If you have a certain kind of rare medical condition, your doctor might suggest Ultomiris as a treatment option for you. It’s a prescription drug used to treat:
- paroxysmal nocturnal hemoglobinuria in adults and some children
- atypical hemolytic uremic syndrome* in adults and some children
- generalized myasthenia gravis in certain adults
The active ingredient in Ultomiris is ravulizumab-cwvz.† (An active ingredient is what makes a drug work.) Ultomiris belongs to a group of drugs called complement inhibitors.
Ultomiris comes as a liquid solution that’s given as an injection under your skin or as an intravenous (IV) infusion (an injection into a vein over a period of time).
This article describes the dosages of Ultomiris, as well as its strengths and how to use it. To learn more about Ultomiris, see this in-depth article.
Note: This article covers the usual dosages for Ultomiris, which are provided by the drugmaker. But when giving yourself Ultomiris, always inject the dosage that your doctor prescribes.
* Ultomiris is not approved to treat Shiga toxin E. coli related hemolytic uremic syndrome.
† The reason “-cwvz” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
This section describes the usual dosages of Ultomiris for adults and children.
What are the forms of Ultomiris?
Ultomiris comes as a liquid solution that can be given in two ways:
- intravenous (IV) infusion (an injection into a vein over a period of time)
- injection under your skin
What strengths does Ultomiris come in?
Ultomiris for IV infusion comes in three sizes and strengths:
- 300 milligrams in 3 milliliters of liquid solution (100 mg/mL)
- 1,100 mg in 11 mL (100 mg/mL)
- 300 mg in 30 mL (10 mg/mL)
Ultomiris for injection under the skin comes in one size and strength:
- 245 mg in 3.5 mL (70 mg/mL)
What are the usual dosages of Ultomiris?
Your first dose of Ultomiris will be a loading dose given by IV infusion. (With a loading dose, a higher amount of drug is given at the start of treatment. It helps the drug start working right away.)
Your first maintenance dose will depend on your current treatment for your condition. (This dose maintains a steady level of the drug in your body over time.) See the sections below for more details.
Your Ultomiris dosage is determined by weight. Your doctor will likely check your weight at each appointment to make sure you receive the correct dosage. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for paroxysmal nocturnal hemoglobinuria (PNH)
When Ultomiris is used to treat PNH, it can either be given as an IV infusion or as an injection under your skin.
If you receive the drug by IV infusion, your dose is based on your body weight in kilograms (kg).
You’ll start treatment by receiving one loading dose. You’ll receive your first maintenance dose 1 to 8 weeks later, depending on your treatment plan. Then, 4 or 8 weeks later, you’ll receive your next maintenance dose.
| Body weight in kg* | Ultomiris loading dose | Ultomiris maintenance dose | Dosing schedule |
| 5 kg to less than 10 kg | 600 mg | 300 mg | once every 4 weeks |
| 10 kg to less than 20 kg | 600 mg | 600 mg | once every 4 weeks |
| 20 kg to less than 30 kg | 900 mg | 2,100 mg | once every 8 weeks |
| 30 kg to less than 40 kg | 1,200 mg | 2,700 mg | once every 8 weeks |
| 40 kg to less than 60 kg | 2,400 mg | 3,000 mg | once every 8 weeks |
| 60 kg to less than 100 kg | 2,700 mg | 3,300 mg | once every 8 weeks |
| 100 kg or greater | 3,000 mg | 3,600 mg | once every 8 weeks |
* 1 kg is equal to 2.2 pounds (lb).
If you give yourself Ultomiris injections under the skin, you’ll still receive your loading dose as an IV infusion. Then, 2 weeks later, your maintenance doses will be given as injections under the skin.
The maintenance dosage for PNH when given as an injection under the skin is 490 mg given once weekly for adults weighing 40 kg or more.
If you’ve been receiving Ultomiris as an IV infusion and want to switch to getting injections under the skin, you’ll receive your first injection 8 weeks after your last infusion. Or, if you’ve been receiving Ultomiris injections and want to switch to receiving IV infusions, you’ll get your first maintenance dose 1 week after your last injection of Ultomiris.
Dosage for atypical hemolytic uremic syndrome (aHUS)
The dosage for aHUS is the same as the recommended dosage for PNH. See the section directly above for details.
Dosage for generalized myasthenia gravis (gMG)
When used for gMG, Ultomiris is only given by IV infusion at your doctor’s office.
The dose is based on your body weight in kg. You’ll first receive one loading dose. You’ll receive your first maintenance dose 2 weeks later. You’ll receive your next maintenance dose 8 weeks later.
| Body weight in kg* | Ultomiris loading dose | Ultomiris maintenance dose | Dosing schedule |
| 40 kg to less than 60 kg | 2,400 mg | 3,000 mg | once every 8 weeks |
| 60 kg to less than 100 kg | 2,700 mg | 3,300 mg | once every 8 weeks |
| 100 kg or greater | 3,000 mg | 3,600 mg | once every 8 weeks |
* 1 kg is equal to 2.2 pounds (lb).
What’s the dosage of Ultomiris for children?
Ultomiris is used to treat PNH and aHUS in children ages 1 month and older. Your child’s dosage is based on weight. For details, see the “Dosing schedule for PNH” and “Dosing schedule for aHUS” sections directly above.
When used in children, Ultomiris is only given as an IV infusion by your child’s doctor. (It’s not given as an injection under the skin.)
If you have questions about your child receiving Ultomiris, talk with their doctor.
Is Ultomiris used long term?
Yes, Ultomiris is usually prescribed as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely use it long term.
If you’re prescribed the intravenous (IV) infusion form of Ultomiris, you’ll receive doses at your doctor’s office. The length of your infusion may depend on your specific dosage. It could take from 24 minutes to 90 minutes or longer.
If your doctor recommends the injection form of Ultomiris, you’ll likely be able to give yourself injections at home. Your doctor or pharmacist will show you how to do this. You can also refer to these step-by-step instructions for help.
For information on the expiration, storage, and disposal of Ultomiris, see this article.
Accessible drug containers and labels
If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:
- have large print or 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.
If you miss an appointment to get an Ultomiris intravenous (IV) infusion, call your doctor’s office as soon as possible. You should get your missed infusion within 7 days of when it was scheduled. Then, you’ll follow your original dosing schedule for the next dose.
If you miss an appointment and don’t get your dose within 7 days of when it was due, your doctor will adjust your future dosing schedule as needed.
If you give yourself Ultomiris injections at home and you miss a dose or aren’t sure whether you received a full dose, call your doctor right away. If it’s within 1 day of when you missed your dose, you’ll likely be able to take your missed dose and continue with your regular dosing schedule.
If you miss a dose and it’s been more than 1 day since it was due, your doctor will adjust your future dosing schedule as needed.
If you need help remembering to take your dose of Ultomiris on time or remembering your infusion appointments, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Ultomiris for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Ultomiris without your doctor’s recommendation. Only use Ultomiris 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 change my dosage of Ultomiris if I’m taking other medications with it?
- Will you change my dosage if Ultomiris isn’t working well enough for me?
- Would a different dosage increase or decrease my risk of side effects from Ultomiris?
To learn more about Ultomiris, you may be interested in 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.
