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)

🔀 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).