zilucoplan

Contraindicated in:

Unresolved Neisseria meningitidis infection.

Use Cautiously in:

OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

GI: diarrhea, nausea, pancreatic cysts, PANCREATITIS, vomiting

Misc: INFECTION (INCLUDING NEISSERIA MENINGITIDIS, STREPTOCOCCUS PNEUMONIAE, AND HAEMOPHILUS INFLUENZAE)Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae)

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Solution for injection (prefilled syringes): 16.6 mg/0.416 mL; 23 mg/0.574 mL; 32.4 mg/0.81 mL

Route/Dosage ⬆ ⬇

SC (Adults ≥77 kg): 32.4 mg once daily.
SC (Adults 56–<77 kg): 23 mg once daily.
SC (Adults <56 kg): 16.6 mg once daily.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to the complement protein C5 and inhibits its cleavage to C5a and C5b, preventing the production of the terminal complement complex, C5b-9 and its deposition at the neuromuscular junction.

Therapeutic effects:

Reduction in muscle weakness.
Improvement in ability to perform activities of daily living.

Classifications ⬆ ⬇

Therapeutic Classification: antimyasthenics

Pharmacologic Classification: complement.inhibitors

Pharmacokinetics ⬆ ⬇

Absorption: Extent of absorption following SUBQ administration unknown.

Distribution: Minimally distributed to extravascular tissues.

Protein Binding: >99%.

Metabolism/Excretion: Degraded into small peptides and amino acids via catabolic pathways; one active metabolite formed through this pathway. Another active metabolite forms via metabolism by the CYP4F2 isoenzyme. Excretion of zilucoplan and metabolites in urine and feces negligible.

Half-Life: 7–8 days.

Time/Action Profile ⬆ ⬇

(↓ muscle weakness)

ROUTE	ONSET	PEAK	DURATION
SUBQ	1 wk	8–12 wk	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information and REMS educational materials before starting therapy.
- If patient is to self-inject, provide teaching on SUBQ injection technique.
Counsel on ↑ risk of meningococcal infection and the need to take meningococcal vaccines and antibiotics as indicated. Advise patient to notify health care professional at 1st signs of meningococcal infection (fever, rash, stiff neck/back, muscle aches, headache, confusion, photosensitivity, nausea, vomiting) and to carry the Patient Safety Card at all times during and for 2 mo following therapy completion.
Advise patient to notify health care professional for any new infection or signs of pancreatitis (abdominal or back pain, vomiting).
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