FDA-filed SPL labeling · retrieved through openFDA

Remestemcel-L-Rknd

Remestemcel-L-rknd (RYONCIL) is a cell-based therapy used to treat steroid-refractory acute graft versus host disease in children 2 months of age and older.

Brand name Ryoncil
Rx
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveSep 11, 2025
AvailabilityRx
Earliest approval/marketing year ⓘ2025
FDA-listed product records ⓘ12
Boxed warningNone found in compared labels
How we combine label and product data →
✓No current FDA shortage listed · checked Sep 25, 2026
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HelloPharmacist Editorial Team Bottom Line
RYONCIL is a specialized cell therapy given by IV infusion in a clinical setting to children whose acute graft versus host disease has not responded to steroids. It works by calming the overactive immune response driving the disease. Because it is made from living human and animal-derived materials, close monitoring for allergic reactions and infection is essential throughout treatment.

📖 Remestemcel-L-Rknd: Patient Information Guide

A plain-language walkthrough of Remestemcel-L-Rknd — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for▾

RYONCIL (remestemcel-L-rknd) is approved for one specific condition in pediatric patients:

  • RYONCIL is indicated for the treatment of steroid-refractory acute graft versus host disease (SR-aGvHD) in pediatric patients 2 months of age and older — meaning acute GvHD that has not adequately responded to steroid treatment.
⚙️How it works▾

RYONCIL contains mesenchymal stromal cells (MSCs) — specialized cells harvested from human bone marrow. In graft versus host disease, donor immune cells (called T cells) mistakenly attack the transplant recipient's organs, causing dangerous inflammation. RYONCIL's MSCs appear to reduce T cell activation and lower the production of pro-inflammatory signals, helping to calm this immune attack. After treatment, clinical studies showed meaningful reductions in key inflammatory markers and activated T cells in the blood, though the full mechanism is still being studied.

💊How it's taken▾

RYONCIL is given by intravenous (IV) infusion only, always administered by a trained healthcare professional in a clinical setting. The standard course is twice a week for 4 consecutive weeks (8 infusions total), with infusions spaced at least 3 days apart. Response is assessed around day 28, and the schedule may continue, be reduced, or be stopped based on how the patient responds. Dosing is calculated based on the child's body weight — follow the care team's instructions exactly.

  • Patients are pre-treated with antihistamines and corticosteroids 30–60 minutes before each infusion
  • Infusion rate is adjusted based on the child's weight
  • The infusion must be completed within 5 hours of preparation
🤒Side effects — in detail▾

In clinical studies, the most commonly reported side effects (occurring in 20% or more of patients) were:

  • Viral infections
  • Bacterial infections
  • Infections from unspecified pathogens
  • Fever (pyrexia)
  • Bleeding (hemorrhage)
  • Swelling (edema)
  • Abdominal pain
  • High blood pressure (hypertension)

Serious adverse reactions occurred in about 65% of patients in the clinical trial, including fever, respiratory failure, a bowel complication called pneumatosis intestinalis, and bloodstream bacterial infection (bacteremia) — reflecting how seriously ill these children are. Report any new or worsening symptoms to the care team immediately.

⚠️Warnings & precautions▾
  • Serious allergic/infusion reactions: Reactions including anaphylaxis can occur during or after infusion, triggered by DMSO or trace animal proteins in the product. Patients are always pre-medicated and monitored. If a severe reaction happens, the infusion is stopped and should not be restarted.
  • Risk of infection transmission: Because RYONCIL is made from human donor cells and animal-derived materials, there is a small risk of transmitting infectious agents (including viruses, bacteria, and fungi), even with rigorous donor screening and testing.
  • Ectopic tissue formation: MSCs have the ability to develop into bone, cartilage, or fat cells. There is a risk that these cells could form tissue in unintended areas of the body after treatment.
🔀What it interacts with▾

The FDA label for RYONCIL does not identify specific drug, food, or supplement interactions.

  • Always tell the care team about all medications, supplements, and treatments your child is receiving, as RYONCIL is given in a complex transplant setting where many other drugs may be in use.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it▾
  • Allergy to DMSO or animal proteins: RYONCIL must NOT be given to patients with a known allergy to dimethyl sulfoxide (DMSO) or to porcine (pig) or bovine (cow) proteins — this is an absolute contraindication.
  • Pregnancy: RYONCIL is not recommended for pregnant women — there are no safety data and it is unknown whether it can harm a developing baby.
  • Breastfeeding: It is not known whether RYONCIL passes into breast milk. Discuss risks and benefits with the care team.
  • Children: RYONCIL is approved and studied specifically in pediatric patients 2 months and older. Safety and effectiveness have not been established in adults in this indication.
📡Pharmacodynamics — effects in the body▾

In a clinical study of 40 pediatric patients with SR-aGvHD, RYONCIL reduced blood levels of two key inflammatory proteins — TNFR1 (tumor necrosis factor receptor type I) and ST2 — by 79% and 75%, respectively, by day 180 compared to the start of treatment. These proteins are elevated during active GvHD and serve as markers of inflammation. The treatment also reduced circulating activated T cells (the immune cells driving GvHD) by 64% by day 180, suggesting a meaningful dampening of the immune response over time.

