Zilucoplan
FDA ApprovedAlso known as: Zilbrysq, RA101495
Immune & NeurologicalLast reviewed: April 28, 2026
A macrocyclic peptide complement C5 inhibitor FDA-approved for generalized myasthenia gravis. One of the newest peptide drugs, representing the cutting edge of peptide therapeutics in autoimmune disease.
Mechanism of Action
Binds to complement component C5, preventing its cleavage into C5a and C5b, thereby blocking the terminal complement cascade and formation of the membrane attack complex (MAC). This reduces complement-mediated destruction of the neuromuscular junction in myasthenia gravis.
Common Uses
- Generalized myasthenia gravis (anti-AChR antibody positive)
Known Risks
- Increased risk of meningococcal infections (requires vaccination)
- Injection site reactions
- Upper respiratory infections
- Diarrhea
- Requires daily self-injection
Regulatory Status
FDA-approved as Zilbrysq (2023) for generalized myasthenia gravis in adults who are anti-acetylcholine receptor antibody positive. First subcutaneous complement inhibitor — previous options (eculizumab) required IV infusion.
Common Protocols
Protocol information is for educational reference only. Dosing varies significantly by individual, condition, and physician guidance. Always work with a licensed healthcare provider.
Subcutaneous injection
Typical Dose
16.6 mg (fixed dose) or 32.4 mg (weight-based)
Frequency
Once daily
Cycle Length
Ongoing
Self-administered via pre-filled syringe. Must receive meningococcal vaccination at least 2 weeks before starting. Rotate injection sites.
Related Compounds
Research References
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any peptide therapy. Data is compiled from published research and regulatory sources and may not reflect the most recent developments.