C3 complement inhibitor (pegylated peptide)
Pegcetacoplan
Brand names: Aspaveli, Empaveli
Adult dose
Dose: 1080mg SC twice weekly (self-administered via infusion pump)
Route: Subcutaneous infusion
Frequency: Twice weekly
Clinical pearls
- NICE TA778: paroxysmal nocturnal haemoglobinuria with persistent anaemia despite C5 inhibitor
- Mandatory MenACWY + MenB + Hib + pneumococcal vaccination ≥2 weeks before initiation
- Specialist haematology centre prescribing
Contraindications
- Unresolved Neisseria meningitidis infection
- Unvaccinated against encapsulated bacteria
- Hypersensitivity
Side effects
- Injection-site reactions
- Infections (especially encapsulated bacteria)
- Haemolysis on switching from C5 inhibitor
- Diarrhoea
- Headache
- Fatigue
Interactions
- Live vaccines
Monitoring
- Hb, LDH, reticulocytes (haemolysis)
- Signs of infection
- Platelet count
- Vaccination status
Reference: BNF; NICE TA778; SmPC; https://bnf.nice.org.uk/drugs/pegcetacoplan/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- C-Peptide to Glucose Ratio · Diabetes Classification
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO