Retacrit for Anemia: Benefits, Risks, Dosage, and Pricing

Published on by Dr. Robert Hakim, PharmD

Red blood cells carry oxygen in your blood for delivery throughout your body. When you don’t have enough red blood cells, you can develop a condition called anemia. Anemia can cause symptoms such as dizziness, shortness of breath, and fatigue. If left untreated, severe anemia can become life-threatening. 

Speak to a Specialist

About Copay Assistance
(877) 778-0318

Anemia can be caused by certain conditions, such as chronic kidney disease, or by certain medications like blood thinners or acid-reflux medications. However, blood transfusions may not always be the best or most practical treatment option. That’s where medications like Retacrit can help. Retacrit helps your body produce more red blood cells, which makes it easier to manage anemia and improve symptoms. In this article, we’ll explore everything you need to know about Retacrit, including its uses, dosage, side effects, and much more.

What Is Retacrit?

Retacrit (epoetin alfa-epbx) is an FDA-approved medication used to treat anemia in certain patients. The active ingredient in Retacrit is epoetin alfa-epbx, a lab-made version of the natural protein, erythropoietin (EPO). EPO is a hormone produced mainly by the kidneys that signals the bone marrow to produce red blood cells. When your body does not produce enough EPO, your RBC count drops and you can develop anemia.

Retacrit was developed by Pfizer and was first approved by the FDA in 2018 [3]. It is a biosimilar to Epogen and Procrit. This means the medications have no clinically meaningful differences in safety or effectiveness. However, Retacrit is often less expensive than the other two products. 

What Is Retacrit Used To Treat?

Retacrit is an FDA-approved medication used to treat anemia caused by certain medical conditions and medications. The FDA has approved Retacrit for use in the following situations [1]:

Anemia Treatment: Retacrit is used to treat anemia due to:

  • Chronic Kidney Disease (CKD), including patients on dialysis and those not on dialysis.
  • Chemotherapy that suppresses bone marrow activity, when chemotherapy is expected to continue for at least 2 additional months. 
  • Zidovudine (a medication used to treat HIV).

Reducing Blood Transfusions in Some Surgeries: Retacrit is used to reduce the frequency of blood transfusions in patients undergoing elective surgeries that are not related to the heart or blood vessels.

Retacrit is not intended for the immediate treatment of severe anemia when urgent blood transfusions are required. 

How Does Retacrit Work?

Retacrit works by replacing missing or insufficient EPO, which stimulates the bone marrow to produce more red blood cells [1]. As red blood cell levels increase, the blood can carry more oxygen throughout the body. This helps improve common anemia symptoms such as fatigue, weakness, and shortness of breath.

Side Effects

Like all medications, Retacrit may cause side effects. Some side effects are mild, while others may be serious and require immediate medical attention. Below are some common and serious side effects associated with Retacrit [1,2]: 

Patient experiencing fever as a side effect of taking Retacrit

Common Side Effects

Common side effects include: 

  • Headache and dizziness
  • Fever and chills
  • Pain in your bones, joints, or muscles
  • Nausea and vomiting
  • High blood sugar
  • Itching and rash
  • Trouble sleeping
  • Weight loss
  • Depressed mood

These side effects are usually mild and may improve as the body adjusts to the medication. However, if they persist or become worse, contact your doctor.

Get Financial Assistance

Schedule a Consultation

Severe Side Effects

In rare cases, Retacrit can also cause some serious side effects. Here are some of the serious side effects of Retacrit:

  • Blood Clots: Retacrit may increase the risk of blood clots in the veins or arteries, which can lead to a heart attack or stroke. Seek immediate medical attention if you experience symptoms like chest pain, trouble breathing, sudden weakness, or swelling in your arms or legs.
  • Severe Allergic Reactions: Stop using Retacrit and seek help right away if you experience symptoms of a serious allergic reaction, including difficulty breathing, rash, swelling, or a fast heartbeat.
  • High Blood Pressure: Retacrit can cause or worsen high blood pressure. During treatment, your doctor may regularly monitor your blood pressure.
  • Pure Red Cell Aplasia (PRCA): In rare cases, your body may stop producing red blood cells, causing severe anemia due to an immune reaction against Retacrit. This condition is called pure red cell aplasia. Contact your doctor if your anemia worsens suddenly.
  • Heart Failure: Retacrit may increase your risk of heart failure. Tell your doctor right away if you experience symptoms such as shortness of breath, unusual tiredness, rapid weight gain, or swelling in your feet, ankles, or legs.

Please note that this is not a complete list of all possible side effects. Contact your healthcare provider immediately if you experience any severe side effects of Retacrit.

Dosing

Retacrit is available as a solution for injection in single-dose and multi-dose vials. The dosage of Retacrit depends on body weight, medical condition, hemoglobin levels, and response to treatment. Before starting treatment, your healthcare provider may check your iron levels and continue monitoring them during therapy. Iron supplementation may also be recommended if necessary. Also, other possible causes of anemia should be identified and treated before beginning therapy.

Recommended dosages include [1]: 

Chronic Kidney Disease (CKD): For adult patients, the usual starting dose is 50 to 100 units per kilogram of body weight given three times per week. Pediatric patients usually receive 50 units per kilogram of body weight three times weekly. The maintenance dose is adjusted individually based on the patient’s response.

HIV Patients Taking Zidovudine: The recommended dose is 100 units per kg of body weight three times weekly.

Cancer Patients Receiving Chemotherapy: Adult patients may receive 40,000 units once weekly or 150 units/kg three times weekly. Children older than 5 years may receive 600 units/kg intravenously once weekly.

Surgery Patients: The recommended dose is 300 units/kg daily for 15 days or 600 units/kg once weekly.

Before Starting Retacrit

Before starting treatment, tell your healthcare provider about your complete medical history. This helps ensure that Retacrit is safe and appropriate for you. Make sure to tell your provider if you:

  • Have high blood pressure
  • Have a history of heart disease or stroke
  • Have seizures or epilepsy
  • Have ever had an allergic reaction to epoetin alfa products

Here are some important risks that you should consider carefully before starting Retacrit treatment:

  • In patients with chronic kidney disease (CKD), using Retacrit to raise hemoglobin levels above 11 g/dl may increase the risk of death, stroke, and heart problems.
  • In some cancer patients, Retacrit may increase the risk of tumor growth or shorter survival. These cancers include breast, lung, head and neck, lymphoid, and cervical cancers.
  • Patients undergoing surgery may have a higher risk of blood clots, so preventive treatment may be necessary. 

Talk With a Copay Assistance Specialist

(877) 778-0318

Cost

Retacrit is available in different strengths and vial sizes. The cost of treatment can vary depending on your weight, dosage, treatment duration, insurance coverage, and the pharmacy you visit.

The following is an example of treatment cost: Suppose your weight is 70 kg and you are prescribed a dose of 100 units/kg three times weekly. In this example, the total weekly dose would be 21,000 units. A 1 ml vial containing 2,000 units costs around $22.87 [4]. Therefore, the weekly treatment cost may exceed $240 without insurance coverage. 

Contact us if you are interested in financial assistance or copay assistance for Retacrit.

Myasthenia Gravis and Exercise: Tips for Staying Active and Healthy

Published on by Dr. Mark Alfonso, PharmD, BCMTMS

For many years, people living with myasthenia gravis (MG) have avoided exercise or intense physical activity because they think that it could worsen symptoms or even trigger flare-ups. 

Speak to a Specialist

About Copay Assistance
(877) 778-0318

It’s possible that exercise can make symptoms worse, but staying inactive with this fear isn’t the best approach either. 

You need to move your body regularly. A sedentary lifestyle can lead to muscle deconditioning, in which your muscles weaken and lose strength over time. It also increases the risk of other health conditions (e.g., heart disease, osteoporosis, and obesity), which can affect your overall physical and mental well-being.

The latest research suggests that exercise can help maintain muscle function, improve physical fitness, and support overall quality of life in people with myasthenia gravis.

In this article, we’ve listed some suitable physical activities and shared practical tips that can help you stay active and healthy without worsening your symptoms.

Understanding Myasthenia Gravis (MG) and Muscle Function

Myasthenia gravis is a progressive autoimmune condition that affects the connection between your nerves and muscles, leading to severe weakness and fatigue. This chronic condition mainly affects the voluntary muscle functions involved in walking, lifting, chewing, and even breathing. 

The symptoms of MG can get worse when an individual does repetitive movements. But symptoms often improve with rest. Because of this unique pattern, exercise often feels quite challenging for MG patients, as they experience greater fatigue and muscle weakness than the average person. 

Myasthenia Gravis and Exercise: What Research Says

Recently, several studies and case reports have demonstrated that low-to-moderate exercise can be safe and effective for people with clinically stable myasthenia gravis. In fact, people with mild myasthenia gravis can stay active, just like anyone else, by following the WHO guideline of exercising at least 150 minutes per week. 

A 2026 study reported that regular physical activity can reduce secondary muscle deconditioning, improve functional outcomes, and enhance quality of life in patients with myasthenia gravis.

Similarly, a 2023 review of nine studies found that MG patients who participated in structured exercise programs experienced improvement in muscle strength, balance, and mobility. 

Another study involving 159 patients with generalized myasthenia gravis disease reported improvements in muscle strength, functional capacity, and quality of life.  

Various other studies have supported the beneficial effects of exercise in people with myasthenia gravis. However, large-scale studies are still needed to strengthen these findings. 

Types of Exercises That Are Good for Myasthenia Gravis

Currently, there are no established guidelines for exercise intensity, duration, or loads for individuals with MG. But regular low-impact exercises can actually reduce fatigue in patients with MG. 

Below is the list of exercises that are generally safe and may help you stay active and healthy.

Aerobic (Endurance) Exercise

Aerobic exercise, such as walking, gentle jogging, or light treadmill use, can help improve endurance, reduce fatigue, and support a better quality of life in patients with MG. 

For instance, a randomized controlled trial of 40 patients with mild-to-moderate myasthenia gravis showed that regular 30-minute walks, in addition to standard MG treatment, significantly improved their quality of life. 

Resistance (Strength) Training

Light resistance exercises, such as sit-to-stand or wall push-ups, can help maintain muscle tone and improve daily functional tasks like climbing stairs or lifting objects. For example, one small study of 11 patients with mild MG found that 8 weeks of resistance training led to a 10% increase in knee strength. 

Respiratory (Breathing) Exercises

Group of women practicing tai chi in a park

Since myasthenia gravis also affects breathing muscles, it is important to focus on respiratory exercises to improve pulmonary function and inspiratory muscle strength. 

Balance and Coordination Training

Individuals with MG can experience balance and coordination problems, which often increase the risk of falls. To avoid this, you can focus on standing-balance exercises or on Tai Chi to improve balance and coordination.  

Get Financial Assistance

Schedule a Consultation

Flexibility and Stretching Exercises

Stretching exercises, such as gentle full-body stretching, yoga-based stretching, or range-of-motion exercises, can help maintain joint mobility and reduce stiffness, making daily movements easier. 

Always consult a physical therapist before starting any exercise, as they can help you in planning a physical activity routine based on your functional capacity and MG state. 

Key Benefits of Exercise for People with Myasthenia Gravis

Current research indicates that consistent physical activity can offer several important benefits for people with mild-to-moderate MG. For instance, it can:

  • Improve muscle strength and endurance needed for daily activities.
  • Give you better balance and mobility.
  • Improve breathing patterns and respiratory muscle strength.
  • Improve mental health, which may, in turn, reduce depression-associated fatigue.
  • Help prevent weight gain and muscle wasting from standard MG treatments such as immunosuppressive medications. 
  • Enhance independence and quality of life. 
  • Promote faster recovery in people who undergo surgery to remove the thymus gland, called thymectomy.
  • Reduce the risk of secondary chronic conditions such as muscle deconditioning, osteoporosis, and heart disease. 

Practical Tips for Staying Active and Healthy With Myasthenia Gravis

Here are some practical tips for exercising safely while living with myasthenia gravis: 

1. Start Slow and Build Gradually

If you’re new to exercise, start with light activities like 5–10 minutes of short walks, either outside or on a treadmill, and gradually increase the duration and intensity.

2. Find a Friend

If possible, you can plan an exercise session with your friend, as they can help you in emergencies, such as a myasthenic crisis that requires immediate medical attention.

3. Listen to Your Body

The symptoms of MG can fluctuate daily. Pay close attention to your body signals.  Do not work out beyond your body’s limits. If you feel increased weakness, dizziness, or excessive fatigue, you should stop activity immediately. 

4. Plan Rest Breaks

Always take short breaks between workouts to prevent overexertion. You can talk with your physical therapist or exercise physiologist to learn how often you should take breaks during physical activity. 

5. Exercise at the Right Time of Day

Choose the right time of exercise when your energy levels are high. You can exercise in the morning, as most MG people feel strongest at that time. 

Also, always exercise in a cool environment and stay hydrated during the activity. 

6. Stay Consistent

Always do regular, gentle activity, as it is more beneficial than occasional intense workouts.

7. Work With Professionals

A doctor or physical therapist can help you develop an individualized plan that you can follow to perform new activities safely. 

Talk With a Copay Assistance Specialist

(877) 778-0318

Key Takeaway

In the beginning, you may find exercise a bit challenging due to weakness, fatigue, or other symptoms. But as you stay consistent, you’ll start to see improvements in your overall physical and mental well-being. 

It’s important to always follow the exercise plan designed by your doctor, physical therapist, or exercise physiologist to stay safe and active.

Lumakras for Cancer: Uses, How It Works, Benefits, and Risks

Published on by Dr. Saba Rassouli, PharmD

Lumakras (loo-ma-krass) is an oral targeted cancer medicine used to treat certain types of non-small cell lung cancer and colorectal cancer in adults. It is prescribed for patients whose tumors carry a specific genetic change, the KRAS G12C mutation. 

Get Financial Assistance

(877) 778-0318

Lumakras was the first medicine developed to directly target the KRAS G12C mutation (a cancer-promoting gene) that was once considered “untreatable” due to its complex structure. This cancer drug made a remarkable breakthrough in cancer care, especially for cancer patients with the KRAS G12 mutation who previously had limited therapeutic options. 

The generic name for Lumakras is sotorasib, and it is available as an oral tablet as prescribed by your doctor. Read on to learn its uses, how it works, dosage, possible side effects, and safety measures.  

Lumakras (Sotorasib): Uses

The US Food and Drug Administration approved Lumakras in May 2021 to treat:

  • Non-small cell lung cancer (NSCLC)
  • Colorectal cancer (CRC)

Lumakras is only prescribed to adults under the following cases:

  • When cancer has spread to other parts of the body or cannot be removed by surgery
  • When a tumor has an abnormal KRAS G12C gene 
  • When a patient has already tried other treatments (e.g., chemotherapy)

Before prescribing Lumakras, your healthcare provider will perform a biomarker test to ensure this drug is right for you.

Lumakras: Working Mechanism

Lumakras (sotorasib) specifically targets the cancer mutation (KRAS G12C) that drives tumor growth. Normally, the KRAS protein in your body acts like a molecular switch that tells cells when to grow and when to stop. 

