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Eculizumab
⚠️ Most serious risk: life-threatening Neisserial infections (≈0.5%/year; 5% after 10 years). ✅ All patients treated with eculizumab must be vaccinated against Neisseria meningitidis.
📖 About
- Always check the BNF entry here for up-to-date prescribing advice.
- Prescribing and monitoring are specialist-only.
⚙️ Mode of Action
- Humanised monoclonal antibody that binds to complement protein C5.
- Blocks terminal complement activation → prevents formation of the membrane attack complex (MAC).
- Compensates for CD59 deficiency in Paroxysmal Nocturnal Haemoglobinuria (PNH).
- Reduces intravascular haemolysis in PNH and complement-mediated microangiopathy in aHUS.
🎯 Indications & Dosing (Specialist Use)
| Condition | Initial Dose | Maintenance |
|---|---|---|
| PNH | 600 mg IV weekly × 4 → 900 mg IV week 5 | 900 mg IV every 12–16 days |
| aHUS | 900 mg IV weekly × 4 → 1.2 g IV week 5 | 1.2 g IV every 12–16 days |
🔀 Interactions
- See BNF.
⚠️ Cautions
- Increased risk of severe infections, esp. meningococcal.
- Ensure vaccination before treatment and monitor closely.
🚫 Contraindications
- Unvaccinated against Neisseria meningitidis.
- Ongoing meningococcal infection.
💥 Side Effects
- Common: Headache (esp. after first few doses), diarrhoea, dizziness, chills.
- Occasional: Alopecia.⚠️ Serious: Sepsis, meningococcal meningitis.
📚 References
- BNF – Eculizumab
- Specialist guidelines: PNH & aHUS treatment protocols (NHS England).
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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