Ultomiris Dosage

Generic name: ravulizumab
Drug class: Selective immunosuppressants

Medically reviewed by  A Ras MD.

 Recommended Adult Dosing

Dosage forms:  INJ (on-body injector): 245 mg; INJ (vial): various

Restricted Distribution in US

Paroxysmal nocturnal hemoglobinuria

[20-29 kg]

Dose: 900 mg IV x1 on wk 1, then start maint. dose at 2100 mg IV q8wk on wk 3; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[30-39 kg]

Dose: 1200 mg IV x1 on wk 1, then start maint. dose at 2700 mg IV q8wk on wk 3; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[40-59 kg]

Dose: 2400 mg IV x1 on wk 1, then start maint. dose at 3000 mg IV q8wk on wk 3; Alt: 2400 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[60-99 kg]

Dose: 2700 mg IV x1 on wk 1, then start maint. dose at 3300 mg IV q8wk on wk 3; Alt: 2700 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[>100 kg]

Dose: 3000 mg IV x1 on wk 1, then start maint. dose at 3600 mg IV q8wk on wk 3; Alt: 3000 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

Atypical hemolytic uremic syndrome

[20-29 kg]

Dose: 900 mg IV x1 on wk 1, then start maint. dose at 2100 mg IV q8wk on wk 3 for at least 6mo; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[30-39 kg]

Dose: 1200 mg IV x1 on wk 1, then start maint. dose at 2700 mg IV q8wk on wk 3 for at least 6mo; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[40-59 kg]

Dose: 2400 mg IV x1 on wk 1, then start maint. dose at 3000 mg IV q8wk on wk 3 for at least 6mo; Alt: 2400 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3 for at least 6mo; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[60-99 kg]

Dose: 2700 mg IV x1 on wk 1, then start maint. dose at 3300 mg IV q8wk on wk 3 for at least 6mo; Alt: 2700 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3 for at least 6mo; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[>100 kg]

Dose: 3000 mg IV x1 on wk 1, then start maint. dose at 3600 mg IV q8wk on wk 3 for at least 6mo; Alt: 3000 mg IV x1 on wk 1, then start maint. dose at 490mg SC qwk on wk 3 for at least 6mo; Info: give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from IV to SC maint. regimen, give 1st SC maint. dose 8wk after last IV maint. dose; if switching from SC to IV maint. regimen, give 1st IV maint. dose 1wk after last SC maint. dose; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

Generalized myasthenia gravis

[40-59 kg]

Dose: 2400 mg IV x1 on wk 1, then start maint. dose at 3000 mg IV q8wk on wk 3 for at least 6mo; Info: for anti-acetylcholine receptor antibody positive pts; give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[60-99 kg]

Dose: 2700 mg IV x1 on wk 1, then start maint. dose at 3300 mg IV q8wk on wk 3 for at least 6mo; Info: for anti-acetylcholine receptor antibody positive pts; give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

[>100 kg]

Dose: 3000 mg IV x1 on wk 1, then start maint. dose at 3600 mg IV q8wk on wk 3 for at least 6mo; Info: for anti-acetylcholine receptor antibody positive pts; give meningococcal vaccine >2wk before tx if unvaccinated, or give 2wk antibacterial prophylaxis if tx must start w/in 2wk of vaccination; if switching from eculizumab, give 1st dose 1wk after last eculizumab induction dose or 2wk after last eculizumab maint. dose; see pkg insert for supplemental dose if plasma exchange, plasmapheresis, or IVIG

Renal dosing

[see below]

eGFR >30: no adjustment; eGFR <30: not defined

HD/PD: not defined

Hepatic dosing

[not defined]

SRC: NLM .