How to Inject Nucala: 6 Tips for Getting the Most From This Biologic

If you’re living with a health condition such as severe asthma, your care team may prescribe Nucala (mepolizumab). It’s an injectable biologic medication, meaning that it comes from living sources. Nucala comes in an autoinjector or a prefilled syringe, each of which you can use to give yourself the medicine at home.

Your first Nucala dose is given by a healthcare professional in a medical setting. After that, you may have the option to administer Nucala at home. Your healthcare team will show you how to give yourself or a loved one the injections correctly. But if you need a refresher, we cover how to inject Nucala — plus five other tips to get the most from treatment.

1. Nucala can be injected into one of three different body areas

You can inject Nucala subcutaneously (under the skin) into your abdomen or thigh. For your abdomen, inject your dose at least 2 inches away from your belly button. You can inject Nucala anywhere into your thigh. If someone else is giving you the injection, they can also inject it into your upper arm.

Avoid injecting Nucala into areas where your skin is tender, scarred, or bruised. And if you need to give yourself more than one injection, place them at least 2 inches apart.

2. How to inject Nucala

With both the autoinjector and the prefilled syringes, you’ll first prepare your dose by following these general steps:

• Gather all necessary supplies: alcohol wipes, a cotton ball or gauze, and a sharps disposal container. You may also want a bandage.

• Check the security seals on the Nucala carton to make sure they aren’t broken, then remove the tray from the carton and peel off the plastic cover.

• Check the expiration date to be sure the medication is still OK to use.

• Do not use the medication if it has been left out of its carton for more than 8 hours. Check that the medication is not cloudy or discolored.

• Leave the medication out at room temperature for 30 minutes before you inject it. This can help lessen discomfort from your injection.

Below are general steps for injection. Keep in mind that your healthcare team may provide different instructions for you. Always follow their instructions, and ask them for guidance if you’re unsure.

Autoinjector

To use the Nucala autoinjector, follow these steps:

• Wash your hands with soap and water.

• Choose your injection site, and clean the area with an alcohol wipe. Allow the skin to air dry completely.

• Remove the clear needle cap. You should inject your dose within 5 minutes of removing the needle cap.

• Place the yellow needle guard flat on your skin. Push the autoinjector all the way down until you hear a click.

• Hold the autoinjector down until you hear a second click. This could take up to 15 seconds.

• Continue to hold the autoinjector down for 5 more seconds after hearing the second click.

After administering the medication, remove the autoinjector from the skin and apply gentle pressure with a cotton ball or gauze. Do not rub the area, as this might cause irritation. 

Dispose of the autoinjector in your sharps container. Don’t attempt to reuse it.

Prefilled syringe

To use the Nucala prefilled syringe, follow these steps:

• Wash your hands with soap and water.

• Choose your injection site, and clean the area with an alcohol wipe. Allow the skin to air dry completely.

• Remove the gray needle cap. Inject your dose within 5 minutes of removing the cap.

• Hold the syringe like a pencil. Using your other hand, pinch the skin around the injection site. Insert the needle into the pinched skin at a 45-degree angle.

• Using your thumb, slowly push the white plunger all the way down to inject the dose.

• Slowly remove your thumb from the white plunger. This will cause the needle to retract back into the syringe.

After the medication has been administered, apply gentle pressure to the injection site with a cotton ball or gauze. Do not rub the area, as this might cause irritation. 

Dispose of the syringe in your sharps container. Don’t attempt to reuse it. 

3. You can change your Nucala injection site as long as you haven’t started the injection

If you haven’t started injecting your Nucala dose yet, it’s OK to switch injection sites. For example, you may decide to inject into a different area on your abdomen or thigh. Or if someone else injects your dose, they can give it to you in your upper arm. But once you’ve started your injection, do not try to change injection sites.

4. Nucala must be injected within 8 hours of removing it from the carton

Nucala is sensitive to light, which is why it’s stored in a carton. It lasts longest when stored in the refrigerator. You can also store it at room temperature for up to 7 days. But once it’s removed from the carton, it should be injected within 8 hours. 

If you took Nucala out of its carton to prepare your dose but didn’t inject it within 8 hours, you should throw it away. This is also the case if you kept an unopened Nucala carton at room temperature for more than 7 days.

5. Don’t inject Nucala if it looks cloudy, or if it was dropped or damaged

Before injecting Nucala, inspect the medication closely. The liquid should be clear to pale yellow or pale brown. It should not be cloudy or have any noticeable particles (tiny pieces) in it. If it looks discolored or cloudy, do not use the medication.

If you get Nucala from a mail-order pharmacy, it’s especially important to inspect it first. That’s because it may have been exposed to extreme temperatures in the mail. Contact your mail-order pharmacy if you have concerns about how your medication arrived.

Lastly, you shouldn’t inject Nucala if you dropped the syringe or autoinjector or if they look damaged. A damaged syringe or autoinjector can affect the dose you receive. If the medication doesn’t look right or the device looks damaged, contact your healthcare team. In some cases, the manufacturer may be able to provide a replacement dose.

6. Only use a Nucala autoinjector or syringe once, and throw it away after your dose

Each Nucala autoinjector and prefilled syringe is designed for one-time use only. Trying to reuse a syringe or autoinjector can increase your risk for infection. You also will not get a full dose of the medication.

After injecting Nucala, dispose of the syringe or autoinjector in an FDA-cleared sharps disposal container. If you don't have one, use a heavy-duty plastic container with a screw-on lid, such as a laundry detergent bottle. Once the container is full, follow your community guidelines for sharps disposal. In most cases, you will take the container to a designated drop-off site.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Stacey McCoy, PharmD, MS, BCPS

Stacey McCoy is a clinical pharmacy specialist with over 20 years of experience in various practice areas, including nearly 13 years as an emergency medicine specialist.

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