ravulizumab (Ultomiris)

Brand Names: Ultomiris

Generic Name: ravulizumab

What is ravulizumab (Ultomiris)?

Ravulizumab is used to treat paroxysmal nocturnal hemoglobinuria (PNH) in adults.

Ravulizumab is also used to treat a rare chronic blood disease called atypical hemolytic uremic syndrome (aHUS) in adults and children who are at least 1 month old.

Ravulizumab is available only under a special program. You must be registered in the program and understand the risks and benefits of this medicine.

Ravulizumab may also be used for purposes not listed in this medication guide.

What are the possible side effects of ravulizumab (Ultomiris)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your caregiver if you feel light-headed or if you have chest pain, trouble breathing, or swelling in your face.

You may get infections more easily, even serious or fatal infections. Call your doctor right away if you have signs of infection such as:

Call your doctor at once if you have symptoms of gonorrhea, such as:

  • pain or burning when you urinate;
  • pain or swelling of the genital or rectal area;
  • unusual vaginal bleeding; or
  • foul discharge from the penis or vagina.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about ravulizumab (Ultomiris)?

Ravulizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, flu-like symptoms, muscle pain, headache, confusion, neck or back stiffness, vomiting, rash, or your eyes are more sensitive to light.

You will need to be vaccinated against meningococcal infections before you start using ravulizumab.

Ravulizumab comes with a Patient Safety Card listing symptoms of meningococcal infection. Keep this card with you at all times while using ravulizumab and for at least 8 months after your last dose. Your infection risk could last for several months after you stop using ravulizumab.

Some people may have an increased risk of gonorrhea (a sexually transmitted disease) while using this medicine. Talk with your doctor about safe ways to keep from getting an infection during sex.

What should I discuss with my healthcare provider before receiving ravulizumab (Ultomiris)?

You should not be treated with ravulizumab if you are allergic to it, if you have a meningococcal infection (such as meningitis or sepsis), or if you are not currently vaccinated against meningitis (unless the risks of delaying treatment outweigh the risks of developing meningitis).

You will need to receive a vaccine to protect against meningococcal infections at least 2 weeks before you start using ravulizumab. If you have already received a meningococcal vaccine, your doctor will decide if you need a booster dose.

If you need to start receiving this medicine before you are vaccinated, you may be given antibiotic medicine to take during the first 2 weeks of ravulizumab treatment.

Tell your doctor if:

  • you have never received a meningococcal vaccine; or
  • you have recently had any symptoms of infection (fever, chills, or flu-like symptoms).

Tell your doctor if you are pregnant. It is not known whether ravulizumab will harm an unborn baby. However, having PNH during pregnancy may cause complications in the baby or the mother, including blood clots, infections, bleeding, miscarriage, premature delivery, or death. The benefit of treating PNH may outweigh any risks to the baby or the mother.

Do not breastfeed while using this medicine, and for at least 8 months after your last dose.

Ravulizumab should not be given to a child younger than 18 years old with PNH.

Ravulizumab is not approved for use by anyone younger than 1 month old with aHUS.

How is ravulizumab given (Ultomiris)?

If you have been using another drug called eculizumab (Soliris), you will need to wait 2 weeks after your last dose of eculizumab before starting treatment with ravulizumab.

Ravulizumab is given as an infusion into a vein. A healthcare provider will give you this injection. The first two infusions are usually given 2 weeks apart, followed by an infusion once every 8 weeks.

This medicine must be given slowly, and the infusion can take at least 2 hours to complete.

After each infusion, you will be watched closely for at least 1 hour to make sure you do not have an allergic reaction.

Ravulizumab doses are based on weight. Your dose needs may change if you gain or lose weight.

Ravulizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Your doctor will need to examine you on a regular basis.

Some people may have an increased risk of gonorrhea (a sexually transmitted disease). Talk with your doctor about safe ways to keep from getting an infection during sex.

Ravulizumab can have long lasting effects on your body. You may need frequent medical tests while using this medicine and for up to 16 weeks after your last dose.

Tell your doctor if you have signs of red blood cell breakdown: stomach pain, trouble swallowing, blood in your urine, feeling tired or short of breath, or (in men) trouble having an erection.

If you have aHUS, tell your doctor if you have the following symptoms: confusion or loss of consciousness, seizures, chest pain, difficulty breathing, or stroke.


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What happens if I miss a dose (Ultomiris)?

Call your doctor for instructions if you miss an appointment for your ravulizumab injection.

What happens if I overdose (Ultomiris)?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving ravulizumab (Ultomiris)?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What other drugs will affect ravulizumab (Ultomiris)?

Other drugs may affect ravulizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information (Ultomiris)?

Your pharmacist can provide more information about ravulizumab.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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Reviewed on 10/12/2022

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