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Vyvgart

efgartigimod alfa
Used for Myasthenia Gravis
Used for Myasthenia Gravis

Vyvgart (efgartigimod alfa or efgartigimod alfa-fcab) is an FDA‑approved medication that's used to treat certain adults with an autoimmune condition called generalized myasthenia gravis (gMG). It can help lower muscle weakness and improve the ability to talk, swallow, and breathe. Vyvgart (efgartigimod alfa) is injected into a vein, typically at an infusion center or your provider's office. This medication is also available as Vyvgart Hytrulo as an injection under the skin. The dosages are given once a week, but side effects are slightly different depending on which formulation you're using.

Reviewed by:
reviewer
Ally Tsai, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on August 31, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Vyvgart (efgartigimod alfa)?

What is Vyvgart (efgartigimod alfa) used for?

How Vyvgart (efgartigimod alfa) works

Normally, your nerves send a chemical called acetylcholine (ACh) to your muscles to help control muscle movements. In people with gMG and anti-AChR antibodies (proteins that damage acetylcholine receptors or AChR), this communication is interrupted. This causes symptoms such as blurry vision, difficulty chewing or speaking, shortness of breath, weakness in arms and legs, and trouble walking.

Both Vyvgart and Vyvgart Hytrulo contain efgartigimod alfa, a part of an antibody that attaches to and blocks a protein called neonatal Fc receptor (FcRn). By blocking FcRn, Vyvgart (efgartigimod alfa) helps lower the amount of harmful anti-AChR antibodies in the body that cause gMG symptoms.

Vyvgart Hytrulo also contains a second active ingredient called hyaluronidase. Hyaluronidase is an enzyme that allows efgartigimod alfa to get absorbed into the body better when the medication is injected under the skin.

Drug Facts

Common BrandsVyvgart, Vyvgart Hytrulo
Drug ClassNeonatal Fc receptor blocker
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Vyvgart (efgartigimod alfa) essentials

FDA: Approval: Approved: GRxH FDA approval-02

FDA Approves Vyvgart to Treat Myasthenia Gravis

Written by Alex Brewer, PharmD, MBA
Health: Myasthenia gravis: closeup arm infusion 1289422467

Ultomiris vs. Vyvgart for Myasthenia Gravis: 4 Differences to Consider

Written by ThienLy Neal, PharmD
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What are the side effects of Vyvgart (efgartigimod alfa)?

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

Other common side effects with Vyvgart Hytrulo:
  • Injection site reactions

Other Side Effects

  • Tingling sensation
  • Muscle pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reaction: trouble breathing; swelling of the lips, tongue, or face; rash

Source: DailyMed

The following 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
  • Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
  • Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

  • Burning or tingling sensation in hands or feet
  • Headache
  • Muscle pain
pros-and-cons

Pros and cons of Vyvgart (efgartigimod alfa)

thumbs-up

Pros

Works well to improve daily abilities in some adults with gMG

Only injected once a week so it's convenient for most people

First-of-its-kind, FDA-approved medication for gMG

thumbs-down

Cons

Can raise the risk of infections

Not recommended to get any live vaccines, such as the nasal spray flu vaccine, while taking this medication

Unknown if safe or works well in children

pharmacist-tips

Pharmacist tips for Vyvgart (efgartigimod alfa)

pharmacist

  • Most commonly, you'll get treated with Vyvgart (efgartigimod alfa) at an infusion center or a provider's office. If you're taking Vyvgart, the medication is infused through the vein, and the IV infusion takes about an hour. If you're taking Vyvgart Hytrulo, the medication is injected under the skin and it takes about 30 to 90 seconds for the full dose.

    • Tell your provider if you experience any notable changes in weight while receiving Vyvgart. They might need to change your dose since the IV infusion is based on your weight.

      • If you're getting treated with Vyvgart Hytrulo, let your provider know if your skin is bruised, red, tender, or hard so they can avoid injecting into those areas.

        • Be sure to plan for some extra time at the office or infusion center after you get your Vyvgart (efgartigimod alfa) treatment. Your provider will monitor you for allergic reactions during the injection and for another 30 minutes to 1 hour afterwards. Tell your provider right away if you experience rash, shortness of breath, or swelling of the tongue or throat.