However, when a mutation occurs in the KRAS protein, it gets stuck in an “ON” state, leading to continuous, uncontrolled cell growth and tumor formation (most commonly in NSCLC). 

Sotorasib, the active component in Lumakras, attaches to the KRAS G12C mutation and locks it in an inactive state, so it can’t send a signal to cancer cells to multiply, thus preventing the growth of tumor cells. 

Unlike traditional chemotherapy that kills both healthy and cancer cells, Lumakras works in a more selective way and only kills cancer cells with the KRAS G12C mutation. 

Lumakras: Drug Forms

Lumakras is available as an oral tablet in the following strengths: 

  • 320 mg
  • 240 mg
  • 120 mg 

Talk With a Copay Assistance Specialist

Schedule a Consultation

FDA Recommended Dosage

The FDA-approved dosage for patients with non-small cell lung cancer and metastatic colorectal cancer is 960 mg once a day. 

Depending on the Lumakras tablet strength you have, you may take:

  • Three 320 mg tablets
  • Four 240 mg tablets
  • Eight 120 mg tablets. 

Your doctor will tell you exactly how many tablets to take each day to reach the total dose of 960 mg.

How It Is Taken

Lumakras tablet is taken orally, with or without food. You should swallow the tablets whole. Do not chew, crush, or split tablets.

If you have colorectal cancer, you’ll also receive a recommended dose of panitumumab intravenously (through a vein) after taking your first dose of Lumakras. 

If You Cannot Swallow Lumakras Tablets

If swallowing tablets is difficult, you can take Lumakras by mixing it with water:

  • Put your dose in 120 ml (4 oz) of room-temperature, non-carbonated water (don’t crush or use other liquids). 
  • Stir for about 3 minutes until the tablets break into small pieces (they won’t fully dissolve).
  • Drink the mixture right away or within 2 hours.
  • Do not chew any pieces.
  • Rinse the glass with another 120 ml of water and drink it to get the full dose.
  • If you missed a dose by more than 6 hours or vomit after taking a dose, do not take an extra dose; just continue with your next scheduled dose. 

Possible Side Effects

Woman experiencing fatigue as a side effect of taking Lumakras

Lumakras can cause mild and serious side effects in patients with NSCLC and metastatic colorectal cancer. 

Common Side Effects

The most common side effects of Lumakras when used alone for NSCLC are:

  • Diarrhea
  • Musculoskeletal pain (pain in the muscle and bone)
  • Nausea
  • Tiredness
  • Cough

The most common side effects of Lumakras when used in combination with panitumumab for CRC include:

  • Rash
  • Dry skin
  • Diarrhea
  • Stomatitis (mouth sores)
  • Fatigue
  • Muscle or bone pain 

Serious Side Effects

Serious side effects can rarely occur, which include:

  • Liver problems (common signs include jaundice, bleeding or bruising, lack of appetite, weakness, dark urine, pain or aching in your stomach)
  • Lung or breathing problems (common signs include new or worsening shortness of breath, cough, or fever). This could happen due to the inflammation in the lungs, which sometimes leads to death if not treated immediately.

Speak to a Specialist

About Copay Assistance
(877) 778-0318

Lumakras: Interaction with Other Drugs

You should not take stomach acid–reducing medicines such as Proton Pump Inhibitor (PPI) or H2 blockers at the same time as your scheduled Lumakras dose. This is because antacid medicines can affect how Lumakras works, and vice versa. 

If you cannot avoid taking antacid medicines, then administer Lumakras either 4 hours before or 10 hours after the antacid. 

Lumakras: Safety Measures

Before taking Lumakras, tell your healthcare provider if you:

  • Have liver problems
  • Have lung or breathing problems other than lung cancer
  • Are allergic to sotorasib or any of the other ingredients of this medicine
  • Are pregnant or plan to become pregnant. It is not known if Lumakras is safe for your unborn baby. 
  • Are breastfeeding or plan to breastfeed. It is not safe to breastfeed while taking Lumakras. You may start breastfeeding 1 week after your last dose. 
  • Are taking any prescription or non-prescription medicines, vitamins, and herbal supplements. Lumakras may affect the way other medicines work, and other medicines may affect how Lumakras works. 

Estimated Cost

Lumakras is currently available as a brand-name drug only, and no generic version is available yet. It can be quite expensive without insurance. Below are the estimated costs for different tablet strengths: 

  • 120 mg tablets: $22,315.10 for 240 tablets
  • 240 mg tablets: $22,315.10 for 120 tablets
  • 320 mg tablets: $22,315.10 for 90 tablets

The cost of Lumakras can vary depending on the pharmacy, location, and insurance coverage. You may not pay the full price because insurance coverage, copay assistance, or pharmacy discount cards can help reduce the cost. Contact us if you are interested in exploring financial assistance opportunities or copay assistance for Lumakras.

Hemophilia Symptoms in Children: A Guide for Parents

Published on by Dr. Mark Alfonso, PharmD, BCMTMS

Early recognition of hemophilia symptoms in children and prompt treatment are essential to prevent lifelong disabilities. Symptoms can range from minor cuts to potentially life-threatening internal bleeding. 

Get Financial Assistance

(877) 778-0318

What Is Hemophilia?

Hemophilia is a bleeding disorder that prevents blood from clotting as usual. Children born with this condition have little or no clotting factor in their blood. A clotting factor (coagulation factor) is a protein in the blood that helps blood clot. Consequently, children are more likely to have severe bleeding and other complications. 

The two main types are:

  • Hemophilia A: Children either lack or have too little clotting factor VIII. 
  • Hemophilia B: Children either lack or have too little clotting factor IX. 

Depending on the clotting factor levels, hemophilia may be [1]:

  • Mild: 5% to 40% of clotting factor levels
  • Moderate: 1% to 4% of clotting factor levels
  • Severe: Less than 1% of clotting factor levels

Though incurable, hemophilia is treatable. With appropriate treatments, children with hemophilia can lead healthy lives. 

Recognizing Hemophilia Symptoms in Children

Hemophilia symptoms in children can vary depending on the severity of the condition. 

Many parents first notice hemophilia symptoms soon after their baby starts crawling or walking. Symptoms at this stage can include large bruises, swollen and warm joints, and avoiding using the affected arm or leg. Likewise, some parents may notice prolonged bleeding during vaccination, circumcision, or routine dental care. 

In mild cases, obvious symptoms may not appear unless severe bleeding occurs following surgery or injury. 

Hemophilia can cause external and internal bleeding. The signs of external bleeding can include:

  • Bleeding in the child’s mouth from a cut, bite, or loss of a baby tooth
  • Bleeding from a cut that stops for a short period, then continues
  • Unusual bleeding from a minor cut
  • Nosebleeds without any obvious cause
  • Heavy periods in girls 

Internal bleeding means bleeding in the organs and muscles. When bleeding occurs in the bladder or kidneys, it can cause blood in urine (may be red or brown). Likewise, bleeding in the digestive tract can cause black, tarry stool or stool mixed with bright red blood. Large bruises may indicate bleeding into large muscles. 

Bleeding Into a Joint

Joint bleeding (hemarthrosis) is common in children with hemophilia. The most commonly affected joints are knees, ankles, and elbows. Joint bleeding may occur without a major injury. If a child with joint bleeding does not get immediate treatment, the affected joint may be permanently damaged. 

A baby with joint bleeding may be cranky for no obvious reason. Older children may describe having an “aura” or tingling in the joint before the external signs. Other signs and symptoms can include:

  • Stiff, painful, swollen, and warm joints
  • Inability to move or straighten an arm or leg

Talk With a Copay Assistance Specialist

Schedule a Consultation

Bleeding in the Brain

Bleeding in the brain is the most serious complication of hemophilia. It is more common in children younger than two years. Notably, it is the major cause of death and disability in children with hemophilia. 

The signs of bleeding in the brain include:

  • Seizures
  • Constant vomiting
  • Double vision
  • Neck pain or stiffness
  • Long-lasting headaches
  • Sleepiness 
  • Behavior changes
  • Sudden weakness of arms or legs 
  • Problems with balance and coordination

If your child shows any of these signs, particularly after a bump on the head, seek emergency medical care. 

Hemophilia Symptoms in Children: When To Call a Healthcare Provider

Seek immediate medical care if your child:

  • Has a major injury 
  • Passes out
  • Vomits after a bump on the head
  • Has seizures

Does Hemophilia Affect the Vaccine Schedule in Children With Hemophilia?

Children with hemophilia should receive all necessary vaccines according to the schedule, regardless of the severity of hemophilia. Your child’s doctor may administer a vaccine by injecting it under the skin (subcutaneous) instead of injecting it into the muscle tissue (intramuscular).

How To Deal With Ulcerative Colitis Flare-Ups

Published on by Dr. Christine Leduc, PharmD

Together with medications, diet and lifestyle changes may help reduce the severity of ulcerative colitis symptoms during flare-ups.  

Get Copay Assistance Now

(877) 778-0318

Ulcerative colitis (UC) is a long-term condition. It causes inflammation and ulcers (sores) on the inner lining of the large intestine. While the exact cause is unclear, health experts believe a combination of genes, an abnormal immune response, and gut microbiome may play a role. 

UC symptoms typically worsen over time. However, in some people, the symptoms may improve or disappear temporarily. This period, when you experience minimal or no symptoms, is known as remission. 

What Are Ulcerative Colitis Flare-Ups?

An ulcerative colitis flare-up is a period when the symptoms reappear or worsen after remission. Flare-ups can cause mild or severe symptoms, which may last for hours, a few days, or months. Likewise, the gap between flares might be weeks or years. 

What Causes Ulcerative Colitis Flare-Ups?

Researchers have yet to find the exact cause of ulcerative colitis flare-ups. What they know is that diet and stress may trigger flare-ups.

You may be at a higher risk of developing recurrent UC flare-ups if you have [1]:

  • Bowel incontinence (failure to control bowel movements)
  • A family history of ulcerative colitis

Symptoms of Flare-Ups

Patient leaning over and holding stomach, experiencing abdominal pain

Symptoms vary widely and may include:

  • Diarrhea six or more times a day
  • Blood or mucus in the stool
  • Severe abdominal pain and cramps
  • Urgency to pass stool
  • Fatigue 
  • Fever 
  • Weight loss
  • Anemia (low hemoglobin level or fewer red blood cells in the blood)
  • Shortness of breath 
  • Irregular heartbeat 

Some people may have joint pain, mouth ulcers, and irritated eyes. 

How To Manage Ulcerative Colitis Flare-Ups

Because UC is a lifelong condition, you will need to visit your provider regularly. Regular visits are necessary even when you are in remission. When you first experience a flare-up, inform your provider. They will help you determine the cause and adjust medication if needed. 

To reduce irritation during a flare-up, replace your toilet paper with wipes. You may also take acetaminophen to relieve pain. 

Along with your prescribed medications, use the following tips to help manage symptoms. 

Get Financial Assistance

Schedule a Consultation

Identify the Triggers

Triggers can vary from one person to another. Common triggers include:

  • Pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen, naproxen, aspirin)
  • Antibiotics (they can disrupt microbial balance in your gut)
  • Foods, such as dairy products, high-fiber foods, greasy foods, caffeine, spices, sodas, and alcohol
  • Stopping your UC medications without talking to your provider 
  • Hormonal changes during periods and pregnancy
  • Abnormal electrolyte levels 

Manage Stress

Stress does not cause ulcerative colitis, but it can trigger a flare-up or worsen symptoms. Try meditation, yoga, mindfulness, or exercise to reduce stress. 

Regular exercise may help boost your feeling of well-being and diminish some UC symptoms [2].

Watch What You Eat

Certain foods may trigger flare-ups. Avoid them if you know which foods are the culprit. Eat mindfully whenever possible. Instead of large meals, eat four or five small meals every day. 

According to the Crohn’s & Colitis Foundation, the following foods may help reduce discomfort during a flare-up [3]:

  • Fruits like bananas and raspberries
  • Cooked green vegetables 
  • Healthy fats (fatty fish, walnut butter, flaxseed oil)
  • Cooked or reheated starches (rice, potatoes, sweet potatoes, oatmeal)
  • High-protein foods, such as chicken, tofu, fish, turkey, eggs, yogurt, beans, and chia seeds

Drink plenty of fluids every day to maintain electrolyte balance and prevent dehydration. Apart from water, which is the best for rehydration, you may take broth, smoothies, or oral rehydration solution. 

Keep a food journal to determine potential triggers. 

Further Reading: Ulcerative Colitis Diet Plan: What To Eat & Avoid

Stick to Your Treatment Regimen

Take your medications exactly as prescribed by your healthcare provider. Never discontinue your medication without talking to your provider. Abruptly discontinuing your medication may trigger a flare-up. 

When To Seek Medical Help

Talk to your healthcare provider immediately if you:

  • Notice blood clots in your stool
  • Have heavy and persistent diarrhea
  • Have a high fever
  • Have severe vomiting
  • Have continuous pain

Probiotics for Ulcerative Colitis Flare-Ups: Do They Work?

Probiotics may be effective in preventing flare-ups and reducing symptom severity. However, more studies are needed to confirm these benefits, determine the beneficial bacterial species, and the dosage. 

Moreover, there’s insufficient evidence to recommend probiotics alone as the primary treatment for UC. 

Talk With a Copay Assistance Specialist

(877) 778-0318

Frequently Asked Questions

What are the new prescription treatments for ulcerative colitis?

The new prescription treatments for ulcerative colitis are:

  • Interleukin-23 selective inhibitors (risankizumab-rzaa and mirikizumab-mrkz)
  • Sphingosine 1-phosphate modulators (ozanimod and etrasimod)
  • Janus kinase inhibitors (tofacitinib and upadacitinib)

What are the apps that track ulcerative colitis flare-ups and symptoms?

Examples of apps for tracking and managing UC are: mySymptoms Food Diary, Aila Health, LyfeMD, We Can’t Wait, and Trellus Health. 

How can I control ulcerative colitis?

No cure for ulcerative colitis is available. However, medications and lifestyle changes can help manage symptoms, reduce relapse, and prevent complications. Always take your medications as prescribed and never stop medical treatment without talking to your provider. 

Can coffee trigger ulcerative colitis flare-ups?

Coffee may trigger a flare-up in some people. The exact mechanism is unclear, but health experts think it might involve stimulation of colon contractions. Avoid or try small servings if you think coffee worsens your condition. 

What foods should I avoid during a flare-up?

Foods to avoid during a UC flare-up include:

  • Alcohol
  • Sugary foods and drinks
  • Caffeine
  • Dairy products (milk, cheese, cream)
  • Greasy food
  • Foods that cause gas, such as beans and carbonated beverages
  • Heavily seasoned foods
  • Foods rich in insoluble fiber (raw vegetables, some raw fruits)
  • Red meat
  • Spicy food

How can I prevent UC flare-ups?

The following may help lower your risk of flare-ups:

  • Avoiding triggers
  • Engaging in regular physical activity
  • Managing stress 
  • Seeing your healthcare provider regularly 
  • Sticking to the treatment regimen 
  • Avoiding pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs)

IVIG Mechanism of Action: A Detailed Look

Published on by Dr. Saba Rassouli, PharmD

IVIG works through multiple pathways rather than a single mechanism. These mechanisms include suppression of specialized white blood cells, neutralization of autoantibodies, and regulation of immune responses. 

