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Ravulizumab Treatment: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Ravulizumab is a medication used to treat serious immune-related conditions, including paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS). It works by inhibiting a part of the immune system that can damage red blood cells. Ravulizumab is administered through intravenous (IV) infusion. Always consult your healthcare provider before starting or adjusting your Ravulizumab treatment.
Names of Medication
US Brand Name: Ultomiris
Generic Name: Ravulizumab
The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. In this article, the generic name will be shown in parentheses.
Pharmacologic Category
Complement Inhibitors
Monoclonal Antibodies
Ravulizumab Dosage
Ravulizumab is prescribed for various conditions, with the dosage depending on the specific disease being treated. Below are the recommended doses for adults. Always consult your doctor before making any changes to your Ravulizumab dosage. If needed, you can schedule a telemedicine appointment with one of our providers.
Ravulizumab for Paroxysmal Nocturnal Hemoglobinuria (PNH)
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Atypical Hemolytic Uremic Syndrome (aHUS)
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Myasthenia Gravis
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Hemolytic Anemia
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Thrombotic Microangiopathy
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Complement-Mediated Diseases
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Chronic Kidney Disease
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Autoimmune Hemolytic Anemia
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Neuromyelitis Optica Spectrum Disorder
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Ravulizumab for Systemic Lupus Erythematosus
Initial Dose: 2,400 mg to 3,000 mg IV infusion, based on body weight.
Maintenance Dose: 3,000 mg every 8 weeks.
Dosage Forms and Strengths
Ravulizumab is available in the following forms:
- Injection, solution: 300 mg/30 mL (10 mg/mL)
- Injection, solution: 1,100 mg/11 mL (100 mg/mL)
Ravulizumab Infusion Process and Administration Instructions
Ravulizumab is administered through an intravenous (IV) infusion, which delivers the medication directly into a vein. The infusion typically takes place in a healthcare setting, such as a hospital or clinic, and may last several hours. Your healthcare provider will monitor you during the infusion to ensure there are no adverse reactions. It is essential to follow your provider’s instructions carefully and avoid missing any scheduled doses.
Contraindications for Ravulizumab Treatment
A contraindication is a specific condition or situation where a medication should not be used due to potential harm. Understanding these contraindications is crucial to avoid serious side effects or complications.
Contraindications for Ravulizumab
Known hypersensitivity to Ravulizumab: If you have had an allergic reaction to Ravulizumab or any of its ingredients, you should not take this medication. Allergic reactions can be severe, with symptoms such as rash, difficulty breathing, or swelling of the face and throat.
Active meningococcal infection: Ravulizumab increases the risk of meningococcal infections. If you currently have a meningococcal infection, taking Ravulizumab could worsen the infection or make it more difficult to treat.
Not vaccinated against meningococcal infection: Since Ravulizumab increases the risk of meningococcal infections, it is contraindicated in patients who have not been vaccinated against meningococcal disease. Vaccination should occur at least two weeks before starting Ravulizumab.
Drug-to-Drug Interactions with Ravulizumab
Ravulizumab can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal remedies.
Medications that May Interact with Ravulizumab
Eculizumab (Soliris): Eculizumab is another complement inhibitor, and taking it with Ravulizumab may increase the risk of infections and other side effects. These medications should not be used together.
Live vaccines: Live vaccines, such as the MMR (measles, mumps, rubella) or varicella vaccines, may be less effective if you are taking Ravulizumab. Additionally, live vaccines may increase your risk of infections while on Ravulizumab.
Ravulizumab in Pregnancy
Is it safe to take Ravulizumab when pregnant?
The safety of Ravulizumab during pregnancy has not been fully established. There are limited studies on its effects in pregnant women and their unborn babies. While animal studies have not shown harm to the fetus, there is not enough data to confirm its safety in humans. If you are pregnant or planning to become pregnant, it is crucial to discuss the potential risks and benefits of Ravulizumab with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore your options.
Ravulizumab while Breastfeeding
Is it safe to take Ravulizumab while breastfeeding?
It is currently unknown whether Ravulizumab passes into breast milk or if it could affect a nursing baby. Given the lack of information, it is important to weigh the benefits of breastfeeding against the potential risks of taking Ravulizumab. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to make an informed decision. You can also speak with one of our telemedicine providers to discuss your treatment plan.
