Rystiggo
Rystiggo (rozanolixizumab) is a medication used to treat generalized myasthenia gravis (gMG) which is a long-term condition that causes muscle weakness throughout the body. It’s given by a healthcare provider as a once a week injection under the skin in 6-week cycles, with a break of around 2 months in between each cycle. Some side effects include headache, infections, fever, diarrhea, and nausea.
What is Rystiggo (rozanolixizumab)?
What is Rystiggo (rozanolixizumab) used for?
How Rystiggo (rozanolixizumab) works
Rystiggo (rozanolixizumab) is a neonatal Fc receptor (FcRn) blocker, so it works by blocking the activity of the FcRn receptor. These receptors lengthen the life of harmful antibodies that normally stop signals between the nerves and the muscles, leading to muscle movement problems. By preventing this receptor from working, Rystiggo (rozanolixizumab) lowers the number of harmful antibodies, which helps improve muscle weakness and fatigue.
Drug facts
Side effects of Rystiggo (rozanolixizumab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (44%)
- Infections (23%)
- Diarrhea (20%)
- Fever (17%)
- Allergic Reactions (11%)
- Nausea (10%)
Less Common Side Effects
- Stomach pain
- Joint pain
- Injection-site reaction
Rystiggo (rozanolixizumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe infection: fever, chills, shortness of breath, sore throat, chest pain
- Inflammation of the brain (aseptic meningitis): severe headache, neck stiffness, fever, nausea, vomiting, sensitivity to light, painful eye movements, drowsiness
- Severe allergic reaction: Swelling of the eyes, lips, or tongue (angioedema), rash, difficulty breathing, swelling of the throat
The following Rystiggo (rozanolixizumab) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Fever, neck pain or stiffness, sensitivity to light, headache, nausea, vomiting, confusion, which may be signs of meningitis
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Rystiggo (rozanolixizumab)
Pros
- Only taken once a week for 6 weeks at a time
- Infusions typically take around 15 min
- No known interactions with other medications or supplements
- First FDA approved medication to work in people with both types of myasthenia gravis antibodies
Cons
- Might require multiple rounds of the medication
- Can make it more difficult for your body to fight off infections
- Can only be administered by a healthcare provider
- No lower-cost generic available
Pharmacist tips for Rystiggo (rozanolixizumab)
- A typical infusion of Rystiggo (rozanolixizumab) will take around 15 minutes and is given in the lower stomach area. But infusion time can vary slightly based on your dose, which depends on your weight. Be sure to wear comfortable and loose fitting clothing on the day of your infusion.
- Avoid getting any live vaccines while taking Rystiggo (rozanolixizumab). Rystiggo (rozanolixizumab) can weaken the body's immune system and affect how well your body can fight off infections. Before starting Rystiggo (rozanolixizumab) talk with your healthcare provider to make sure you are up to date with your vaccinations.
- Rystiggo (rozanolixizumab) can raise the risk of getting infections such as COVID-19, herpes, urinary tract infections, and upper respiratory tract infections. Contact your healthcare provider if you’re experiencing fever, chills, shortness of breath, sore throat, and chest pain that won't go away.
- People who take Rystiggo (rozanolixizumab) commonly report headaches as a side effect. If you start to experience a headache try drinking plenty of water, avoid alcohol, or take an over the counter medication such as ibuprofen.
- If you experience headaches that won't go away, become more severe, or you begin to experience neck stiffness, sensitivity to light, eye pain, or a fever after taking Rystiggo (rozanolixizumab), this may be a sign of a more dangerous condition called aseptic meningitis. Talk to your healthcare provider right away.
- If you miss your dose of Rystiggo (rozanolixizumab), you can still receive the dose for up to 4 days after. So reschedule your appointment as soon as possible if this happens.
Common questions about Rystiggo (rozanolixizumab)
Myasthenia gravis is an autoimmune condition that causes muscle weakness and fatigue. It commonly affects muscles located in the face, eyes, arms, and legs. In serious cases it can affect breathing and swallowing muscles. Common symptoms include droopy eyelids, blurry vision, and seeing double. These symptoms happen because there is an issue with the signals between the nerves and muscle. Rystiggo (rozanolixizumab) is a medication used for myasthenia gravis that strengthens these signals, which helps to improve symptoms of the condition.
No. There is currently no cure for myasthenia gravis. But medications like Rystiggo (rozanolixizumab) can allow people to live a higher quality of life. The medication can improve symptoms of the condition like breathing, mobility, muscle fatigue, and weakness. Talk to your provider if you have questions about available treatment options for myasthenia gravis.
