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Omalizumab
Specialty Drug

Xolair

OMALIZUMAB is used to help treat allergic asthma and other allergies. It may be given with other treatments for these conditions. Compare anti-IgEs.
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What is Omalizumab?

Commonly Used Brand Name(s)Xolair

Therapeutic ClassificationsAntiasthma

Pharmacologic ClassificationsMonoclonal Antibody

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Blackbox WarningTOP

Subcutaneous route (Powder for Solution)

Anaphylaxis, presenting as bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue, has been reported with omalizumab administration. Anaphylaxis may occur at any time from the first dose to more than a year after omalizumab initiation. Closely monitor patients after omalizumab administration and prepare to manage any anaphylactic reactions .

OverviewTOP

Omalizumab injection is used to treat moderate to severe persistent allergic asthma. It is used when a patient's asthma has not been controlled sufficiently on other asthma medicines. This medicine will not relieve an asthma attack that has already started.

Omalizumab injection is also used to treat chronic idiopathic urticaria (CIU) in patients who continue to have hives that are not controlled by an antihistamine.

Omalizumab is a medicine called an IgE blocker. IgE is short for immunoglobulin E. IgE is a substance that occurs naturally in the body in small amounts. This substance plays an important role in allergic asthma. When people with allergic asthma breathe in a year-round allergen, such as cat or dog dander, their bodies make more IgE. This may cause a series of reactions in your body that can lead to asthma attacks and symptoms. Omalizumab works by helping to block IgE.

This medicine is to be given only by or under the direct supervision of your doctor.

Proper UseTOP

A nurse or other trained health professional will give you or your child this medicine. Omalizumab is given as a shot under your skin.

If you are receiving this medicine for asthma, you will receive omalizumab once every 2 or 4 weeks. Your dose will be determined by your IgE level, which your doctor will measure with a simple blood test before treatment begins, and your body weight. Based on your dose, your doctor will also tell you if you will need 1, 2, or 3 injections per dose. If you need more than 1 injection, each will be given in a different place on your body.

Omalizumab is not a rescue medication and should not be used to treat sudden asthma attacks. It is not a substitute for the medicines you are already taking. Never suddenly stop taking, or change the dose of your inhaled steroids or any other asthma medicine you are taking unless your doctor tells you to do so.

If you are receiving this medicine for chronic idiopathic urticaria, you will receive this medicine every 4 weeks.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Before UsingTOP

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

AllergiesTOP

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

PediatricTOP

Use of omalizumab injection to treat asthma in children younger than 6 years of age and CIU in children younger than 12 years of age is not recommended. Safety and efficacy have not been established.

GeriatricTOP

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of omalizumab injection in the elderly.

PregnancyTOP

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast FeedingTOP

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug InteractionsTOP

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other InteractionsTOP

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical ProblemsTOP

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma attack or
  • Bronchospasm (breathing problem), acute or
  • Other allergic conditions (besides asthma)—Should not be used for patients with these conditions.
  • Cancer, or history of or
  • Parasite infection—Use with caution. May make these conditions worse.

PrecautionsTOP

It is very important that your doctor check your or your child's progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood and other exams may be needed to check for unwanted effects.

If you stop receiving omalizumab injections, your symptoms can be expected to return.

You may not see immediate improvement in your asthma after omalizumab treatment begins. It takes time for the medicine to work. It is important to continue your omalizumab injections until your doctor tells you otherwise.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you or your child have a rash, cough, chest tightness, trouble breathing, lightheadedness, dizziness, fainting, rapid or weak heartbeat, anxiety, flushing, itching, hives, feeling warm, swelling of the throat or tongue, throat tightness, hoarseness, or trouble swallowing after receiving this medicine.

A rare but serious condition called eosinophilia (increased white blood cells in the body) may occur while you are receiving this medicine. A condition called vasculitis (inflammation of the blood vessels) may also be present. Eosinophilia can be serious and requires immediate medical attention. Tell your doctor right away if you or your child have worsening lung symptoms, rash or bruising of the skin, fever, chest pain, or burning, tingling, or numbness in the hands and feet after receiving this medicine.

Your doctor will ask you or your child to remain at the healthcare facility or clinic for at least 2 hours after each injection to watch for immediate side effects that can be serious.

Some patients who are receiving this medicine may have fever, rash, or muscle or joint pain. Tell your doctor right away if you or your child have any of these symptoms.

Using this medicine may increase your risk of getting certain cancers or infections. Talk to your doctor if you or your child have concerns about this risk.

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