequently asked questions
Find answers to some of the most frequently asked questions about ZEPOSIA below.
It’s important to tell your MS healthcare team about any other medicines or supplements that you’re taking or have recently taken, including:
- Prescription medicines
- Over-the-counter medicines
- Herbal supplements
Using ZEPOSIA with other medicines can cause serious side effects.
Especially tell your MS healthcare team if you take or have taken medicines, such as:
- Medicines that affect your immune system, such as alemtuzumab
- Medicines to control your heart rhythm (also called antiarrhythmics) or heartbeat
- CYP2C8 inducers such as rifampin
- CYP2C8 inhibitors such as gemfibrozil (medicine to treat high fat in your blood)
- Opioids (pain medicine)
- Medicines to treat depression
- Medicines to treat Parkinson’s disease
- Medicines to control your heart rate and blood pressure (beta blocker medicines and calcium channel blocker medicines)
Before you start taking ZEPOSIA, two routine tests are required. If you have a history of certain eye conditions (macular edema or uveitis) or diabetes, you may also need an eye exam.
Let your healthcare provider know if you’ve had some of these tests within the last six months, as they may not need to be repeated:
- Blood work—including complete blood count and liver function tests
- An electrocardiogram (ECG)—a common test that uses small sensors to monitor your heart and makes sure it’s working normally before you start treatment
The ZEPOSIA Prescribing Information does not require ongoing lab monitoring unless indicated by your healthcare professional.
How long will the medical tests take?
If you plan to complete all of the tests in one visit at a healthcare professional’s office, it may take as little as 1 hour to complete. If your appointment is at home, please be available for up to 2 hours.*
Are there any potential out-of-pocket costs?
Depending on your insurance coverage and financial needs, there may be several different ways to save on the cost of ZEPOSIA and the tests needed before treatment. To learn more, speak with our Support Coordinators or explore ZEPOSIA cost information.†
- Patient must have a valid prescription for ZEPOSIA for an FDA-approved indication. Patients are not eligible if they have prescription insurance coverage through a state or federal healthcare program, including but not limited to Medicare, Medicaid, Medigap, CHAMPUS, TRICARE, Veterans Affairs (VA), or Department of Defense (DoD) programs, or reside in Rhode Island. To receive the In-Home Medical Services Program, the prescriber must request in-home assessment assistance through the ZEPOSIA 360 Support program. The patient’s insurance will not be billed, and the patient will not be responsible for any out-of-pocket costs. Patients who move from commercial plans to state or federal healthcare programs will no longer be eligible. The program cannot be combined with any other offer, rebate, coupon, or free trial. The program is not conditioned on any past, present, or future purchase, including refills. Only valid in the United States and US Territories. Void where prohibited by law, taxed, or restricted. The program is not insurance. Bristol-Myers Squibb Company reserves the right to rescind, revoke, or amend this program at any time without notice. Other limitations may apply.
- While Support Coordinators can answer questions about ZEPOSIA 360 Support™, they cannot provide medical advice.
You should not receive live vaccines during treatment with ZEPOSIA, for at least 1 month before taking ZEPOSIA, and for 3 months after you stop taking ZEPOSIA. Vaccines may not work as well when given during treatment with ZEPOSIA.
Talk to your MS healthcare team before receiving any vaccines while on ZEPOSIA.
See the question below for information about the varicella zoster virus (VZV) vaccine and taking ZEPOSIA.
Your doctor may require you to receive the VZV vaccine, also known as the chickenpox vaccine, before you take ZEPOSIA. The VZV vaccine includes two doses. If you haven’t received the VZV vaccine in the past, you may need to postpone the start of treatment with ZEPOSIA.
If you’re unsure of your vaccination status, there is a test that can determine whether or not you've already received the VZV vaccine, have had chickenpox, or have received the vaccine for chickenpox. Your MS healthcare team may do a blood test for the chickenpox virus. You may need to get the full course of the vaccine for chickenpox and then wait 1 month before you start taking ZEPOSIA.
You should take ZEPOSIA exactly as prescribed by your MS healthcare team.
If you miss 1 or more doses during the first 14 days of treatment, contact your MS healthcare team. You’ll need a new 7-day Starter Pack to restart treatment. This will allow you to increase your dosage gradually to help avoid a decrease in heart rate, which is a possible serious side effect of ZEPOSIA.