          • It's best to get your Vyvgart (efgartigimod alfa) injections around the same day every week. If you miss an appointment, talk with your provider right away about rescheduling. Typically, you can still get your Vyvgart (efgartigimod alfa) injection up to 3 days after your missed appointment. You might need to restart the treatment cycle if you miss this window of time.

            • Avoid getting live vaccines, such as FluMist (nasal spray flu vaccine), while you're using Vyvgart (efgartigimod alfa). It isn't known whether live vaccines are safe or work well while you're taking this medication. If you're due for a vaccine or you're not sure which vaccines are safe for you, talk with your provider or pharmacist. They can let you know which ones are safe and help schedule them while you’re taking Vyvgart (efgartigimod alfa).

              faqs

              Frequently asked questions about Vyvgart (efgartigimod alfa)

              How is Vyvgart (efgartigimod alfa) administered?
              Vyvgart is injected into the veins at an infusion center or a provider's office. Usually, it takes about an hour to receive the full dose. On the other hand, Vyvgart Hytrulo is injected under the skin at a provider's office. It typically takes about 30 to 90 seconds to receive the full dose. Talk to your provider if you have questions about each formulation.
              Does Vyvgart (efgartigimod alfa) cause weight gain?
              Vyvgart (efgartigimod alfa) isn't known to cause weight gain. But other medications that might be part of your gMG treatment plan, like steroids, can cause weight gain when used long term. Make sure to update your provider if you've had any significant changes in weight since your Vyvgart (efgartigimod alfa) dose might be dependent on your body weight.
              Who can benefit from Vyvgart (efgartigimod alfa) the most?
              Vyvgart (efgartigimod alfa) is used in certain people with gMG who have anti-AChR antibodies detected in their body. In a clinical study, Vyvgart (efgartigimod alfa) helped 68% of people improve their ability to perform daily tasks for at least 4 weeks. In addition, 63% of people reported less muscle weakness. Follow up with your provider for more information if you have any questions about whether Vyvgart (efgartigimod alfa) is right for you.
              How often is Vyvgart (efgartigimod alfa) given?
              Vyvgart (efgartigimod alfa) is given once a week for 4 weeks. This is considered one treatment cycle. After your treatment cycle, your provider will discuss with you to decide whether you need additional cycles. You might need more treatment when your symptoms of gMG come back or get worse. Consider keeping track of your symptoms every week so your provider can determine when you should receive the next set of injections. Keep in mind that you need at least a 50-day break between treatment cycles.
              Will Vyvgart (efgartigimod alfa) affect how well other medications work?
              Maybe. Vyvgart (efgartigimod alfa) can prevent certain antibody medications from working well. Some examples include immunoglobulin products and monoclonal antibody medications. When used together, these medications and Vyvgart (efgartigimod alfa) can sometimes work against each other since they can attach to the same protein (FcRn) in the body. Before you start Vyvgart (efgartigimod alfa), let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements. Talk with your provider or pharmacist if you have any questions about interactions with this medication.
              Is Vyvgart (efgartigimod alfa) an immunosuppressant?
              No, Vyvgart (efgartigimod alfa) isn't an immunosuppressant. Even though it's not considered an immunosuppressant, Vyvgart (efgartigimod alfa) can put you at risk for infections because it lowers the amount of antibodies in your immune system. Let your provider know if you have symptoms of a respiratory tract infection (sore throat, runny nose, and fever) or a urinary tract infection (pain while urinating, urgent need to urinate, and cloudy urine).
              How long does Vyvgart (efgartigimod alfa) last?
              Vyvgart (efgartigimod alfa) can last for 15 to 25 days before most of the medication leaves your body. This time frame is estimated based on the half-life of Vyvgart (efgartigimod alfa). It can also be affected by your health conditions and age, so it can be different for each individual person. Keep in mind that each treatment cycle is made up of four injections. This means that you can still be at risk for side effects like infection or allergic reactions for up to about 3 weeks even after your last dose of your treatment cycle. Let your provider know right away if you experience rash, hives, trouble breathing, fever, or other symptoms of infection.
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              warings-icon

              What are the risks and warnings for Vyvgart (efgartigimod alfa)?

