XOLAIR (Omalizumab)

What is this medication?

XOLAIR (Omalizumab)
Monoclonal Antibody; Anti-Asthmatic

XOLAIR (Omalizumab) is indicated for treatment of asthma; chronic idiopathic urticaria.

ALERT: WARNING
Anaphylaxis, presenting as bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue, has been reported to occur after administration of omalizumab. Anaphylaxis has occurred as early as after the first dose of omalizumab but also has occurred beyond 1 year after beginning regularly administered treatment. Because of the risk of anaphylaxis, observe patients closely for an appropriate period of time after omalizumab administration. Healthcare providers administering omalizumab should be prepared to manage anaphylaxis that can be life-threatening. Inform patients of the signs and symptoms of anaphylaxis and instruct them to seek immediate medical care if symptoms occur.

How does this medication work? 

XOLAIR (Omalizumab) is a recombinant DNA IgG monoclonal antibody which blocks the high-affinity IgE receptor on mast cells and basophils. Decreasing bound IgE, the activation and release of allergic response mediators is reduced. Serum free IgE levels and the number of high-affinity IgE receptors are decreased. Long-term treatment in patients with allergic asthma showed a decrease in asthma exacerbations and corticosteroid usage. The mechanism by which these effects of omalizumab result in an improvement of chronic idiopathic urticaria symptoms is unknown.

How should I take this medication? 

Asthma
Oral: Take 75mg to 375 mg SQ every 2 or 4 weeks. Determine dose (mg) and dosing frequency by serum total IgE level (IU/mL), measured before the start of treatment, and body weight (kg). 

Nasal Polyps
Oral: Take 75mg to 600 mg SQ every 2 or 4 weeks. Determine dose (mg) and dosing frequency by serum total IgE level (IU/mL). 

Chronic Spontaneous Urticaria
Oral: Take 150mg or 300 mg SQ every 4 weeks. Dosing in CSU is not dependent on serum IgE level or bodyweight. 

Dose and frequency based on body weight and pre-treatment total IgE serum levels. 

How to Take: Administer via subcutaneous injection. No more than 150mg should be injected in one injection site. Doses over 150mg should be divided into multiple injections of no more than 150mg per injection.  Each injection site should be separated by ≥1 inch. Injections may take 5 to 10 seconds to administer (solution is slightly viscous). Administer only under direct medical supervision and observe patient for 2 hours after the first 3 injections and 30 minutes after subsequent injections or in accordance with individual institution policies and procedures.  

Do not inject into moles, scars, bruises, tender areas, or broken skin. 

What should I watch for while using this medication? 

Before starting XOLAIR (Omalizumab) make sure your physician is aware of any allergies or medications you currently take, if you are high risk for parasitic helminth infections, are pregnant, or breastfeeding. Omalizumab use has been associated with rare but serious adverse events such as cerebrovascular effects, eosinophilia, vasculitis, fever, arthralgia, rash, hypersensitivity reactions, and malignant neoplasms.

What if I miss a dose?

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule.

How should I store this medication?

Store under refrigeration at 2°C to 8°C (36°F to 46°F) in the original carton and protect from direct sunlight. Do not freeze.

What are the possible side effects of using this medication?

Headache, injection site reaction, pain, arthralgia, nasopharyngitis, sinusitis.

Note this is not a complete list of side effects for XOLAIR (Omalizumab), only common ones.