If you miss a dose after the first 14 days of treatment, take your scheduled dose (1 pill) the next day at your usual time.
A missed dose is when you don’t take ZEPOSIA on the scheduled day your doctor has prescribed.
Tyramine (TIE-ruh-meen) is a type of compound (monoamine compound) found naturally in the body. It can also be found in high amounts in certain foods and beverages. Consuming a large amount of tyramine while taking ZEPOSIA could lead to severe high blood pressure (hypertension).
It’s recommended that people taking ZEPOSIA avoid foods and beverages that have more than 150 mg of tyramine. The following foods may be high in tyramine and should be avoided:
- Aged foods
- Fermented foods
- Cured foods
- Smoked foods
- Pickled foods
The list includes the amount of tyramine per serving, as well as the amount of each food and beverage that could contain 150 mg of tyramine.
Please note that different people react to tyramine differently. Speak with your healthcare provider before making any changes to your diet.
You and your healthcare professional should work together to make sure ZEPOSIA is right for you before starting treatment. Be sure to let your healthcare professional know if you have any of these conditions or do not know if you have any of these conditions before taking ZEPOSIA:
- Have had a heart attack, chest pain (also known as unstable angina), a stroke or mini-stroke (also known as transient ischemic attack or TIA), or certain types of heart failure in the last 6 months
- Have or have had a history of certain types of irregular or abnormal heartbeat (also known as arrhythmia) that is not corrected by a pacemaker
- Have untreated, severe breathing problems during your sleep (also known as sleep apnea)
- Take certain medicines called monoamine oxidase (MAO) inhibitors (eg, selegiline, phenelzine, linezolid)
Talk with your MS healthcare team if you are pregnant or plan to become pregnant. If you are a female who can become pregnant, you should use effective birth control during your treatment with ZEPOSIA and for 3 months after you stop taking ZEPOSIA.
Tell your MS healthcare team right away if you become pregnant while taking ZEPOSIA or if you become pregnant within 3 months after you stop taking ZEPOSIA.
If you become pregnant while taking ZEPOSIA for MS, tell your healthcare provider right away and enroll in the ZEPOSIA Pregnancy Registry by calling 1-877-301-9314 or visiting www.zeposiapregnancyregistry.com
If you are a female who can become pregnant, you should use effective birth control during your treatment with ZEPOSIA and for 3 months after you stop taking ZEPOSIA. Talk with your healthcare provider about what birth control method is right for you during this time.
If you have private or commercial insurance, you may be eligible to pay as little as $0 a month for your ZEPOSIA prescription. Additional eligibility requirements and terms & conditions apply. Please click here for more information.
How do I sign up?
You can sign up and determine if you’re eligible in two ways:
- Enroll by submitting this form
- Contact a Support Coordinator at
1-833-ZEPOSIA(833-937-6742) Monday to Friday, 8 AM to 8 PMET*
- While Support Coordinators can answer questions about ZEOPSIA 360 Support, they cannot provide medical advice.
Before you begin treatment, your Support Coordinator will help you understand your medical and pharmacy benefits.
If you have private or commercial insurance and are experiencing delays or issues with coverage, the ZEPOSIA Bridge Program may be able to provide ZEPOSIA to you, as needed (for up to
- The Bridge Program is available at no cost for eligible, commercially insured, on-label diagnosed patients if there is a delay in determining whether commercial prescription coverage is available, and is not contingent on any purchase requirement, for up to 24 months (dispensed in 30-day increments). The Bridge Program is not available to patients who have prescription insurance coverage through a state or federal healthcare program, including but not limited to Medicare, Medicaid, Medigap, CHAMPUS, TRICARE, Veterans Affairs (VA), or Department of Defense (DoD) programs and is available for no more than 12 months to patients in MA, MN, and RI. Appeal of any prior authorization denial must be made within 90 days or as per payer guidelines, to remain in the program. Eligibility will be re-verified in January for patients continuing into the following year, and may be at other times during program participation. Offer is not health insurance. Once coverage is approved by the patient’s commercial insurance plan, the patient will no longer be eligible. Void where prohibited by law, taxed, or restricted. Bristol-Myers Squibb Company reserves the right to rescind, revoke, or amend this program at any time without notice. Other limitations may apply.