Ultomiris (ravulizumab-cwvz)* is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat the following blood disorders in certain adults and children:
In addition, this medication is also approved to treat myasthenia gravis in certain adults.
Ultomiris comes as a solution that’s given as an IV infusion by a doctor or another healthcare professional. It can also be injected subcutaneously. The medication belongs to a group of drugs called complement inhibitors.
Ultomiris is a biologic drug. At this time, the drug is only available in the brand-name form. There aren’t any biosimilar forms of Ultomiris currently available.
For information about the dosage of Ultomiris, including its strengths and how to it’s given, keep reading. For a comprehensive look at Ultomiris, including details about its uses and limitation of use, see this article.
This article describes typical dosages for Ultomiris provided by the drug’s manufacturer. In some cases, you may need to go to your doctor’s office, hospital, or infusion center to get your dose of Ultomiris. However, if you’re taking the subcutaneous injection, you’ll likely take your dose at home. In this case, always follow the Ultomiris dosage prescribed by your doctor.
* The reason “-cwvz” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
Before you start taking Ultomiris, your doctor will recommend the best dosage of this medication for you. They may also give you a dosing schedule to keep track of your Ultomiris doses.
Ultomiris forms
Ultomiris comes as a solution that’s given as an IV infusion by a doctor or another healthcare professional. It can also be injected subcutaneously.
The IV form of the drug comes in a vial. And the subcutaneous form of the drug comes in a prefilled cartridge that’s inserted into a single-use injector.
Ultomiris strengths
The IV infusion form of Ultomiris comes in the following strengths:
- 300 milligrams (mg)/30 milliliters (mL)
- 300 mg/3 mL
- 1,100 mg/11 mL
The subcutaneous form of Ultomiris comes in one strength: 245 mg/3.5 mL.
Typical dosages
Typically, Ultomiris treatment begins with a one-time loading dose. A loading dose helps the drug start working right away. After your loading dose, you’ll continue treatment with a maintenance (long-term) dose of the medication.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for atypical hemolytic uremic syndrome (aHUS)
The IV infusion dosage of Ultomiris for aHUS is based on body weight in kilograms (kg). (One kg is about 2.2 pounds [lb].)
You’ll start with a loading dose of medication. After 2 weeks, you’ll continue treatment with a maintenance dosage. Your doctor may use a dosage calculator to determine your dose of Ultomiris based on your body weight.
Below is a dosage chart for the recommended IV infusion doses of Ultomiris for aHUS:
| Body weight | Loading dose | Maintenance dosage |
| 40 kg to less than 60 kg (about 88 lb to less than 132 lb) | 2,400 milligrams (mg) | 3,000 mg every 8 weeks |
| 60 kg to less than 100 kg (about 132 lb to less than 220 lb) | 2,700 mg | 3,300 mg every 8 weeks |
| 100 kg or more (about 220 lb or more) | 3,000 mg | 3,600 mg every 8 weeks |
Your loading dose of Ultomiris will always be given by IV infusion. However, if you weigh at least 40 kg (about 88 lb), you may be able to switch to the subcutaneous injection for maintenance treatment.
For aHUS, the recommended dosage of the subcutaneous injection is 490 mg once weekly.
If you’d like to switch between the IV infusion and subcutaneous forms of Ultomiris, your doctor can recommend when to switch. Also, if you switch from another drug, such as eculizumab (Soliris), to Ultomiris, your doctor can help determine your dosing schedule.
Dosage for paroxysmal nocturnal hemoglobinuria (PNH)
The IV infusion dosage of Ultomiris for PNH is based on body weight in kg.
You’ll start with a loading dose of medication. Two weeks after, you’ll continue treatment with a maintenance dosage.
Below is a dosage chart for the recommended IV infusion doses of Ultomiris for PNH:
| Body weight | Loading dose | Maintenance dosage |
| 40 kg to less than 60 kg (about 88 lb to less than 132 lb) | 2,400 mg | 3,000 mg every 8 weeks |
| 60 kg to less than 100 kg (about 132 lb to less than 220 lb) | 2,700 mg | 3,300 mg every 8 weeks |
| 100 kg or more (about 220 lb or more) | 3,000 mg | 3,600 mg every 8 weeks |
Your loading dose of Ultomiris will always be given by IV infusion. However, if you weigh at least 40 kg (about 88 lb), you may be able to switch to the subcutaneous injection for maintenance treatment.
For PNH, the recommended dosage of the subcutaneous injection is 490 mg once weekly.
If you’d like to switch between the IV infusion and subcutaneous forms of Ultomiris, your doctor can recommend when to switch. In addition, if you switch from another drug, such as eculizumab (Soliris) to Ultomiris, your doctor can help determine your dosing schedule.
Dosage for myasthenia gravis (MG)
To treat MG, Ultomiris is only recommended for adults weighing 40 kg (about 88 lb) or more. In addition, only the IV infusion form of the drug is approved for this use. So, adults taking Ultomiris for MG should not use the subcutaneous injection form of the drug.