Get IVIG Copay Assistance

(877) 778-0318

What Is IVIG?

Intravenous immunoglobulin (IVIG) is a blood product administered through an intravenous (IV) infusion. It contains purified antibodies obtained from the pooled plasma of healthy donors. 

When a foreign substance enters your body, your immune system produces protective proteins called antibodies or immunoglobulins (Ig). These antibodies attach to the foreign invader and eliminate it from the body. 

There are five types of antibodies: IgA, IgD, IgE, IgG, and IgM. IVIG products mainly contain IgG antibodies (over 90% of the total). 

Your healthcare provider may prescribe IVIG to boost the immune system, treat autoimmune conditions, and prevent infections in individuals with weakened immune systems. 

IVIG Mechanism of Action

IVIG is not a single-target therapy; its effects vary depending on dose, disease, and patient factors.

For example, IVIG acts as a replacement therapy in individuals with antibody deficiencies. Also, it acts as an immunomodulator and an anti-inflammatory in many autoimmune and inflammatory disorders. 

Moreover, IVIG can be both pro-inflammatory and anti-inflammatory, depending on the dose. 

IVIG Mechanisms of Action in Immunodeficiencies

As a replacement therapy, IVIG primarily acts by replacing the deficient IgG. This helps neutralize pathogens and reduce recurrent infections.

For this purpose, the typical replacement dose is 200 mg/kg to 400 mg/kg body weight, administered every 3 weeks [1].

At low doses, IVIG interacts with the foreign invaders to help activate the first line of immune defense. This part of the immune system (also known as the complement system):

  • Targets the foreign substance, such as bacteria
  • Triggers inflammation to prevent infection
  • Eliminates the foreign substance from the body

So, low-dose IVIG usually promotes inflammation to protect your body from foreign organisms [2].

Get IVIG Prior Authorization

Schedule a Consultation

IVIG Mechanism of Action in Autoimmune and Inflammatory Diseases

IVIG nurse standing next to a pole set up with an IVIG bottle and a pump

IVIG can simultaneously interact with different components of the immune system. Thus, the immunomodulatory actions of IVIG involve multiple mechanisms and vary widely among diseases. 

High doses, usually 2 g/kg/month, are used in autoimmune and inflammatory diseases. Unlike replacement IVIG, high-dose IVIG is more immunosuppressive and anti-inflammatory [3]. 

The immunomodulatory effects of IVIG are thought to occur as a result of the following interactions [4,5,6,7,8]:

Interaction With Specific Blood Cells

Monocytes and macrophages are white blood cells that identify and remove pathogens from the body. They do so by releasing inflammatory substances and engulfing pathogens. In a healthy individual, the lifespan of these cells is tightly regulated to prevent excessive inflammation.  

However, in chronic inflammatory diseases, these cells survive for longer than usual. Consequently, their accumulation further increases inflammation. IVIG binds to these cells and helps reduce inflammation. 

IVIG may help reduce inflammation by suppressing T cell multiplication. T cells are white blood cells that fight off disease-causing microorganisms. 

According to a 2024 study, T cells that migrate from the periphery to the site of tissue injury are involved in the development of many chronic inflammatory disorders, including [9]:

IVIG can enhance or block the activity of natural killer cells (NK cells). NK cells are white blood cells that kill virally infected cells and cancer cells. IVIG blocks NK cell activity in women experiencing recurrent spontaneous abortions, leading to favorable pregnancy outcomes. 

Contrarily, IVIG enhances NK activity in Kawasaki disease and seizure disorders. 

Interaction With Autoantibodies

Autoantibodies are proteins made by the immune system. They attack the body’s healthy tissues instead of foreign substances. In some individuals, they can lead to the development of autoimmune disorders. 

IVIG neutralizes the pathogenic autoantibodies. By doing this, it prevents the immune system from attacking the body’s healthy tissues and organs. IVIG reduces the production of autoantibodies by blocking the expansion of B cells. 

IVIG is used in many autoimmune disorders, such as: 

Speak to a Specialist

About Copay Assistance
(877) 778-0318

Frequently Asked Questions

What is the mechanism of action of IVIG?

IVIG mechanisms of action vary widely depending on the dose, disease being treated, and patient factors. As a replacement therapy, IVIG works by replacing the missing antibodies in individuals with immunodeficiencies. As an immunomodulator, IVIG affects various immune cells and steps involved in immune regulation. 

What are IgM, IgG, IgA, IgD, and IgE?

They are five major types of immunoglobulins (antibodies). The subclasses of IgG and IgA are IgG1, IgG2, IgG3, IgG4, and IgA1 and IgA2, respectively. 

How does IVIG work to increase platelets?

Though the exact mechanism is unclear, IVIG may:

  • Reduce platelet destruction
  • Enhance signals for platelet production

How does IVIG work for Guillain-Barre syndrome?

Researchers have yet to determine the exact mechanism of action. However, they think IVIG can work for Guillain-Barre syndrome (GBS) by decreasing the pathogenic antibodies that attack the nerve cells. 

How does IVIG work in autoimmune disease? 

IVIG can help prevent tissue/organ damage in autoimmune disease by neutralizing the harmful antibodies and reducing the production of antibodies by B cells. 

How does IVIG help with myasthenia gravis?

The exact mechanism is not entirely understood. However, IVIG can help improve myasthenia gravis (MG) symptoms and muscle strength by neutralizing autoantibodies that impair communication between muscles and nerves.

Sevenfact: A New Treatment Option for Hemophilia With Inhibitors

Published on by Dr. Mark Alfonso, PharmD, BCMTMS

Sevenfact is an FDA-approved medication used to treat or control bleeding in patients with hemophilia A or B with inhibitors. In this article, you will learn about its mechanism of action, dosage, side effects, cost, and more.

Get Copay Assistance Now

(877) 778-0318

What Is Sevenfact?

Sevenfact is a brand-name prescription medication. The active ingredient in this product is coagulation factor VIIa (recombinant)-jncw, also called eptacog beta. 

Sevenfact belongs to a class of medications known as hemostatics.

The term “recombinant” means this medication is made in a lab using recombinant DNA technology. The four lowercase letters “jncw” are used to distinguish Sevenfact from other similar products. 

The U.S. FDA approved Sevenfact in April 2020 to treat and control bleeding in individuals 12 years and older with hemophilia A or B with inhibitors. 

This product should not be used to treat individuals with congenital Factor VII deficiency.

What Is Sevenfact Used For?

Sevenfact is used to treat and control bleeding episodes in patients with hemophilia A or B who have developed inhibitors to standard clotting factor treatments.

Inhibitors are antibodies that develop in some patients and block standard clotting factor treatments, making bleeding more difficult to control.

Sevenfact Mechanism of Action

Recombinant coagulation Factor VIIa (rFVIIa) in Sevenfact helps the blood to clot by activating another clotting factor called Factor X. 

Normally, activation of Factor X depends on Factors VIII and IX. Sevenfact bypasses this pathway, allowing clot formation even when these factors are absent. For this reason, it is known as a “bypassing agent.”

Sevenfact Dosing

This medication comes as a white to off-white powder for solution (reconstitution) for intravenous (IV) injection in single-dose vials. 

The following strengths are available in the U.S.:

  • 1 mg of coagulation factor VIIa (recombinant)-jncw
  • 2 mg of coagulation factor VIIa (recombinant)-jncw
  • 5 mg of coagulation factor VIIa (recombinant)-jncw

The liquid to prepare the solution comes in single-dose prefilled glass syringes. Each syringe contains 1.1 ml, 2.2 ml, or 5.2 ml of sterile water for injection. 