Rystiggo (rozanolixizumab) works best for people with myasthenia gravis who have specific harmful antibodies: anti-acetylcholine receptor (AChR) or anti muscle-specific tyrosine kinase (MuSK) antibodies. A blood test can be done in order to find out if you have these antibodies. Before starting this medication, talk with your healthcare provider about getting the proper testing done to see if this medication is right for you. Luckily, most people with myasthenia gravis have at least one of these antibodies present. And Rystiggo (rozanolixizumab) can ease symptoms of myasthenia gravis by stopping these 2 harmful antibodies from working.
On average, an infusion of Rystiggo (rozanolixizumab) will take around 15 minutes. But these infusion times can be different for some people based on factors like your body weight or your dose. After each dose, you’ll have to stay for an additional 15 minutes to watch for any signs of an allergic reaction.
Maybe. Rystiggo (rozanolixizumab) is given once a week for a total of 6 weeks per cycle. In studies done with Rystiggo (rozanolixizumab), people received anywhere between 1 to 7 cycles with an average of 4 cycles of the 6 week treatment every year. There is a break of at least 2 months between each cycle. The length of the break can be different for some people based on how their symptoms are doing. Make sure you keep track of how you’re feeling during the breaks and discuss any changes with your healthcare provider. They can help you decide if another round of Rystiggo (rozanolixizumab) is needed.
In clinical studies some people saw symptom improvements as soon as one week after the first dose of Rystiggo (rozanolixizumab). People in the study saw improvement in their movement, swallowing, breathing, and talking. But for other people, it may take longer to see improvements. If you haven't noticed any improvements after a while, talk to your healthcare provider.
There aren't enough studies to show whether Rystiggo (rozanolixizumab) is safe to use in pregnancy. In animal studies where Rystiggo (rozanolixizumab) was given at much higher doses, the medication caused harm to unborn babies. It’s important to talk with your provider if you’re pregnant or plan on getting pregnant to make sure this medication is safe for you and your baby.
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Risks and warnings for Rystiggo (rozanolixizumab)
Rystiggo (rozanolixizumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infections
- Risk factors: Having a current infection | Recently receiving a live vaccine
Rystiggo (rozanolixizumab) can increase the risk of certain infections. If you currently have an active infection, you’ll need to wait until the infection has cleared before starting treatment. Let your healthcare provider know right away if you start feeling symptoms of an infection such as fever, chills, shortness of breath, sore throat, chest pain. You might need to stop treatment temporarily until the infection is treated
Because Rystiggo (rozanolixizumab) can make infections more likely, it isn’t recommended to receive live vaccines like MMR, chickenpox, some flu vaccines, and yellow fever during treatment. Rystiggo (rozanolixizumab) can weaken your immune system, which means your body might not be as good at fighting infections.. If you plan on receiving or have recently received any vaccines, tell your healthcare provider before starting treatment with Rystiggo (rozanolixizumab).
Inflammation of the brain (aseptic meningitis)
Although rare, Rystiggo (rozanolixizumab) might increase the risk of aseptic meningitis, a condition which can be life threatening. Keep an eye out for symptoms such as severe headache, neck stiffness, fever, nausea, vomiting, sensitivity to light, painful eye movements, drowsiness. If you notice any of these symptoms let your provider know to see if the medication needs to be stopped.
Severe allergic reactions
Rystiggo (rozanolixizumab) can sometimes cause people to have a severe allergic reaction. Your care team will monitor you for 15 minutes after giving you Rystiggo (rozanolixizumab) to watch for any symptoms of an allergic reaction. Keep in mind that serious allergic reactions have been reported up to 2 weeks after the last Rystiggo (rozanolixizumab) dose. Continue to monitor for allergic reactions even after you go home. If you experience any swelling of the eyes, lips, or tongue (angioedema), rash, difficulty breathing, or swelling of the throat, tell your healthcare provider right away.
In addition, Rystiggo (rozanolixizumab) can also cause injection reactions at the site where the dose is given, sometimes even 3 days after a dose. Let your provider know if you experience redness, pain, or swelling at the injection site that's bothersome and doesn't go away.
Rystiggo (rozanolixizumab) dosage
Typical dosage for Rystiggo (rozanolixizumab)
Rystiggo (rozanolixizumab) is an under the skin infusion that’s given by a healthcare provider once a week for 6-week cycles. There is typically a break of at least 2 months between each cycle. The dose is based on your body weight.
- Less than 50 kg: The typical dose is 420 mg once a week
- 50 to less than 100 kg: The typical dose is 560 mg once a week
- 100 kg or more: The typical dose is 840 mg once a week
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