The dosage of Ultomiris for MG is based on your body weight. You’ll start with a loading dose of medication. After 2 weeks, you’ll continue treatment with a maintenance dosage.
Below is a dosage chart for the recommended IV infusion doses of Ultomiris for MG:
| Body weight | Loading dose | Maintenance dosage |
| 40 kg to less than 60 kg (about 88 lb to less than 132 lb) | 2,400 mg | 3,000 mg every 8 weeks |
| 60 kg to less than 100 kg (about 132 lb to less than 220 lb) | 2,700 mg | 3,300 mg every 8 weeks |
| 100 kg or more (about 220 lb or more) | 3,000 mg | 3,600 mg every 8 weeks |
Children’s dosage
Ultomiris is also approved for use in children 1 month and older with either aHUS or PNH. Only the IV infusion form of the drug is recommended for this use. The subcutaneous injection has not been approved for use in children.
The dosage of Ultomiris for these conditions is based on your child’s body weight in kilograms (kg). (One kg is about 2.2 pounds [lb]). They’ll start with a loading dose of medication. Two weeks after, they’ll continue treatment with a maintenance dosage.
Below is a dosage chart for the recommended IV infusion doses of Ultomiris:
| Body weight | Loading dose | Maintenance dosage |
| 5 kg to less than 10 kg (about 11 lb to less than 22 lb) | 600 mg | 300 mg every 4 weeks |
| 10 kg to less than 20 kg (about 22 lb to less than 44 lb) | 600 mg | 600 mg every 4 weeks |
| 20 kg to less than 30 kg (about 44 lb to less than 66 lb) | 900 mg | 2,100 mg every 8 weeks |
| 30 kg to less than 40 kg (about 66 lb to less than 88 lb) | 1,200 mg | 2,700 mg every 8 weeks |
| 40 kg to less than 60 kg (about 88 lb to less than 132 lb) | 2,400 mg | 3,000 mg every 8 weeks |
| 60 kg to less than 100 kg (about 132 lb to less than 220 lb) | 2,700 mg | 3,300 mg every 8 weeks |
| 100 kg or more (about 220 lb or more) | 3,000 mg | 3,600 mg every 8 weeks |
Note: Ultomiris is not approved to treat MG in children.
Long-term treatment
Ultomiris is meant to be used as a long-term treatment. If you and your doctor determine that Ultomiris is safe and effective for you, you’ll likely take it long term.
The Ultomiris dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re using Ultomiris to treat
- the form of Ultomiris you take
- your age and body weight
Other medical conditions you have can also affect your Ultomiris dosage.
Dosage adjustments
In some cases, you may need to get an additional dose of Ultomiris. This can occur if you have any blood infusions or certain procedures, such as plasma exchange, plasmapheresis or intravenous immunoglobulin. Usually, these doses range from 600 milligrams (mg) to 1,800 mg and are one-time doses.
Talk with your doctor if you have any blood infusions or procedures. They can help determine if you may need an additional dose of Ultomiris.
Ultomiris comes as a solution that’s given as an IV infusion by a doctor or another healthcare professional. (An IV infusion is an injection given in a vein over time.) It can also be injected subcutaneously (under the skin) using a pre-filled cartridge and single-use injector.
If you’re taking the IV form of Ultomiris, your doctor or another healthcare professional will give you your dose of medication. This can be done at your doctor’s office, infusion center, or in the hospital. In some cases, your doctor may be able to give your Ultomiris dose at home.
Your doctor will dilute your medication so that it’s the right dose for you. Then, they’ll give your dose through a vein in your arm over time.
If you’re taking the subcutaneous injection of Ultomiris, you’ll inject your dose under the skin once weekly. In this case, you’ll inject two 245-milligram (mg) doses of Ultomiris under your skin. You can inject your dose of Ultomiris into your thigh, abdomen or upper arm.
You should try to switch your injection sites with each dose so that you avoid skin side effects.* In addition, do not inject into an area that’s tender, bruised, red, discolored, hard, or scarred.
It’ll take about 10 minutes to administer your subcutaneous injection of Ultomiris. For step-by-step instructions on how to inject the drug, see it’s instructions for use.
* To learn about the side effects of Ultomiris, see this article.
If you miss your appointment to get your IV infusion of Ultomiris, call your doctor’s office right away to reschedule it.
If you forget to inject your subcutaneous dose of Ultomiris at home, talk with your doctor about when to take your next dose.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
It’s important that you don’t use more Ultomiris than your doctor prescribes. For some medications, taking more than the recommended amount may lead to side effects or overdose.
If you take more than the recommended amount of Ultomiris
Call your doctor right away if you believe you’ve taken too much Ultomiris. Another option is to call the American Association of Poison Control 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.
The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Ultomiris for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Ultomiris without your doctor’s recommendation. If you have questions about the dosage of Ultomiris that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Ultomiris. These additional articles might be helpful to you:
- More about Ultomiris. For information about other aspects of Ultomiris, refer to this article.
- Side effects. To learn about side effects of Ultomiris, see this article. You can also look at the Ultomiris prescribing information.
- Details about your condition. For details about blood disorders, see our list of blood and hematology articles.
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.