From the FDA Drug Label
2.4 Dosing Considerations Supplemental Dose of ULTOMIRIS Plasma exchange (PE), plasmapheresis (PP), and intravenous immunoglobulin (IVIg) have been shown to reduce ULTOMIRIS serum levels. A supplemental dose of ULTOMIRIS is required in the setting of PE, PP, or IVIg (Table 3)
Ultomiris can be given with IVIg, but a supplemental dose of Ultomiris is required after completion of an IVIg cycle 1.
- The supplemental dose should be administered within 4 hours following completion of an IVIg cycle.
- The dose of the supplemental Ultomiris is based on the patient's body weight and the most recent Ultomiris dose, as shown in Table 3 1.
From the Research
Yes, Ultomiris (ravulizumab) can be given with IVIG (intravenous immunoglobulin), as there are no known significant drug interactions between these two medications that would prevent their concurrent use. Ultomiris is a complement inhibitor primarily used to treat paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), while IVIG is used for various immune-related conditions 2. The timing of administration may be important - typically, these would be given as separate infusions rather than mixed together, with appropriate intervals between them as determined by the treating physician.
Some key points to consider when administering Ultomiris with IVIG include:
- Monitoring patients closely for any potential interactions or adverse effects 3
- Ensuring patients are current on all meningococcal vaccines, as Ultomiris significantly suppresses the immune system 4
- Considering antibiotic prophylaxis for patients receiving both treatments, due to the increased risk of infection 4
- The combination may be particularly relevant in patients with certain autoimmune neurological conditions or those transitioning between therapies 5
It's essential to consult with a specialist before combining these treatments, as individual patient factors may affect safety and dosing schedules 6. Additionally, the most recent study on the use of IVIG in kidney transplant recipients with chronic active antibody-mediated rejection found that IVIG therapy was associated with stabilization in allograft histology and eGFR 6, which may be relevant when considering the use of IVIG with Ultomiris in certain patient populations.