              Vyvgart (efgartigimod alfa) 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.

              risk-warning

              Risk of infections

              • Risk factor: Active, long-term, or recurrent infection

                Vyvgart (efgartigimod alfa) can lower your body's ability to fight infections. In fact, urinary tract infections (UTIs) and respiratory tract infections (e.g., sinus infections, bronchitis) were common side effects of Vyvgart (efgartigimod alfa) in clinical studies. Infections are typically mild or moderate in severity. Let your provider know right away if you have signs or symptoms of a urinary tract infection (e.g., pain while urinating, frequent urination, bloody urine) or respiratory tract infection (e.g., fever, cough, sore throat). Your provider might ask you to stop using Vyvgart (efgartigimod alfa) until your infection goes away.

                risk-warning

                Allergic reaction

                In rare cases, some people treated with Vyvgart (efgartigimod alfa) or Vyvgart Hytrulo experienced allergic reactions. Your provider will watch out for these reactions when you get the injection and for another 30 minutes to 1 hour after you've received the medication. This make sures the medication is safe for you. But sometimes, allergic reactions can happen even up to 3 weeks after your injection. Keep an eye out for signs and symptoms of allergic reactions, such as shortness of breath; rash; or swelling of the face, tongue, or throat. Get medical help right away if you experience signs of a serious reaction.

                dosage

                Vyvgart (efgartigimod alfa) dosage forms

                Typical dosing for Vyvgart (efgartigimod alfa)

                Vyvgart is an intravenous (IV) infusion that's given by a provider in a healthcare setting. Your provider will calculate the appropriate dose for you based on your body weight.

                • The typical dose is 10 mg/kg of body weight injected into a vein once a week for 4 weeks. The maximum dose is 1,200 mg per infusion.

                Vyvgart Hytrulo is an injection under the skin that's given by a provider in a healthcare setting.

                • The typical dose is 1,008 mg injected under the skin once a week for 4 weeks.

                alternatives

                What are alternatives to Vyvgart (efgartigimod alfa)?

                There are a number of medications that your doctor can prescribe in place of Vyvgart (efgartigimod alfa). Compare a few possible alternatives below.
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                References

                Best studies we found

                argenx US. (n.d.). Answers to commonly asked questions about Vyvgart.

                argenx US. (n.d.). Track your symptoms to help your neurologist determine your next treatment cycle.

                argenx US. (n.d.). Vyvgart for intravenous (IV) infusion is given over 1 hour at an infusion center, neurologist’s office, or at home.

                View All References (11)

                argenx US. (2023). Vyvgart- efgartigimod alfa injection [package insert]. DailyMed.

                argenx US. (2023). Vyvgart Hytrulo (efgartigimod alfa and hyaluronidase- human recombinant injection, solution [package insert]. DailyMed.

                Centers for Disease Control and Prevention. (2022). Live attenuated influenza vaccine [LAIV] (the nasal spray flu vaccine).

                Heo, Y. A. (2023). Efgartigimod alfa in generalised myasthenia gravis: A profile of its use. Central Nervous System Drugs.

                Howard, J., et al. (2021). Efficacy, safety, and tolerability of efgartigimod in patients with generalized myasthenia gravis: Analysis of the phase 3 ADAPT study (4520). Lancet Neurology.

                Knowles, S. P., et al. (2021). Safety of recombinant human hyaluronidase PH20 for subcutaneous drug delivery. Expert Opinion on Drug Delivery.

                National Human Genome Research Institute. (2023). Antibody.

                National Institute of Neurological Disorders and Stroke. (2023). Myasthenia gravis.

                Suresh, A, B., et al. (2023). Myasthenia gravis. StatPearls.

                U.S. Department of Health and Human Services. (2022). Vaccine types.

                U.S. Food and Drug Administration. (2021). FDA approves new treatment for myasthenia gravis.

                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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