📦How to store it▾

RYONCIL must remain frozen at ≤ -135°C in liquid nitrogen vapor phase until thawed immediately prior to administration.

📄 Written from Remestemcel-L-Rknd’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Remestemcel-L-Rknd — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is RYONCIL and how is it different from a regular medicine? ▾
RYONCIL isn't a pill or a standard drug — it's actually made of living human cells called mesenchymal stromal cells, collected from bone marrow donors. These cells are infused into your child through an IV and work by calming the overactive immune response causing graft versus host disease. It's a specialized therapy only given in a clinical setting, not something you take at home.
How will my child receive RYONCIL, and how often? ▾
RYONCIL is given as an IV infusion at a hospital or clinic by a trained healthcare team. The standard schedule is twice a week for 4 weeks — that's 8 infusions total, spaced at least 3 days apart. Around day 28, the team checks how your child is responding and may adjust the schedule from there. Before each infusion, your child will be given antihistamines and a steroid to help prevent reactions.
What side effects should I watch for during or after an infusion? ▾
During the infusion, the team watches closely for allergic or infusion reactions — things like fever, trouble breathing, or a drop in blood pressure. These can happen because of ingredients in the product. Over the course of treatment, infections were the most commonly reported problem in clinical studies, along with fever, bleeding, swelling, and abdominal pain. Tell the care team right away if anything new or concerning develops.
Is there any risk of my child catching an infection from this therapy? ▾
There is a small risk, because RYONCIL is made from human donor cells and some animal-derived materials. Donors are carefully screened and tested for a long list of viruses and bacteria, but no screening process can eliminate all risk entirely. The care team is aware of this and will monitor your child throughout treatment. It's one of the reasons this therapy is only given in a supervised clinical setting.
My child is very young — is this treatment safe for infants? ▾
RYONCIL is approved for pediatric patients as young as 2 months of age, and the clinical evidence supporting its use includes children in this age group. The care team will calculate the dose based on your child's body weight and adjust the infusion rate for smaller patients. All infusions are supervised by professionals experienced in managing this condition in children.
What if my child is pregnant or I am breastfeeding — is RYONCIL safe? ▾
RYONCIL is not recommended during pregnancy because there is no safety data available for pregnant women, and it's unknown whether it could affect a developing baby. If you are breastfeeding, there's also no information yet on whether it passes into breast milk. Make sure to discuss your situation openly with the care team so they can weigh the risks and benefits for your specific circumstances.
Is Remestemcel-L-Rknd available over the counter? ▾
Remestemcel-L-Rknd is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Remestemcel-L-Rknd first available? ▾
Remestemcel-L-Rknd has been available in the United States since at least 2025, based on FDA approval history (Drugs@FDA) and product marketing records.

💬 Answers drafted from Remestemcel-L-Rknd’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

📊 Remestemcel-L-Rknd across the U.S. market

How Remestemcel-L-Rknd appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Manufacturers
1
Brand names
12
FDA-listed product records ⓘ
2025
First marketed ⓘ

Also listed with the FDA, not a patient dose form: Kit (12) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

🔍 Compare Remestemcel-L-Rknd products

A representative set of FDA-listed product records for Remestemcel-L-Rknd — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Manufacturer / Labeler Category ⓘ Details
💊Kits
Mesoblast × 12 listings BLA View NDC →

Showing 12 of 12 products — FDA National Drug Code Directory. See every product, package size and price: browse all 12 Remestemcel-L-Rknd NDCs →

🏷️ Sold under these brand names

Ryoncil

🏭 Manufacturers & labelers

Mesoblast 12

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Sep 11, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Remestemcel-L-Rknd.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Remestemcel-L-Rknd after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
NDC products indexed
12
Distinct labelers/manufacturers represented
1
Linked representative label ⓘ
Mesoblast
Linked label effective
Sep 11, 2025
Composite sections available
18
Linked SPL Set ID
a4e0918f-7444-4694-adeb-d38d98345659
Linked SPL Document ID
59dc6f33-2845-4182-81ae-04d34d7f2204
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Mesoblast is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.