C5 complement inhibitor (subcutaneous)
Zilucoplan
Brand names: Zilbrysq
Adult dose
Dose: 0.3mg/kg SC OD (self-administered)
Route: Subcutaneous
Frequency: OD
Clinical pearls
- Anti-AChR antibody-positive generalised myasthenia gravis — NICE HST25
- Patient self-administers SC; complement inhibitor class risk of meningococcal disease
- Meningococcal vaccination (MenACWY + MenB) and prophylactic antibiotics mandatory before initiation
Contraindications
- Unresolved Neisseria meningitidis infection
- Not vaccinated against meningococcal disease (MenACWY, MenB) and prophylactic antibiotics not initiated
- Hypersensitivity
Side effects
- Injection-site reactions
- Infections (especially encapsulated bacteria — meningococcus, pneumococcus, Haemophilus)
- Headache
- Diarrhoea
- Abdominal pain
Interactions
- Live vaccines
Monitoring
- Signs of infection/meningococcal disease
- Disease severity (MG-ADL, QMG)
- Injection-site reactions
Reference: BNF; NICE HST25; SmPC; https://bnf.nice.org.uk/drugs/zilucoplan/. 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
- 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
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS