Soliris (eculizumab) is a prescription drug that’s used to treat certain rare autoimmune conditions. Soliris is given as an intravenous (IV) infusion by a doctor or other healthcare professional.
Soliris basics
Soliris contains the active ingredient eculizumab. Soliris is a biologic medication. A biologic is made from parts of living organisms. It’s available only as a brand-name drug. It isn’t available in a biosimilar form.
Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.
Soliris has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should be considered before using Soliris?” section.
Like most drugs, Soliris may cause mild to serious side effects. The lists below contain some of the more common side effects Soliris may cause, but they don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Soliris. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Soliris can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Soliris’s prescribing information.
Mild side effects of Soliris that have been reported include:
- headache
- mild infections, such as coughs, colds, or cold sores
- sore throat
- nausea and vomiting
- diarrhea
- abdominal pain
- back, joint, or muscle pain
- dizziness
- swelling of the lower legs or feet
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Soliris can occur, but they aren’t common. If you have serious side effects from Soliris, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Soliris that have been reported include:
- reactions to the infusion, such as shortness of breath or chest pain
- high blood pressure
- serious infections, such as pneumonia and gonorrhea
- boxed warning: risk of serious meningococcal infection*
* For more information, see the “What should be considered before using Soliris?” section.
Allergic reactionFor some people, Soliris can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue using Soliris.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Soliris, they may have you switch to a different treatment.
Find answers to some commonly asked questions about Soliris.
How does Soliris compare with pegcetacoplan (Empaveli)?
Both Soliris and pegcetacoplan (Empaveli) are drugs that can be used to treat paroxysmal nocturnal hemoglobinuria (PNH). Empaveli is only used for PNH, but Soliris also has other uses as well.
Soliris is given by intravenous (IV) infusion (an injection into a vein given over a period of time). Empaveli is given as a subcutaneous infusion (injection under the skin given over a period of time). A doctor or other healthcare professional will usually administer Soliris. But after training, you can self-administer Empaveli. Soliris is typically given once every 2 weeks, while you can self-administer Empaveli twice per week.
These medications work in a similar way in your body and can cause some similar side effects. For example, both drugs have a boxed warning* for an increased risk of meningococcal infections. But they can also cause some different side effects as well.
To find out more about how these drugs compare, talk with your doctor.
* A boxed warning is a serious warning from the Food and Drug Administration (FDA). For more information, see the “What should be considered before using Soliris?” section.
How does Soliris compare with Ultomiris?
Soliris and ravulizumab (Ultomiris) are used to treat the same conditions. (For more information about the conditions these drugs treat, see the “What is Soliris used for?” section.)
Both of these drugs are given by IV infusion by a doctor or other healthcare professional. Soliris is usually given once every 2 weeks, while Ultomiris is typically given every 4 to 8 weeks.
Soliris and Ultomiris can cause very similar side effects. Both drugs have a boxed warning for an increased risk of meningococcal infections. (For more information, see the “What should be considered before using Soliris?” section.)
For more details on how these drugs compare, talk with your doctor.
Whether you have health insurance or not, cost may be a factor when you’re considering Soliris. What you’ll pay for Soliris may depend on several things, such as your treatment plan and the pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called OneSource may also be available.
You can also check out this article to learn more about saving money on prescriptions.
Soliris is used to treat certain autoimmune conditions. With these conditions, your immune system attacks healthy tissues in your body by mistake.
Specifically, Soliris is used to treat the following conditions in adults:
- generalized myasthenia gravis, which causes weakness in certain muscles
- paroxysmal nocturnal hemoglobinuria, a condition that destroys your red blood cells and can lower your levels of other blood cells
- neuromyelitis optica spectrum disorder, which damages your optic nerves and spinal cord
- atypical hemolytic uremic syndrome (aHUS), which damages small blood vessels in your body (especially in your kidneys) and can cause blood clots in your kidneys
Note: Soliris is also used to treat aHUS in children ages 2 months and older. Soliris is not used to treat people with HUS triggered by E.coli. infection of the digestive system.
Your doctor will recommend the dosage of Soliris that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Form and strength
Soliris is available as a liquid solution that’s given as an intravenous (IV) infusion (injection into a vein that’s given over a period of time). It comes in one strength of 300 milligrams (mg) in 30 milliliters (mL) of solution.
Recommended dosages
The usual recommended dosages of Soliris for adults are as follows:
| Condition being treated | Recommended dosage |
|---|---|
| generalized myasthenia gravis | • weeks 1 to 4: 900 mg once per week • week 5 and after: 1,200 mg once every 2 weeks |
| paroxysmal nocturnal hemoglobinuria | • weeks 1 to 4: 600 mg once per week • week 5 and after: 900 mg once every 2 weeks |
| atypical hemolytic uremic syndrome | • weeks 1 to 4: 900 mg once per week • week 5 and after: 1,200 mg once every 2 weeks |
| neuromyelitis optica spectrum disorder | • weeks 1 to 4: 900 mg once per week • week 5 and after: 1,200 mg once every 2 weeks |
Dosage for children
Soliris is also used for atypical hemolytic uremic syndrome in children ages 2 months and older. The dosage for children is based on body weight. Your child’s doctor will calculate the correct dosage based on their weight.
How it’s given
Your doctor will explain how Soliris will be given to you. They’ll also explain how much you’ll be given and how often.
Soliris is given as an intravenous (IV) infusion (an injection into a vein given over a period of time). For adults, Soliris infusions usually last about 35 minutes. For children, the infusions may be given over 1 to 4 hours.
You’ll usually receive infusions at your doctor’s office or a clinic. But in some cases, you may be able to receive them at home.
Questions about receiving Soliris
Below are some common questions about receiving Soliris.
- What if I miss a dose of Soliris? If you miss an appointment to receive an infusion of Soliris, call your doctor’s office as soon as possible to reschedule.
- Will I need to use Soliris long term? Soliris is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely receive it long term.
- How long does Soliris take to work? Soliris begins to work after you take your first dose. But you likely won’t feel the drug working in your body. Your doctor will order tests throughout your treatment to check whether Soliris is working to treat your condition.
Below is important information you should consider before starting Soliris treatment.
Interactions
Combining a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Soliris can interact with some other medications and certain other treatments.
Before starting Soliris treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Drug interactions
Below is a list of medications that can interact with Soliris. This list does not contain all drugs that may interact with Soliris. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
| Drug group or drug name | Drug examples |
|---|---|
| neonatal Fc receptor (FcRn) blockers | • efgartigimod alfa (Vyvgart) • efgartigimod alfa/hyaluronidase-qvfc (Vyvgart Hytrulo) • rozanolixizumab (Rystiggo) |
Soliris and alcohol
Alcohol is not known to interact with Soliris. But alcohol may increase the risk or severity of certain side effects of the drug, such as nausea, dizziness, or headache. Because of this, your doctor may recommend that you limit the amount of alcohol you drink during your Soliris treatment.
Other interactions
Soliris can interact with other substances or treatments, such as:
- plasmapheresis (a treatment that removes your plasma, the liquid part of your blood that contains antibodies)
- plasma exchange (a treatment that replaces your plasma with plasma from a donor)
- fresh frozen plasma infusion (a treatment where you’re given plasma from a donor)
Pregnancy and breastfeeding
It’s not known whether it’s safe to receive Soliris during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding or planning to become pregnant or to breastfeed, talk with your doctor before starting Soliris treatment.
Birth control
If you’re able to become pregnant, your doctor may recommend using a form of birth control during your Soliris treatment. To learn more, talk with your doctor.
Boxed warning
Soliris has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.
Soliris can make it harder for your body to fight certain infections. It can raise your risk of serious meningococcal infections, such as meningitis. These infections can be severe and even life threatening.
To help prevent meningococcal infections, your doctor will make sure that you’re up to date with recommended
Meningococcal vaccines can take about 2 weeks to start working. So if you need one, it’s best to receive it at least 2 weeks before starting Soliris treatment. If your doctor recommends starting Soliris sooner than this, they may prescribe antibiotics to help prevent meningococcal infections while the vaccine begins to fully work.
Although meningococcal vaccines lower your risk of meningococcal infections, they may not protect you completely. If you develop symptoms of a meningococcal infection during or after Soliris treatment, it’s important to see your doctor right away. Symptoms to watch for include:
- skin rash that does not fade when pressed
- fever with or without a skin rash
- headache with fever, nausea, vomiting, stiff neck, or stiff back
- flu-like symptoms with aching muscles or joints
- sensitivity to light
- cold hands and feet
- sleepiness
- confusion
If you have questions about the risk of meningococcal infections during Soliris treatment, talk with your doctor or pharmacist.
Other warnings
Soliris can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Soliris is a good treatment option for you.
Talk with your doctor about your health history before you take Soliris. Be sure to tell them if any of the following factors apply to you:
- low white blood cell count
- current infection
- previous allergic reaction to Soliris
- pregnancy
- breastfeeding
Other drugs are available that can treat your condition. If you’d like to explore an alternative to Soliris, talk with your doctor. They can tell you about other medications that might work well for you.
The following drugs are similar to Soliris:
- efgartigimod (Vyvgart, Vyvgart Hytrulo)
- pegcetacoplan (Empaveli)
- ravulizumab-cwvz (Ultomiris)
- rozanoxilixizumab (Rystiggo)
- satralizumab-mwge (Enspryng)
- zilucoplan (Zilbrysq)
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.