Ultomiris (ravulizumab-cwvz)
Complement Inhibitors Intravenous Vial (ML)
Last reviewed · Source: First Databank (FDB) drug data
Overview
USES: Ravulizumab is used to treat a certain blood disorder (paroxysmal nocturnal hemoglobinuria). This disorder causes your body's immune system to destroy red blood cells, which results in anemia. It works by helping block your body's destruction of red blood cells.
This effect helps lessen symptoms of anemia (such as tiredness, shortness of breath), and may reduce the need for blood transfusions. This medication may also be used to treat a certain immune system disorder (atypical Hemolytic Uremic Syndrome). It helps to prevent blood clots caused by this disorder.
Ravulizumab may be used to treat a certain muscle condition (generalized myasthenia gravis). It may help to improve symptoms of muscle weakness. This medication is also used to treat a certain nervous system disorder that affects the spinal cord and eye nerve (neuromyelitis optica spectrum disorder).
It may help to reduce the number of hospital stays due to the disease. Ravulizumab belongs to a class of medications known as monoclonal antibodies.
Generic name: ravulizumab-cwvz
Pronunciation: (RAV-ue-LIZ-ue-mab)
Drug class: Complement Inhibitors
Therapeutic class: Hematological Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Ultomiris
Indications
The following indications are listed for Ultomiris:
- Anti-Acetylcholine Receptor (AChR) Antibody Positive Generalized Myasthenia Gravis
- Atypical Hemolytic Uremic Syndrome
- Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 (AQP4) Antibodies
- Paroxysmal Nocturnal Hemoglobinuria
Also known as: Achr-Ab(+) Generalized Myasthenia Gravis, Anti-Aquaporin-4 (AQP4) Antibody Positive Neuromyelitis Optica Spectrum Disorder, Anti-Aquaporin-4 Positive Devic's Disease, Diarrhea-Negative Hemolytic Uremic Syndrome.
Dosing
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Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
C5 Complement Inhibitors/Crovalimab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Crovalimab is a complement C5 inhibitor which binds to epitopes on C5. Other complement C5 inhibitors such as eculizumab and ravulizumab bind to different epitopes on C5. Use of multiple complement inhibitors may lead to formation of drug-target-drug complexes (DTDCs) which may increase the risk of serious type III hypersensitivity reactions.(1)
CLINICAL EFFECTS: Use of multiple complement inhibitors may lead to formation of drug-target-drug complexes (DTDCs) which may increase the risk of serious type III hypersensitivity reactions. Type III hypersensitivity reactions can present as vasculitis, serum sickness, lymphadenopathy with arthralgias, rheumatoid arthritis, or glomerulonephritis.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of crovalimab states caution is advised when switching patients between other complement C5 inhibitors such as eculizumab or ravulizumab. The formation of drug-target-drug complexes (DTDCs) can occur when switching therapies. DTDCs are expected to be cleared within approximately 8 weeks (with eculizumab) or longer (with ravulizumab). Consider the risks and benefits of the timing of switching therapies with the risk of type III hypersensitivity reactions.(1) Monitor patients closely for signs of type III hypersensitivity reactions.(1) If patients develop a hypersensitivity reaction, for mild or moderate Type III hypersensitivity reactions, administer symptomatic treatment, such as topical corticosteroids, antihistamines, antipyretics, and/or analgesics. For severe reactions, initiate and taper oral or systemic corticosteroids therapy as clinically indicated.(1)
DISCUSSION: Clinical drug interaction studies with crovalimab have not been performed. Use of multiple complement inhibitors may lead to formation of drug-target-drug complexes (DTDCs) which may increase the risk of serious type III hypersensitivity reactions.(1) In clinical trials, type III hypersensitivity reactions were reported in 19% of patients who switched from eculizumab or ravulizumab to crovalimab. Also, type III hypersensitivity reactions were documented in 25% of patients who switched from crovalimab to either eculizumab or ravulizumab.(1)
Igg Antibodies And Derivatives/Efgartigimod-Alfa
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Efgartigimod-alfa binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of efgartigimod-alfa states that efgartigimod-alfa should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, efgartigimod-alfa should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with efgartigimod-alfa have not been performed. Efgartigimod-alfa may decrease concentrations of compounds that bind to the human FcRn.(3)
Igg Antibodies And Derivatives/Nipocalimab-Aahu
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Nipocalimab-aahu binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of nipocalimab-aahu states that nipocalimab-aahu should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, nipocalimab-aahu should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with nipocalimab-aahu have not been performed. Nipocalimab-aahu may decrease concentrations of compounds that bind to the human FcRn.(3)
Moderate Interaction: Assess the risk to the patient and take action as needed.
Igg Antibodies And Derivatives/Rozanolixizumab-Noli
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Rozanolixizumab-noli binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medications that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of rozanolixizumab-noli states that concurrent use with medications that bind to the human neonatal Fc receptor (FcRn) should be closely monitored for reduced effectiveness of these medications. If long-term use of such medications is essential for the patient, consider discontinuing rozanolixizumab-noli and use alternative therapies.(3)
DISCUSSION: Clinical drug interaction studies with rozanolixizumab-noli have not been performed. Rozanolixizumab-noli may decrease concentrations of compounds that bind to the human FcRn.(3)
Contraindications
There is no enhanced messaging for this drug.
- Lactation
- Meningococcal meningitis
- Meningococcemia
- Infection
There are no moderate contraindications for this drug.
Adverse reactions
There is no enhanced messaging for this drug.
More Frequent
- Infection
Less Frequent
- Hypokalemia
- Hypotension
- Pneumonia
Rare or Very Rare
- Anaphylaxis
- Hypersensitivity drug reaction
- Meningitis
- Meningococcemia
- Septic shock
More Frequent
- Constipation
- Diarrhea
- Fever
- Headache disorder
- Hypertension
- Nausea
- Upper respiratory infection
- Vomiting
Less Frequent
- Acute abdominal pain
- Alopecia
- Anemia
- Anorexia
- Arthralgia
- Back pain
- Bruising
- Chills
- Cough
- Dizziness
- Drowsy
- Dry skin
- Dysgeusia
- Dyspnea
- Fatigue
- Lymphadenopathy
- Muscle spasm
- Myalgia
- Pain
- Pain in extremities
- Peripheral edema
- Symptoms of anxiety
- Tonsillitis
- Viral gastroenteritis
- Vitamin D deficiency
Precautions
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Anti-acetylcholine receptor (Achr) antibody positive generalized myasthenia gravis | ||
| G70.0 | ICD10CM | Myasthenia gravis |
| G70.00 | ICD10CM | Myasthenia gravis without (acute) exacerbation |
| G70.01 | ICD10CM | Myasthenia gravis with (acute) exacerbation |
| Atypical hemolytic uremic syndrome | ||
| D59.3 | ICD10CM | Hemolytic-uremic syndrome |
| Neuromyelitis optica spectrum disorder with anti-aquaporin-4 (AQp4) antibodies | ||
| G36.0 | ICD10CM | Neuromyelitis optica [devic] |
| Paroxysmal nocturnal hemoglobinuria | ||
| D59.5 | ICD10CM | Paroxysmal nocturnal hemoglobinuria [marchiafava-micheli] |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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