The dose and duration of treatment depend on:

  • Location and severity of bleeding
  • Need for urgent bleeding control
  • Frequency of administration
  • Response to bypassing agents during earlier bleeding episodes

Recommended Sevenfact Dosing:

Mild and moderate bleeding: 75 mcg/kg repeated every 3 hours until bleeding stops. Alternatively, a 225 mcg/kg initial dose may be used. If bleeding doesn’t stop within 9 hours, an extra dose of 75 mcg/kg every 3 hours may be given as needed to stop bleeding.

If bleeding doesn’t stop within 24 hours after the first dose, your healthcare provider will likely switch you to an alternative treatment. 

Severe bleeding: 225 mcg/kg initial dose. If needed after 6 hours, give 75 mcg/kg every 2 hours until bleeding stops.

The duration of treatment depends on the site and severity of bleeding. 

Do You Qualify for $0 Copay?

Talk to a Specialist To Find Out
Schedule a Call

Sevenfact Side Effects

Common Side Effects

Patient with fever, a side effect of taking Sevenfact
  • Headache
  • Dizziness
  • Pain, redness, or swelling at the infusion site
  • Fever
  • Joint pain
  • Mild itching 
  • Nausea 
  • Vomiting 

Serious Side Effects

Call your healthcare provider immediately if you experience any of the following signs:

Stroke

  • Sudden numbness or weakness
  • Severe headache
  • Slurred speech
  • Difficulty with vision or balance

Blood clot in the lung

  • Chest pain
  • Sudden cough or breathing difficulty
  • Dizziness
  • Coughing up blood

Blood clot deep in the body

  • Pain, swelling, or warmth in one of your legs

Allergic Reactions

This medication may cause allergic reactions, which can be fatal. Seek emergency medical care if you experience:

  • Hives
  • Breathing difficulty
  • Swelling in the face or throat
  • Chest tightness
  • Fast heartbeat

Warnings and Precautions

This medication can cause severe or life-threatening reactions. Call your healthcare provider immediately if you experience:

  • Hives, itching, or rash
  • Chest pain or tightness
  • Shortness of breath
  • Wheezing
  • Dizziness
  • Low blood pressure
  • Pain, swelling, and warmth in one leg
  • Sudden numbness or weakness (particularly affecting one side of the body)
  • Severe headache
  • Slurred speech
  • Problems with vision or balance

Get Financial Assistance

(877) 778-0318

Before Using Sevenfact

You should not use this medication if you:

  • Have a history of allergic reactions to rabbits or rabbit proteins
  • Are allergic to this product or any product components

Before you receive your first dose of Sevenfact, inform your healthcare provider if you have or have ever had:

  • Coronary artery disease (narrowing of the arteries that supply oxygen to the heart)
  • Heart attack or stroke
  • Severe injury or infection
  • Allergic reactions to mouse, hamster, or cow proteins
  • Liver disease

Also, inform your healthcare provider if you are:

  • Pregnant or planning to get pregnant
  • Breastfeeding or planning to breastfeed

Sevenfact vs. NovoSeven

Sevenfact and NovoSeven are coagulation factors. The differences are listed below:

FeaturesSevenfactNovoSeven
Approved Use Hemophilia A or B with inhibitors in adults and adolescents 12 years and older Adults and children with hemophilia A or B with inhibitors, congenital Factor VII deficiencyAdults with acquired hemophilia 
FDA approval date20201999
Active ingredient eptacog beta eptacog alfa
Available strengths 1 mg, 2 mg, and 5 mg  of coagulation factor VIIa (recombinant)-jncw 1 mg, 2 mg, 5 mg, or 8 mg recombinant coagulation factor VIIa (FVIIa)
Manufacturer HEMA Biologics Novo Nordisk Limited
ContraindicationsKnown allergy to rabbits or rabbit proteinsSevere allergy to this product or any product componentsNone

Sevenfact Cost

Cost can vary depending on your insurance plan, location, and pharmacy. Contact your insurance provider to find out if your plan covers this medication or if you need prior authorization.

The manufacturer of Sevenfact, HEMA Biologics, offers several support services through its “HEMA Biologics Cares” program for eligible patients. These include:

Sevenfact Co-pay Savings Program

Eligible patients may receive up to $12,000 in savings per calendar year through HEMA Biologics Cares. 

Patient Assistance Program (PAP) 

The Patient Assistance Program (PAP) provides this medication at no cost if patients meet specific income requirements. 

Quick Start Program

This program is for new users who are having an insurance coverage-related delay in getting their treatment. 

Bridge Program

This program is for current users who are having a delay in getting their treatment due to changes in their insurance coverage. 

Contact us if you are interested in exploring financial assistance opportunities or copay assistance for Sevenfact. 

IVIG for Long COVID: Early Findings Suggest Potential Relief for Patients

Published on by Dr. Saba Rassouli, PharmD

Use of IVIG for long COVID is experimental, with some small studies showing IVIG may improve some symptoms. Large trials are currently underway. IVIG therapy may be considered in selected cases under specific circumstances.

Speak to a Specialist

About Copay Assistance
(877) 778-0318

What Is Long COVID?

Synonyms: Post COVID-19 Condition, Infection-associated chronic condition, long-haul COVID, post-COVID-19 syndrome, post-acute sequelae of SARS-CoV-2 (PASC)

Long COVID is a chronic (long-term) condition. It occurs when an individual affected by the SARS-CoV-2 infection continues to have or develops new symptoms 3 months after initial infection. These symptoms usually last for at least 2 months. 

According to a 2022 WHO report, long COVID may affect 10% to 20% of individuals infected by the virus that causes COVID-19 [1].

Long COVID Symptoms

Man with headache suffering from symptoms of long COVID

Research shows long COVID may have over 200 symptoms. Common symptoms can include:

  • Excessive tiredness, typically after activity
  • Brain fog (problems with memory)
  • Dizziness
  • Shortness of breath
  • Changes in smell and taste
  • Sleep problems
  • Cough
  • Headache
  • Rapid or irregular heartbeat
  • Digestive issues, such as loose stools or constipation 

Scientists are studying how COVID-19 causes these symptoms. COVID-19 can affect almost every system in the body. 

While the exact mechanism is unclear, long-term illness may result due to:

  • Changes in immune system communication, causing the immune cells to attack the body’s healthy cells and tissues (autoimmunity)
  • Reactivation of viruses that were previously dormant
  • Unfavorable changes in the gut, blood vessels, and certain areas of the brain

IVIG for Long COVID: What Does the Latest Research Say?

Limited evidence suggests IVIG for long COVID may be an option. Below are the findings of the most recent studies. 

2021 

In a 2021 case report, a 12-year-old girl who developed burning pain, limb weakness, slurred speech, and impaired cognition following COVID-19 received IVIG 2 g/kg/month for 5 months. After IVIG therapy, she achieved overall initial improvement [2].

2023

In a 2023 study, researchers from the University of Kentucky administered IVIG to six participants with long COVID. The most common symptoms in the participants were brain fog, fatigue, chest pain, and shortness of breath. 

IVIG treatment was initiated 101 days to 547 days after initial COVID infection. The IVIG dosage used in this study was 0.5 g/kg every 2 weeks for up to one year. At the end of the study, the researchers concluded that IVIG may bring meaningful benefits to patients with long COVID, such as improvements in neurological problems, chest pain, and fatigue [3]. 

Interestingly, nearly half of the participants in this study reported getting back to “almost normal.”

Get Financial Assistance

Schedule a Consultation

2024

According to a 2024 study, IVIG might be a candidate treatment for improving neurological symptoms, fatigue, and disability risk in individuals with long COVID [4]. This study involved 21 participants who received 3 monthly courses of 0.5 g/kg IVIG, along with supportive therapy. 

