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Ravulizumab-cwvz (Intravenous)

Medically reviewed by Last updated on May 1, 2022.

Intravenous route(Injectable)

Warning: Serious Meningococcal InfectionsLife-threatening meningococcal infections/sepsis have occurred in patients treated with ravulizumab-cwvz. Meningococcal infection may become rapidly life-threatening or fatal if not recognized and treated early. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for meningococcal vaccination in patients with complement deficiencies. Immunize patients with meningococcal vaccines at least 2 weeks prior to administering the first dose of ravulizumab-cwvz, unless the risks of delaying ravulizumab-cwvz therapy outweigh the risk of developing a meningococcal infection. Vaccination reduces, but does not eliminate, the risk of meningococcal infections Monitor patients for early signs of meningococcal infections and evaluate immediately if infection is suspected. Ravulizumab-cwvz is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Under the ravulizumab-cwvz REMS, prescribers must enroll in the program .

Commonly used brand name(s)

In the U.S.

  • Ultomiris

Available Dosage Forms:

  • Solution

Therapeutic Class: Blood Modifier Agent

Pharmacologic Class: Ravulizumab

Uses for ravulizumab-cwvz

Ravulizumab-cwvz injection is used to treat a type of blood disease called paroxysmal nocturnal hemoglobinuria (PNH). Ravulizumab-cwvz helps reduce red blood cell destruction or breakdown (hemolysis) in patients with PNH.

Ravulizumab-cwvz injection is also used to treat atypical hemolytic uremic syndrome (aHUS) in adults and children.

Ravulizumab-cwvz injection is also used to treat a nerve and muscle problem called generalized myasthenia gravis (gMG) in patients who are anti-acetylcholine receptor (AChR) antibody positive.

Ravulizumab-cwvz injection is a monoclonal antibody that works on the immune system.

Ravulizumab-cwvz is available only under a restricted distribution program called Ultomiris® REMS (Risk Evaluation and Mitigation Strategy) Program.

Before using ravulizumab-cwvz

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ravulizumab-cwvz, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to ravulizumab-cwvz or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ravulizumab-cwvz injection to treat paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) in children 1 month of age and older. However, safety and efficacy have not been established to treat paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) in children younger than 1 month of age or to treat generalized myasthenia gravis (gMG) in children.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ravulizumab-cwvz injection in the elderly.


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ravulizumab-cwvz, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ravulizumab-cwvz with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Immune Globulin

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of ravulizumab-cwvz. Make sure you tell your doctor if you have any other medical problems, especially:

  • Infection (eg, gonorrhea, influenza, pneumonia)—Use with caution. Ravulizumab-cwvz may decrease your body’s ability to fight infection.
  • Meningococcal infection—Should not be given to patients with this condition.
  • No current vaccination against meningitis infection—Should not be given to patients with this condition unless the doctor decides that urgent treatment is needed.

Proper use of ravulizumab-cwvz

A nurse or other trained health professional will give you or your child ravulizumab-cwvz in a medical facility. It is given through a needle placed into one of your veins. It must be injected slowly, so your IV tube will need to stay in place for at least 2 hours.

Your doctor will monitor you for at least 1 hour for any unwanted effects after the infusion.

It is very important that you understand the requirements of the Ultomiris® REMS program, and become familiar with the Ultomiris® Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the medication guide if you do not have one.

Missed dose

Call your doctor or pharmacist for instructions.

Precautions while using ravulizumab-cwvz

It is very important that your doctor check your or your child's progress at regular visits to make sure that ravulizumab-cwvz is working properly. Blood tests may be needed to check for unwanted effects.

Ravulizumab-cwvz may increase your chance of having serious infections, including a meningococcal infection. Avoid people who are sick or have infections. Tell your doctor right away if you or your child develop headaches, nausea, vomiting, fever, a stiff neck or back, rash, confusion, muscle aches, or if your eyes have become sensitive to light. Make sure you have received a vaccine to prevent meningococcus infections at least 2 weeks before you receive ravulizumab-cwvz. You may also be given antibiotic medicines for 2 weeks to prevent infections if you are to use ravulizumab-cwvz right away. If you have already received the meningococcal vaccine in the past, your doctor will decide if you need another dose.

Ask your doctor for a patient safety card. This card will list the symptoms of meningococcus infections and what to do if you have them. Carry the card with you at all times during treatment and for 8 months after your last dose. You will need to show the card to any doctor who treats you.

You could develop hemolysis (breakdown of red blood cells) when you stop receiving ravulizumab-cwvz for PNH. Your doctor will monitor you closely for at least 16 weeks after the last dose of ravulizumab-cwvz. Be sure to keep all appointments.

Ravulizumab-cwvz may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you or your child start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving ravulizumab-cwvz.

You could also develop a condition called thrombotic microangiopathy (TMA) when you or your child stop receiving ravulizumab-cwvz for aHUS. Tell your doctor right away if you or your child have confusion, seizures, chest pain, trouble breathing, blood clots, or stroke.

Tell your doctor if you are also receiving other procedures (eg, plasma exchange, plasmapheresis) or medicines (eg, efgartigimod, immunoglobulin injection) for myasthenia gravis.

Ravulizumab-cwvz side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • blurred vision
  • body aches or pain
  • chills
  • cough
  • difficulty with breathing
  • dizziness
  • ear congestion
  • extremely high fever or body temperature
  • fast, shallow breathing
  • fast, weak heartbeat
  • fever
  • headache
  • loss of voice
  • muscle cramps
  • nervousness
  • pale, clammy skin
  • pounding in the ears
  • rapid weight gain
  • runny or stuffy nose
  • sneezing
  • slow or fast heartbeat
  • sore throat
  • thirst
  • tingling of the hands or feet
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Diarrhea
  • difficulty having a bowel movement (stool)
  • fear
  • hair loss or thinning of the hair
  • muscle spasms
  • nausea or vomiting
  • pain in the arms or legs
  • stomach pain

Less common

  • Difficulty with moving
  • joint pain
  • muscle pain or stiffness

Incidence not known

  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.