eculizumab at a glance
Medicine class
Monoclonal antibody and terminal complement C5 inhibitor
Licensed uses
PNH and aHUS in adults and children, subject to product-specific restrictions
Administration
Diluted intravenous infusion given by a healthcare professional; not a rapid injection or bolus
Key safety issue
Substantially increased susceptibility to meningococcal infection; vaccination does not eliminate the risk
What is eculizumab used for?
Licensed uses include:
PNH in adults and children where haemolysis causes clinical symptoms indicating high disease activity.
aHUS in adults and children.
How does eculizumab work?
Eculizumab binds complement protein C5 and prevents formation of C5a, C5b and the terminal complement complex C5b-9. This reduces complement-driven red-cell destruction in PNH and thrombotic microangiopathy in aHUS.
eculizumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 300 mg
How to take eculizumab
A healthcare professional dilutes and infuses eculizumab into a vein under specialist supervision. Observation is needed because infusion or allergic reactions can occur. Home infusion may be considered only after clinical assessment, previous good tolerance and suitable professional and emergency-care arrangements.
Food does not affect an intravenous infusion.
Keep your patient card with you and show it to healthcare professionals.
Tell the infusion team about fever, active infection, new medicines or symptoms during the infusion.
eculizumab side effects
Common or expected effects
- Headache
- Respiratory or urinary tract infections
- Nausea, vomiting, diarrhoea or abdominal pain
- Dizziness or raised blood pressure
- Rash, itching or hair loss
- Joint, muscle or limb pain
- Fever, tiredness or an infusion-related reaction
Get urgent medical advice
- Meningococcal infection, meningitis or sepsis
- Severe allergic or anaphylactic reaction
- Other serious infections, particularly from Neisseria or encapsulated bacteria
- Possible liver injury, including jaundice or dark urine with marked tiredness
- Severe haemolysis or thrombotic microangiopathy after treatment interruption
eculizumab in pregnancy
Pregnancy data remain limited, although available evidence has not identified increased fetal malformation or fetal-neonatal toxicity. Eculizumab can potentially cross the placenta. Use requires individual specialist assessment and close maternal and fetal monitoring when considered necessary.
eculizumab while breastfeeding
Limited evidence suggests eculizumab is not detectable in human milk, and effects in a breastfed infant are not anticipated. Review the benefits of breastfeeding, the need for treatment and remaining uncertainty with the specialist team.
eculizumab interactions
Tell the specialist team about all medicines and plasma-based procedures. Important interactions include:
Rituximab
Eculizumab may reduce rituximab's expected complement-dependent effect.
Plasma exchange or plasmapheresis
These procedures can substantially lower eculizumab concentrations and require specialist treatment adjustment.
Fresh frozen plasma infusion
May affect eculizumab exposure and requires coordination by the treating team.
Common questions about eculizumab
Answers are fully visible for fast scanning and source review.
Why are meningococcal vaccines needed?
Blocking C5 reduces defence against meningococcal bacteria. Vaccination lowers but does not remove the risk, so suggestive symptoms need urgent assessment.
Can meningitis occur after vaccination?
Yes. Meningococcal disease can occur despite vaccination.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.