In the study, the control group (29 participants) received only supportive therapy. 

Ongoing Research: IVIG for Long COVID 

The National Institutes of Health (NIH) is currently conducting a large study to evaluate IVIG for long COVID. Known as Researching COVID to Enhance Recovery (RECOVER), it is one of the world’s largest studies dedicated to understanding, diagnosing, and treating long COVID. 

This trial is evaluating three potential treatments:

  • Gamunex-C (an IVIG preparation)
  • Ivabradine (an oral medicine to lower heart rate)
  • Coordinator-guided, non-pharmaceutical care 

The result of this trial is scheduled to be presented at the American College of Cardiology (ACC) Annual Conference. 

IVIG for Long COVID: What Are the Potential Advantages?

IVIG therapy has been found to be effective in over 100 hematologic, inflammatory, autoimmune, and infectious diseases. Moreover, many studies have established that IVIG can effectively regulate the immune system. 

Also, a growing body of evidence suggests that autoimmunity might be one of the drivers of long COVID [5]. Given the demonstrated benefits of IVIG for autoimmune disorders, there is a potential for IVIG for long COVID as well. 

IVIG for Long COVID: What Are the Limitations?

First and foremost, the efficacy of IVIG for long COVID has not been established in large trials. Available information about potential benefits is largely based on small studies. Besides, other factors like cost, accessibility, and a lack of standard dose/timing all seem to affect the routine use of IVIG for long COVID. 

Current Treatments for Long COVID

Currently, there is no definitive treatment for long COVID. Treatment can vary depending on the bodily systems involved and an individual’s unique signs and symptoms.

Symptomatic treatment aims to relieve specific symptoms in an individual. For example, if they have a fever, a healthcare provider may give them acetaminophen. Likewise, vitamin C may be given to relieve fatigue. 

Supportive treatment can include appropriate counseling and talk therapy, such as cognitive-behavioral therapy (CBT). 

Other options can include rehabilitation for chronic cough, breathing exercises, and self-monitoring. 

Key Takeaways

Because long COVID affects multiple bodily systems and has a wide range of symptoms, health experts agree that IVIG may not work as a standalone therapy. However, IVIG can be a valuable addition to a multidisciplinary treatment approach. 

Do You Qualify for $0 Copay?

Talk to a Specialist To Find Out
(877) 778-0318

IVIG for Long COVID: Frequently Asked Questions

What is the best treatment for long COVID symptoms?

There is no single best treatment for long COVID. Treatment can be symptomatic, supportive, and rehabilitative, depending on the specific situation. Long COVID treatment requires a multidisciplinary and individualized approach. 

Is IVIG used for long COVID?

Studies evaluating IVIG for long COVID are underway. Some small studies show IVIG may improve certain symptoms of long COVID. 

What are the top-rated IVIG brands for long COVID?

So far, studies have used only two IVIG brands for long COVID: Privigen and Gamunex-C. 

Does insurance cover IVIG for long COVID?

Because the use of IVIG for long COVID is still experimental, it is unlikely that your insurance will cover it. 

What medication is used for long COVID fatigue? 

Some emerging therapies, such as low-dose naltrexone, are being explored for managing long COVID fatigue.

Corifact (Factor XIII Concentrate): FDA-Approved Treatment for Congenital Factor XIII Deficiency

Published on by Dr. Saba Rassouli, PharmD

Corifact (also known by its generic name, factor XIII concentrate) is an injectable prescription medicine used to prevent excessive bleeding in people with congenital factor XIII deficiency, which is a rare inherited bleeding disorder. This condition affects around 1 in every 2 to 3 million people, with an incidence in the U.S. of approximately 150 people.

Do You Qualify for $0 Copay?

Talk to a Specialist To Find Out
(877) 778-0318

Corifact belongs to the drug class of coagulation factors and is also classified as a hemostatic agent that helps prevent and control bleeding by supporting proper blood clot formation. 

This drug was approved by the U.S. Food and Drug Administration (FDA) in 2011 and is available in 12 different countries around the world under the brand name Fibrogammin®- P. 

Read on to learn when it is recommended, how it works, its dosage, and important precautionary measures. 

Approved Uses

Corifact is approved only for the treatment of congenital factor XIII deficiency in both adults and pediatric patients. It is prescribed in the following situations:

  • To help prevent unexpected bleeding before it happens, even if there is no injury.
  • To prevent and treat bleeding during or after minor or major surgical procedures.
  • To prevent uncontrolled bleeding after minor injuries.

How Corifact Works 

To better understand how Corifact works, it is important to first understand congenital factor XIII deficiency. 

This extremely rare bleeding disorder occurs when a person is born with too little or no factor XIII protein. The factor XIII protein usually helps blood clots become strong and stable. 

Normally, when you get a cut or injury, your body forms a clot to stop bleeding. Factor XIII protein strengthens the clot so it stays in place while healing occurs. 

However, when you have factor XIII deficiency, blood clots do form, but they are weak and unstable. Without enough Factor XIII, the clot breaks down too quickly, leading to prolonged or unexpected bleeding, even after minor injuries. 

Corifact Working Mechanism

Corifact contains a purified form of human factor XIII protein extracted from pooled human plasma donated by healthy individuals. It works like the body’s natural clotting protein and replaces the missing factor XIII in the bloodstream. Once infused, it:

  • Increases the level of Factor XIII in the blood
  • Strengthens blood clots
  • Helps clots stay in place long enough for proper healing
  • Reduces the risk of spontaneous or uncontrolled bleeding
  • Helps prevent spontaneous bleeding episodes

By maintaining adequate Factor XIII levels, Corifact helps the body form stronger, more stable clots, lowering the risk of serious bleeding episodes.

Drug Form and Strengths

Corifact comes as a white, lyophilized (freeze-dried) powder form that must be mixed with a sterile diluent before use. It is available in two vial strengths:

  • 250 IU, which is mixed with 4 ml of Sterile Water for Injection
  • 1,250 IU, which is mixed with 20 ml of Sterile Water for Injection

Get Copay Assistance Now

Schedule a Consultation

Dosage for Adults and Children

The dose of Corifact is based on body weight, not age. This means adults and children generally receive the same weight-based dosing schedule.

Routine Preventive Treatment (Prophylaxis)

Both adults and children with congenital Factor XIII deficiency receive a dose of 40 IU/kg body weight intravenously, once every 4 weeks (every 28 days). 

The doctor may adjust the dose based on the factor XIII blood levels, bleeding history, or any upcoming surgeries or procedures. 

For Perioperative Management of Surgical Bleeding

If you need surgery or experience a bleeding episode, your healthcare provider may adjust the dose based on your Factor XIII levels, the type of surgery, and your clinical response.

Corifact: Administration 

Corifact is given as an intravenous (IV) infusion, administered directly into a vein. Before infusing, Corifact is dissolved with sterile water provided in the package.

Possible Side Effects

Man experiencing join inflammation, one of the side effects of Corifact

Corifact is generally a well-tolerated drug. But you may experience some common side effects such as:

  • Joint inflammation
  • Joint pain (arthralgia)
  • Mild rash or itching
  • Headache
  • Pain at the injection site
  • Mild fever
  • Elevated thrombin-antithrombin levels
  • Increased blood lactate dehydrogenase

Serious Side Effects (Rare)

Seek immediate medical attention if you experience:

  • Hypersensitivity or allergic reactions (rash, itching, swelling)
  • Acute ischemia

Corifact: Contraindications and Warnings

You should not use Corifact if you have experienced hypersensitivity reactions, including anaphylactic or severe systemic reactions to human plasma-derived products or to any ingredient in Corifact.  

