Satralizumab
Satralizumab is a monoclonal antibody that targets the IL-6 receptor and is used to reduce the frequency of relapses in adults with neuromyelitis optica spectrum disorder (NMOSD). It is specifically indicated for patients who are anti-aquaporin-4 (AQP4) antibody positive. By binding to IL-6 receptors, it inhibits the inflammatory signaling that drives NMOSD pathology, helping to decrease disease activity and prevent disabling neurological attacks.
Satralizumab is an immunomodulating medication that reduces relapse frequency in adults with NMOSD by blocking IL-6 signaling.
Key facts at a glance
- ATC
- L04AC19
- RxNorm
- 2391541
- Generic
- Satralizumab
- Class
- atc-l04
- Brands
- Enspryng
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- prefilled syringe
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
all trimestersavoid if possible
use only if potential benefits justify potential risks to fetus; discontinue therapy if pregnancy occurs unless clinically necessary
regular prenatal monitoring and fetal ultrasound assessments
Use with caution and monitor for adverse effects.
lactation
breastfeedingnot recommended
discontinue breastfeeding or discontinue satralizumab therapy taking into account benefit of breastfeeding for the child and benefit of therapy for the mother
monitor infant for signs of infection
Use with caution and monitor for adverse effects.
pediatric_age
adolescents 12 to 17 yearsno adjustment needed
approved for use in pediatric patients 12 years and older with NMOSD; same dosing as adults
monitor growth and development; watch for infections
geriatric
elderly 65 years and olderno adjustment needed
use with caution due to increased susceptibility to infections; no dose adjustment required based on pharmacokinetics
close monitoring for infections and overall clinical status
Use with caution and monitor for adverse effects.
renal_impairment
mild to moderateno adjustment needed
no dose adjustment required for patients with mild to moderate renal impairment
standard renal function monitoring
renal_impairment
severeno adjustment needed
limited data for severe renal impairment; use with caution and monitor closely
regular renal function monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateno adjustment needed
no dose adjustment required for patients with mild to moderate hepatic impairment
standard liver function monitoring
hepatic_impairment
severeuse with caution
limited data for severe hepatic impairment; use only if benefits outweigh risks
regular liver function monitoring and clinical assessment
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Pharmacological classification based on mechanism of action
FDA approval year
Regulatory approval timeline for NMOSD treatment
Primary indication
Approved therapeutic indication
Mechanism of action
Pharmacodynamic mechanism
Satralizumab is indicated for the treatment of neuromyelitis optica spectrum disorder (NMOSD) in adults who are anti-aquaporin-4 (AQP4) antibody positive. It is used to reduce the frequency of relapses and may be used as monotherapy or in combination with immunosuppressant therapy.
Satralizumab is a monoclonal antibody that binds to both soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated signaling. Since IL-6 is a key cytokine involved in the inflammatory processes underlying NMOSD, blocking its signaling helps reduce disease activity and prevent immune-mediated damage to the optic nerves and spinal cord.
Satralizumab is administered as a subcutaneous injection, typically every 4 weeks after initial loading doses. Common side effects may include headache, arthralgia, and upper respiratory tract infections. Patients should be monitored for signs of infection and liver enzyme elevations during treatment. Hypersensitivity reactions may occur. It should not be used in patients with active infections.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy