Xolair

Indications

Omalizumab is a biological medicine used for:

• Moderate to severe allergic asthma that is not well controlled by inhaled steroids and other inhalers, in adults and children who have a proven allergy to an airborne allergen such as house dust mite.
• Chronic spontaneous urticaria (long lasting hives without a known cause) that does not improve with antihistamines.
• Severe chronic sinus inflammation with nasal polyps, together with steroid nasal sprays, in adults.

It is an add on treatment and does not replace your regular inhalers or reliever.

How It Works

Omalizumab is a monoclonal antibody, a laboratory made protein that targets one specific substance. It binds to immunoglobulin E (IgE), the antibody that triggers allergic reactions. By lowering the amount of free IgE, it makes allergy cells less reactive, which over weeks reduces asthma attacks, hives and nasal polyp symptoms.

Dosage and Administration

Omalizumab is given as an injection under the skin by a doctor or nurse, usually every 2 or 4 weeks. For asthma, the dose is worked out by the doctor from your body weight and a blood test of your IgE level. For hives and nasal polyps, a fixed dose is used as prescribed. Early doses are given in a clinic where you can be watched for allergic reactions. Some patients may later be trained to inject at home if the doctor agrees. It may take 12 to 16 weeks to see the full benefit.

Interactions

No major interactions with other medicines are known. It is used together with inhalers, steroids and antihistamines. Tell your doctor about all medicines and any planned vaccines. Do not reduce or stop steroid tablets or inhalers on your own after starting Omalizumab.

Contraindications

Do not use if you have had a serious allergic reaction to Omalizumab or any ingredient. It is not used to treat a sudden asthma attack.

Side Effects

Common side effects include pain, swelling, redness or itching at the injection site, headache, sore throat or cold like symptoms, joint pain and tiredness. Less common effects include fever, rash, muscle aches and swollen glands (a reaction that can appear 1 to 5 days after an injection). In people at risk, worm (parasite) infections may become more likely.

Get urgent medical help straight away if you have signs of anaphylaxis (a severe allergic reaction), such as difficulty breathing, wheezing, swelling of the face, lips, tongue or throat, fainting, dizziness or a widespread rash. This can happen after any dose, even long after starting treatment.

Pregnancy and Lactation

Omalizumab passes into the baby during pregnancy. Experience so far has not shown a clear increase in harm, and uncontrolled asthma is itself risky in pregnancy. It is used only if the doctor decides the benefit outweighs the risk. It may pass into breast milk in small amounts; discuss breastfeeding with your doctor.

Precautions and Warnings

• Carry your reliever inhaler and know what to do in an asthma attack.
• Learn the signs of anaphylaxis; your doctor may give you an adrenaline auto injector.
• Tell your doctor if you live in or travel to areas where worm infections are common.
• Tell your doctor if you have an autoimmune disease or a history of cancer.

Overdose

Because it is given by health professionals, overdose is unlikely. No serious effects are known from higher doses. If you think too much was given, contact your doctor, who will watch for side effects.

Therapeutic Class

Monoclonal antibody, anti IgE agent (anti asthmatic and anti allergic biological).

Storage

Store in a refrigerator at 2 to 8°C in the original pack to protect from light. Do not freeze. Keep out of the reach of children.