Ravulizumab
Mechanism :
It binds to complement C5, thus preventing C5a and C5b formation. This prevents immune activation and hemolysis
Indication :
- For atypical hemolytic uremic syndrome
- For paroxysmal nocturnal hemoglobinuria
Contraindications :
Unresolved Neisseria meningitides infections
Dosing :
For atypical hemolytic uremic syndrome:
Loading dose:
5 to <10 kg: 600 mg IV
≥10 to <20 kg: 600 mg IV
≥20 to <30 kg: 900 mg IV
≥30 to <40 kg: 1200 mg IV
≥40 to <60 kg: 2400 mg IV
≥60 to <100 kg: 2700 mg IV
≥100 kg: 3000 mg IV
Maintenance dose:
Give maintenance dose 2 weeks after loading dose.
5 to <10 kg: 300 mg IV for 4 Week
≥10 to <20 kg: 600 mg IV for 4 Week
≥20 to <30 kg: 2100 mg IV for 8 Week
≥30 to <40 kg: 2700 mg IV for 8 Week
≥40 to <60 kg: 3000 mg IV for 8 Week
≥60 to <100 kg: 3300 mg IV for 8 Week
≥100 kg: 3600 mg IV for 8 Week
For paroxysmal nocturnal hemoglobinuria:
≥1 month of age:
Loading dose:
5 to <10 kg: 600 mg IV
≥10 to <20 kg: 600 mg IV
≥20 to <30 kg: 900 mg IV
≥30 to <40 kg: 1200 mg IV
≥40 to <60 kg: 2400 mg IV
≥60 to <100 kg: 2700 mg IV
≥100 kg: 3000 mg IV
Maintenance dose:
Initiate maintenance dose 2 weeks after loading dose
5 to <10 kg: 300 mg IV for 4 Week
≥10 to <20 kg: 600 mg IV for 4 Week
≥20 to <30 kg: 2100 mg IV for 8 Week
≥30 to <40 kg: 2700 mg IV for 8 Week
≥40 to <60 kg: 3000 mg IV for 8 Week
≥60 to <100 kg: 3300 mg IV for 8 Week
≥100 kg: 3600 mg IV for 8 Week
Adverse Effect :
Upper respiratory tract infection ,Headache , Diarrhea , Nausea , Vomiting , Constipation, Vomiting, Hypertension, Hypertension , Arthralgia , Pyrexia ,Contusion, Abdominal pain, Cough, Rash, Peripheral edema ,Urinary tract infection ,Cough ,Dyspnea ,Gastrointestinal infection ,Constipation ,Fatigue ,Anemia ,Anxiety, Hypotension, Nausea
Interaction :
Major interactions with budesonide, burosumab, immune globulins, efgartigimod alfa etc
Lactation :
No dose adjustment required