ZEPOSIA is a once-daily pill for adults with relapsing multiple sclerosis (MS).

Take as directed by your doctor if certain liver problems exist.


ZEPOSIA is a once-daily pill for adults with relapsing multiple sclerosis (MS).

Take as directed by your doctor if certain liver problems exist.

Understanding safety & side effects

When starting any medication, it’s important to learn about its safety and possible side effects.

ZEPOSIA has a well-established safety profile

The safety of ZEPOSIA has been studied:

  • Across 2 conditions—multiple sclerosis and ulcerative colitis
  • In over 1,300 patients

90% of people taking ZEPOSIA remained on treatment throughout the clinical studies

A 6-year clinical study showed that only 3% of patients stopped taking ZEPOSIA due to a side effect they experienced.

Received by ~35,000 patients since approval

Approximately 35,000 patients have received ZEPOSIA across both conditions.*

  • As of April 30, 2023.

Serious and common side effects

These are some of the side effects that people taking ZEPOSIA reported during both of the clinical studies.

  • Infections: ZEPOSIA can increase your risk of serious infections that can be life-threatening and cause death. Symptoms include fever, feeling very tired, flu-like symptoms, cough, painful and frequent urination (signs of a urinary tract infection), rash, or symptoms of meningitis, such as headache with fever, neck stiffness, sensitivity to light, nausea, or confusion
  • Progressive multifocal leukoencephalopathy (PML): ZEPOSIA can increase your risk for PML, which is a rare brain infection that gets worse over days to weeks, and usually leads to death or severe disability
  • ZEPOSIA may cause your heart rate to temporarily slow down (also known as bradyarrhythmia): when you start taking ZEPOSIA—especially during the first 8 days. Symptoms include dizziness, lightheadedness, feeling like your heart is beating slowly or skipping beats, shortness of breath, confusion, chest pain, or tiredness
  • Liver problems: Symptoms include unexplained nausea, vomiting, stomach area (abdominal) pain, tiredness, loss of appetite, yellowing of the whites of your eyes or skin, or dark-colored urine
  • Increased blood pressure: Your healthcare provider should check your blood pressure during treatment with ZEPOSIA. A sudden, severe increase in blood pressure (hypertensive crisis) can happen when you eat certain foods that contain a high level of tyramine
  • Breathing problems: Such as shortness of breath
  • Macular edema (a vision problem): Your risk for macular edema is higher if you have diabetes or have had an inflammation of your eye called uveitis. Symptoms include blurriness, shadows, or a blind spot in the center of your vision, sensitivity to light, or unusually colored vision
  • Swelling and narrowing of blood vessels in your brain. Posterior Reversible Encephalopathy Syndrome (or PRES): A rare condition that has happened with ZEPOSIA and with drugs in the same class. Symptoms include sudden severe headache, sudden confusion, sudden loss of vision or other vision changes, or seizure
  • Severe worsening of multiple sclerosis (MS) after stopping ZEPOSIA: When ZEPOSIA is stopped, MS symptoms may return and become worse compared to before or during treatment. Always talk to your healthcare team before you stop taking ZEPOSIA for any reason

If you feel you are experiencing a side effect while taking ZEPOSIA, reach out to your healthcare professional.

Here are the side effects that occurred in at least 4% of people, along with the percentage of people who experienced each.

Side effect ZEPOSIA
(882 people)
A leading injectable
medicine, Avonex*
(885 people)
Upper respiratory tract infections 26% 23%
Elevated liver enzymes 10% 5%
Low blood pressure upon standing 4% 3%
Painful and frequent urination 4% 3%
Back pain 4% 3%
High blood pressure 4% 2%
  • Avonex® (interferon beta-1a).

If you experience any side effects while taking ZEPOSIA, be sure to talk to your doctor right away. These are not all the possible side effects of ZEPOSIA. To see full side effects, click here.

Please see the full Prescribing Information and Medication Guide for information on all of the side effects reported by those taking ZEPOSIA.

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