Long-acting C5 complement inhibitor
Ravulizumab
Brand names: Ultomiris
Adult dose
Dose: Weight-based loading then maintenance every 8 weeks IV
Route: IV
Frequency: q8w
Clinical pearls
- PNH, atypical HUS, generalised myasthenia gravis
- Vaccinate against meningococcus 2 weeks pre-treatment + ABx prophylaxis if urgent start
Contraindications
- Active untreated meningococcal infection
- Unvaccinated for meningococcal disease (without prophylaxis)
- Hypersensitivity
Side effects
- Meningococcal infection (black box)
- Headache
- Infusion reactions
- Upper respiratory infections
Interactions
- Live vaccines
- Other complement inhibitors
Monitoring
- LDH
- Haemolysis markers
- Infections
Reference: BNF; NICE TA698/TA710; SmPC; https://bnf.nice.org.uk/drugs/ravulizumab/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Corrected QT Interval (Bazett) · ECG
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
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