Estimated Cost of Ravulizumab
The cost of Ravulizumab can be significant, especially without insurance coverage. Using a GoodRX coupon, the estimated cost for a 30-day supply ranges from approximately $6,000 to $7,000. Prices may vary depending on your location and the pharmacy you use. Be sure to check with your insurance provider to see if they cover this medication, or consider using a discount program to help reduce the cost of Ravulizumab treatment.
Possible Alternatives to Ravulizumab
If Ravulizumab is not the right option for you, there may be alternative treatments or lifestyle changes that can help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider, or schedule a telemedicine appointment with one of our providers to explore your options.
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Eculizumab (Soliris): Another complement inhibitor that works similarly to Ravulizumab and may be considered as an alternative.
Blood transfusions: In some cases, blood transfusions may help manage symptoms of PNH.
Iron supplements: If you have anemia due to PNH, iron supplements may help improve your red blood cell count.
Atypical Hemolytic Uremic Syndrome (aHUS)
Eculizumab (Soliris): Another option for treating aHUS by inhibiting the complement system, similar to Ravulizumab.
Plasma exchange: This treatment can help remove harmful substances from the blood in severe cases of aHUS.
Myasthenia Gravis
Pyridostigmine (Mestinon): A medication that improves communication between nerves and muscles, often used in the treatment of Myasthenia Gravis.
Corticosteroids: These medications can help reduce inflammation and improve muscle strength in patients with Myasthenia Gravis.
Thymectomy: Surgical removal of the thymus gland may be recommended in some cases of Myasthenia Gravis.
Hemolytic Anemia
Blood transfusions: These may be necessary to replace lost red blood cells in cases of hemolytic anemia.
Immunosuppressive therapy: Medications like corticosteroids can help reduce the immune system’s attack on red blood cells.
Thrombotic Microangiopathy (TMA)
Plasma exchange: This treatment can help remove harmful substances from the blood in cases of TMA.
Immunosuppressive therapy: Medications to reduce immune system activity may be used in some cases of TMA.
Complement-Mediated Diseases
Eculizumab (Soliris): Another complement inhibitor that may be used as an alternative to Ravulizumab for complement-mediated diseases.
Immunosuppressive therapy: Medications that reduce immune system activity may help manage symptoms of complement-mediated diseases.
Chronic Kidney Disease
Blood pressure control: Managing high blood pressure can help slow the progression of chronic kidney disease.
Dietary changes: Reducing salt and protein intake may help protect kidney function in patients with chronic kidney disease.
Dialysis: In advanced stages of chronic kidney disease, dialysis may be necessary to filter waste from the blood.
Autoimmune Hemolytic Anemia
Corticosteroids: These medications can help reduce the immune system’s attack on red blood cells in autoimmune hemolytic anemia.
Immunosuppressive therapy: Other medications that suppress the immune system may be used in some cases of autoimmune hemolytic anemia.
Neuromyelitis Optica Spectrum Disorder (NMOSD)
Rituximab (Rituxan): A medication that targets specific immune cells involved in NMOSD, offering an alternative to Ravulizumab.
Corticosteroids: These medications can help reduce inflammation and prevent relapses in NMOSD patients.
Systemic Lupus Erythematosus (SLE)
Hydroxychloroquine (Plaquenil): A medication commonly used to manage lupus symptoms, which may be considered as an alternative to Ravulizumab in some cases.
Immunosuppressive therapy: Medications that reduce immune system activity may help control lupus flares.
Lifestyle changes: Regular exercise, a healthy diet, and stress management can help improve overall health and reduce lupus symptoms.
Recent Updates on Ravulizumab Research
Recent studies have focused on expanding the use of Ravulizumab to treat additional complement-mediated diseases. Ongoing clinical trials are investigating its effectiveness in conditions like neuromyelitis optica spectrum disorder (NMOSD) and systemic lupus erythematosus (SLE). Early results suggest that Ravulizumab may offer benefits for patients with these conditions, but more research is needed to confirm its safety and efficacy. If you are interested in learning more about these studies or participating in a clinical trial, speak with your healthcare provider or schedule a telemedicine appointment with one of our providers to discuss your options.