In rare cases, the body may develop antibodies (inhibitors) against Factor XIII, which can reduce how well Corifact works. Your doctor may monitor your blood levels if treatment seems less effective.

Moreover, because Corifact is made from human plasma, there is a very small risk of viral transmission, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

Speak to a Specialist

About Copay Assistance
(877) 778-0318

Precautionary Measures You Should Take

Before using Corifact, it is important to take some safety measures to help ensure the medicine works effectively and safely. Always consult your healthcare provider before taking Corifact if you:

  • Are pregnant or plan to become pregnant, as it is not known whether Corifact can harm your unborn baby.
  • Are breastfeeding or plan to breastfeed, because it is not known if Corifact passes into breast milk.
  • Have experienced allergic reactions to this drug, its ingredients, or components of the container. 
  • Are taking any over-the-counter medications or supplements, or herbal products.
  • Have or have had any liver disease. 
  • Have been told that you have inhibitors (neutralizing antibodies) against factor XIII, as Corifact may not work effectively in this case. 

Corifact: Estimated Cost

The cost of Corifact can vary widely depending on your healthcare coverage and how much medication you need. Because Corifact is a specialized clotting factor product, it is typically very expensive, often costing several thousand dollars per vial depending on dosage and insurance coverage.

Contact us if you are interested in exploring financial assistance or copay assistance for Corifact. 

Natural Treatments for Myasthenia Gravis: Do They Really Work?

Published on by Dr. Samantha Kaeberlein, PharmD

Natural treatments for myasthenia gravis and lifestyle habits may help control symptoms and improve quality of life. These can include acupuncture, speech/swallowing therapy, a balanced diet, and supervised exercise. However, they should not replace standard medical therapy. 

Get Financial Assistance

(877) 778-0318

Myasthenia gravis (MG) is a long-term autoimmune disorder. MG causes weakness of muscles you can control, especially those in the eye, face, throat, neck, and limbs. It occurs when the immune system disrupts the communication between the nerves and muscles. 

Standard treatments for myasthenia gravis include medications, surgery, plasma exchange, and intravenous immunoglobulin (IVIG).

Natural Treatments for Myasthenia Gravis: A Closer Look at the Evidence

Natural treatments may help some people with myasthenia gravis improve their quality of life. Nonetheless, they should not replace conventional MG treatments. 

Acupuncture

Acupuncture is a form of traditional Chinese medicine. During an acupuncture session, a practitioner inserts fine needles through the skin at specific points on the body. According to the practitioners, doing so will help rebalance the flow of “life force” in the body. 

Acupuncture is mainly used to treat:

  • Dental pain 
  • Neck pain
  • Low back pain 
  • Labor pain
  • Menstrual cramps 
  • Joint pain

Acupuncture may help reduce symptom severity and improve quality of life in some MG patients by stimulating local nerves. 

For example, in a 2024 review, researchers found that acupuncture (combined with conventional treatments) may benefit MG patients as a supportive therapy. In this study, acupuncture was associated with improved quality of life and reduced symptom severity [1].

Likewise, participants in a small 2025 trial reported improvements in MG symptoms after twice-weekly acupuncture for 12 weeks. According to the researchers, acupuncture is safe and feasible for MG patients [2].

However, this is an ongoing area of research. Large high-quality studies are necessary to establish acupuncture as an effective MG treatment. 

Speech and Swallowing Therapy

People with MG often have difficulty speaking and swallowing. These issues can occur because MG significantly weakens the muscles in the head, neck, and throat. A 2025 study found that people with MG have a significantly higher risk of speech and swallowing difficulties compared with the general population [3]. 

Common speech problems include vocal fatigue, monotonous or hypernasal voice, and periods of voice loss. 

Speech therapy can help people with MG improve their speech clarity. Moreover, they can learn compensatory strategies to increase understandability, such as [4]:

  • Using short phrases
  • Taking regular breaks to avoid vocal fatigue
  • Developing alternative modes of communication 
  • Using gestures or facial expressions for effective communication 
  • Avoiding speaking in loud environments 

Common swallowing problems include coughing or choking during or after eating, slow eating, and shortness of breath when eating or drinking. 

Swallowing therapy is an evidence-based approach. This rehabilitation program may help reduce the risk of choking, aid efficient eating, and strengthen swallowing-related muscles.

Speak to a Specialist

About Copay Assistance
Schedule a Consultation

Respiratory Muscle Training 

Sometimes, MG can weaken muscles involved in breathing, such as the diaphragm and the intercostal muscles. If this happens, a person may experience shortness of breath. 

Respiratory muscle training (RMT) can help increase respiratory muscle endurance, improve functional outcomes, and reduce fatigue in MG patients [5,6].

A respiratory therapist may recommend breathing exercises, such as:

  • Belly breathing 
  • Inspiratory muscle training
  • Pursed-lip breathing 

Lifestyle Measures for Myasthenia Gravis

Find Ways To Save Your Energy

Fatigue is a common, often debilitating feature of myasthenia gravis. To conserve your energy, try the following:

  • Schedule important or physically demanding tasks appropriately. 
  • Sit more often than you stand.
  • Rest when you need to. 
  • Ask for help when you need to. 
  • Try to eat when you feel the strongest. 
  • Use tools to save your energy. 

Manage Potential Triggers

Stress, infection, heat, and overexertion may worsen myasthenia gravis symptoms. Take steps to avoid these triggers. These can include:

  • Avoiding extreme heat when possible. 
  • Avoiding exposure to people with signs of an infection. 
  • Saving energy to reduce fatigue. 
  • Consulting a healthcare provider before using a new medicine or getting a vaccine.

Symptoms may also worsen during pregnancy. Inform your provider if you are pregnant or plan to get pregnant. 

Exercise 

A woman walking in the park for exercise

Because exercise can increase fatigue, many people with MG tend to avoid physical activity. However, exercise is still crucial for overall health, mood, balance, and strength. 

If you have mild to moderate MG, consider an appropriate activity to meet the weekly goal of 150 minutes of exercise. Always consult your provider before starting any new activity. Also, make sure you don’t overexert yourself. Low-impact exercises such as swimming, walking, or yoga are effective and less rigorous on the body.

A Healthy Diet 

A healthy diet is the foundation of health. While there’s no MG-specific dietary guideline, the fundamentals of healthy eating still apply. 

We have an entire article dedicated to healthy eating when you have myasthenia gravis. Read more about the Best Diet for Myasthenia Gravis. 

Talk With a Copay Assistance Specialist

(877) 778-0318

Myasthenia Gravis Natural Treatments: Frequently Asked Questions 

Can myasthenia gravis be completely cured?

No. Currently available treatments help manage symptoms and prevent complications, but don’t cure myasthenia gravis. 

Are there natural supplements for myasthenia gravis?

Limited evidence suggests certain Chinese herbal formulas and vitamin supplementation may offer additional benefits. However, there is no evidence that these remedies significantly affect disease progression. Always talk to your healthcare provider before trying supplements. 

What medications can trigger myasthenia gravis?

Certain antibiotics, blood pressure medications, and anti-seizure medications may worsen MG symptoms. 

What foods should I avoid if I have myasthenia gravis?

Foods to avoid with myasthenia gravis include:

  • Difficult-to-swallow foods, such as dry/crunchy/crumbly foods
  • Dry bread products such as bagels, muffins, and sandwiches 
  • Tough meats that are hard to chew and swallow
  • Ultraprocessed foods, which are high in added salt or sugar
  • Foods high in caffeine, such as coffee and soda
  • Hot, spicy foods

Does vitamin B12 benefit people with myasthenia gravis?

There is no evidence to suggest that vitamin B12 affects MG disease activity or that vitamin B12 supplementation can improve symptoms.