Ruconest (C1 esterase inhibitor, recombinant) is a brand-name drug prescribed to treat acute episodes of hereditary angioedema in adults and some children. It’s given as an intravenous (IV) injection by you or your healthcare professional.

Ruconest is approved by the Food and Drug Administration (FDA) to treat acute episodes of hereditary angioedema (HAE) in adults and children ages 13 years and older. The episodes, sometimes called “attacks,” involve swelling (angioedema) in various parts of the body and can be severe.

Ruconest is a biologic and belongs to a drug class called C1 esterase inhibitors. It’s not available in a biosimilar version.

Keep reading for specific information about the dosage of Ruconest, including its strength and how to use the medication. For a comprehensive look at Ruconest, see this article.

Note: This article describes typical dosages for Ruconest provided by the drug’s manufacturer. If you inject Ruconest at home, always follow the dosage prescribed by your doctor.

Below is information about Ruconest’s recommended dosages.

Ruconest form

Ruconest comes as a powder in a single-dose vial. The powder is mixed with sterile water to form a solution for IV injection, given slowly over 5 minutes. Your doctor or another healthcare professional can give you the injection. They may also teach you or a caregiver how to do it at home.

Ruconest strength

Ruconest comes in one strength of 2,100 units (U) per 25 milliliters (mL).

Typical dosages

The following information describes dosages that are commonly prescribed or recommended in adults. However, always follow the dosage that your doctor prescribes. They’ll determine the best dosage to fit your needs.

Dosage for HAE episodes

Your doctor may prescribe Ruconest to treat sudden episodes of HAE. The dosage is based on your body weight in kilograms (kg). One kg equals about 2.2 pounds (lb).

If you weigh less than 84 kg (less than about 185 lb), your dose will likely be 50 U per kilogram of body weight, given once. Your doctor will calculate your dose for you. For example, if you weigh 70 kg (about 154 lb), your dose will be 3,500 U.

If you weigh 84 kg (about 185 lb) or more, your dose will likely be 4,200 U, given once.

If your symptoms don’t go away after one dose, you can give a second dose. When your doctor prescribes Ruconest, they’ll tell you how long you should wait before giving a second dose. However, do not give more than 4,200 U of Ruconest per dose. You also should not give more than two doses in a 24-hour period.

For more information about your specific dosage, talk with your doctor.

Children’s dosage

The FDA has approved Ruconest to treat HAE episodes in children ages 13 years and older. The recommended dosage for children is the same as the dosage for adults. For details, see “Dosage for HAE episodes” above.

Talk with your child’s doctor if you have questions about their dosage.

Long-term treatment

Ruconest is meant to be a long-term treatment, but it’s not for everyday use. You’ll only use Ruconest if you have a sudden episode of angioedema. If you and your doctor determine that Ruconest is safe and effective for you, you’ll likely use it long term.

Before you start Ruconest, your doctor will discuss your treatment plan with you.

The Ruconest dosage your doctor prescribes will depend on certain factors. These include:

  • your body weight
  • how your body responds to Ruconest

Ruconest powder is made into a solution for IV injection, given slowly over 5 minutes.

Your doctor or another healthcare professional can give you your dose at the doctor’s office, infusion center, or hospital. They may also teach you or a caregiver how to inject the medication at home.

If you or your caregiver injects Ruconest, it’s important to carefully follow your doctor’s instructions.

If you have questions about Ruconest injections, talk with your doctor. The manufacturer’s website also has step-by-step instructions and helpful videos about Ruconest injections.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

It’s important that you do not use more Ruconest than your doctor prescribes. For some medications, using more than the recommended amount may lead to harmful effects or overdose.

If you use more than the recommended amount of Ruconest

Call your doctor right away if you believe you’ve used too much Ruconest. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Ruconest and dosage.

Is the dosage of Ruconest similar to the dosage of Haegarda or Berinert?

The dosages of these drugs have some similarities, but there are differences as well. Both Ruconest and Berinert come as a powder that’s prepared for injection into a vein. They’re given only when you have an HAE episode. Your doctor can give you the injection, or they may teach you how to do it at home.

Haegarda also comes as a powder, but unlike the other medications, it’s prepared for injection under the skin. Also, Haegarda is approved to prevent HAE episodes. You self-inject the drug, typically twice per week on a regular basis.

Each of these three brand-name drugs contains a unique formulation of a drug called a C1 esterase inhibitor. To learn more about how these drugs compare, talk with your doctor.

How long does it take for Ruconest to start working?

Ruconest starts to work as soon as you get the infusion. Your symptoms should begin to improve about 90 minutes after your infusion. Your doctor may advise a second infusion if your symptoms persist. To learn more about this, see the “Ruconest dosage” section above.

Talk with your doctor if you have questions about what to expect with Ruconest treatment.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Ruconest for you, they’ll prescribe the dosage that’s right for you. If you self-inject the drug, always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Ruconest without your doctor’s recommendation. If you have questions about the dosage of Ruconest that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Ruconest. These additional articles might be helpful:

  • More about Ruconest: For information about other aspects of Ruconest, refer to this article.
  • Side effects: To learn about side effects of Ruconest, see this article. You can also look at the Ruconest prescribing information.
  • Details about HAE: For details about your condition, see this article about HAE.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.