Ruconest (C1 esterase inhibitor, recombinant) is a prescription drug that’s used to treat sudden swelling in people with hereditary angioedema. The drug is given as an intravenous (IV) infusion. Ruconest is typically self-administered after training by a healthcare professional.

Ruconest is used in adults and adolescents to treat attacks of hereditary angioedema (HAE).

Note: It isn’t known if Ruconest is effective for treating HAE attacks that affect the throat.

Ruconest belongs to a group of drugs called C1 esterase inhibitors. C1 esterase inhibitor (C1INH) is a protein typically found in human blood that helps stop swelling. The active ingredient in Ruconest is a recombinant (lab-made) form of C1INH. (An active ingredient is what makes a drug work.)

This article describes the dosages of Ruconest, as well as its strength and how to take it. To learn more about Ruconest, see this in-depth article.

This section describes the usual dosages of Ruconest. Keep reading to learn more.

What is Ruconest’s form?

Ruconest comes in a single-dose vial of powder that’s mixed with sterile water to form a solution. Ruconest is given as an intravenous (IV) infusion (an injection into your vein over a period of time).

What strength does Ruconest come in?

Ruconest comes in one strength of 2,100 units per vial. After the drug is mixed with sterile water to form a solution, the strength is 150 units per milliliter (mL).

What are the usual dosages of Ruconest?

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you.

Dosage for hereditary angioedema (HAE)

The typical Ruconest dosage for adults with HAE depends on body weight in kilograms (kg) and pounds (lb). 1 kg = 2.2 (lb). The volume to administer is expressed in milliliters (mL). The dosage is given as follows:

Body weightDose of RuconestVolume to administer
Less than 84 kg (185 lb) 50 units per kgVaries (see information below table for details)
84 kg or more4,200 units28 mL

If you weigh less than 84 kg (185 lb), the recommended dose is 50 units per kg of body weight.

Your doctor will tell you the exact volume to inject for each dose. They’ll calculate this amount by dividing your body weight in kg by 3. For example, if you weigh 72 kg (about 158 pounds), the volume to administer would be 24 mL. And your dose would be 3,600 units. This is a little less than 1.75 vials.

If you weigh 84 kg (185 lb) or more, the recommended dose is 4,200 units. The volume to administer would be 28 mL, which is two vials.

If you continue to have HAE attack symptoms, you can give yourself another dose. The maximum dose is 4,200 units (two vials) per dose, with no more than two doses given within a 24-hour period.

Talk with your doctor or pharmacist if you have questions about your dosage of Ruconest.

What’s the dosage of Ruconest for children?

Ruconest is used to treat attacks of HAE in adolescents ages 13 to 17 years.

The dosage used in adolescents is the same as the dosage for adults, which is based on body weight. To learn more, see the “What are the usual dosages of Ruconest?” section above.

Is Ruconest used long term?

Ruconest is usually prescribed long-term, but it’s used as a short-term treatment to stop HAE attacks.

If you and your doctor determine that Ruconest is safe and effective for you, you’ll likely use it long term on an as-needed basis.

The dosage of Ruconest you’re prescribed depends on your body weight. For details, see the Dosage section just above.

Ruconest comes in a single-dose vial of powder that’s mixed with sterile water to form a solution. Ruconest is given as an intravenous (IV) infusion (an injection into your vein over a period of time). An infusion takes about 5 minutes.

A healthcare professional will show you how to prepare and administer Ruconest. You’ll give yourself the drug right away any time you notice symptoms of an HAE attack.

Information and videos for preparing and administering Ruconest can be found on the drug manufacturer’s website. Note that you’ll need additional supplies to prepare and administer this medication. To prepare each dose of Ruconest, you’ll need the following supplies, which are sold or dispensed separately:

  • sterile water for injection
  • one 30-millilter (mL) syringe
  • a vial adapter or a large-bore needle
  • one standard butterfly catheter infusion set, which is an intravenous administration kit that includes a butterfly needle that you’ll insert into a vein

You’ll also need a tourniquet, sterile gauze, tape, bandage, gloves, and antiseptic wipes (such as alcohol swabs).

After following all of the preparation steps (as described in the Patient Product Information section of Ruconest’s prescribing information), you’ll slowly inject your dose of Ruconest over approximately 5 minutes.

For information on the expiration, storage, and disposal of Ruconest, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

Do not use more Ruconest than your doctor prescribes as this could lead to harmful effects.

What to do in case you use too much Ruconest

Call your doctor right away if you think you’ve taken too much Ruconest. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Ruconest’s dosage.

How long does it take for Ruconest to start working?

Ruconest starts to work right away after you inject your dose. But it usually takes around 90 minutes before you notice the symptoms of your HAE attack starting to ease. In studies, most people experienced relief within 4 hours of taking Ruconest.

Without treatment, an HAE attack may last for a few days.

If you have other questions about what to expect from your Ruconest treatment, talk with your doctor.

Can Ruconest be used for laryngeal attacks? If so, what’s the dosage?

No, Ruconest isn’t approved for HAE attacks that affect the larynx (voice box). These attacks cause severe swelling of the throat. Based on clinical studies of the drug, it isn’t known if Ruconest is effective for treating laryngeal attacks.

Because Ruconest isn’t approved for laryngeal attacks, the drug manufacturer doesn’t provide recommended dosages for this purpose.

However, in some cases, doctors may prescribe Ruconest off-label to treat laryngeal attacks. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.) If your doctor does this, they will prescribe the dosage that’s right for you.

To learn more about your treatment options for HAE attacks, including Ruconest, talk with your doctor.

The sections above describe the usual dosage provided by Ruconest’s manufacturer. If your doctor recommends this drug, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Ruconest without your doctor’s recommendation. Only take Ruconest exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Will you provide a detailed list of the supplies I’ll need to administer Ruconest and tell me where to get them?
  • I have an event planned today that may be stressful. Should I prepare my dose of Ruconest in advance, just in case?
  • What should I do if my swelling doesn’t go away after using Ruconest?
  • How often can I use Ruconest?

To learn more about Ruconest, see these articles:

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Disclaimer: Healthline 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.