medicationsnucalaNucala dosage

Nucala Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Nucala (mepolizumab) is an injectable medication manufactured by GlaxoSmithKline (GSK). It is a monoclonal antibody that is used to help maintain asthma control and reduce exacerbations in patients with severe eosinophilic asthma not controlled by high-dose corticosteroids. Nucala is typically given as an injection under the skin by your healthcare provider or at home by you or a caregiver.

What does Nucala treat?

Nucala is a biologic medication that is indicated for:

  • Add-on maintenance treatment of adult and pediatric patients aged 6 years and older with severe asthma that has an eosinophilic phenotype
  • Add-on maintenance treatment of adult patients with chronic rhinosinusitis with nasal polyps (CRSwNP)
  • Treatment of adult patients with refractory eosinophilic granulomatosis with polyangiitis (EGPA)
  • Treatment of adult and adolescent patients aged 12 years and older with hypereosinophilic syndrome (HES)

Nucala is not approved to treat acute bronchospasm or status asthmaticus. Your doctor should prescribe you a rescue inhaler to treat sudden breathing problems.

How does Nucala work?

Nucala (mepolizumab) is a humanized monoclonal antibody that attaches to interleukin 5 (IL-5), which plays a role in airways and tissue inflammation. Blocking the activity of IL-5 helps reduce your blood eosinophil count. Eosinophils are a type of white blood cell (WBC) that is part of your body’s immune system. High levels of these cells are thought to be a cause of inflammation and swelling.

Nucala dosage forms and strengths

  • 100mg in a single-dose vial for reconstitution with sterile water for injection
  • 100mg/ml in a single-dose prefilled autoinjector or single-dose prefilled syringe
  • 40mg/0.4ml in a single-dose prefilled syringe

Nucala dosage

  • Severe asthma in adult and adolescent patients 12 years of age and older: 100 mg dose of Nucala given subcutaneously once every 4 weeks.
  • Severe asthma in pediatric and adolescent patients aged 6 to 11 years: 40 mg dose of Nucala given subcutaneously once every 4 weeks.
  • CRSwNP in adult patients: 100 mg dose of Nucala given subcutaneously once every 4 weeks.
  • EGPA in adult patients: 300 mg dose of Nucala as 3 separate 100 mg injections given subcutaneously once every 4 weeks.
  • HES in adult and adolescent patients aged 12 years of age and older:: 300mg of Nucala as 3 separate 100 mg SC injections once every 4 weeks.

Nucala dosage restrictions

No guidelines or dose reduction recommendations are available for patients with liver or kidney impairment, and it appears no adjustments are needed.

How to take Nucala

  • Read the Patient Information, Instructions for Use, and Medication Guide that comes with Nucala.
  • You may receive Nucala as an injection under your skin from your doctor. Your doctor may also determine that you or a caregiver can give your Nucala injection at home. At home, Nucala may be given by a prefilled autoinjector for patients 12 years of age and older or by a prefilled syringe for patients 6 years of age and older.
  • Your doctor will show you or your caregiver how to prepare and administer Nucala injections.
  • Nucala can be injected under the skin of your thigh or stomach. A caregiver may also inject Nucala into your upper arm.
  • If you are taking inhaled or systemic corticosteroids, do not stop them without discussing it with your doctor first. If you suddenly stop corticosteroid therapy, it can cause asthma symptoms to return. Your doctor should slowly decrease your corticosteroid dose to decrease this risk.

Nucala dosage FAQs

What are some side effects of Nucala?

The most common adverse reactions of Nucala seen in clinical trials when compared to the placebo group include:

  • Injection site reactions
  • Headache
  • Fatigue
  • Back pain
  • Arthralgia (joint pain)
  • Abdominal pain
  • Flu-like symptoms
  • Urinary tract infection (UTI)
  • Dizziness
  • Rash
  • Itching
  • Muscle spasms
  • Diarrhea

Nucala can sometimes cause more serious side effects, including:

  • Severe systemic reactions such as allergic reactions and anaphylaxis (hives, swelling of your face or throat, and shortness of breath)
  • Shingles (herpes zoster infection)

Contact your healthcare professional for medical advice about any adverse events you experience while taking Nucala. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Nucala?

The concomitant use of Nucala with other drugs can change how they work or increase the frequency and severity of side effects. You should ask your healthcare professional if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication. Placebo-controlled drug interaction trials have not been performed with Nucala.

Are there any contraindications for Nucala?

You should avoid the use of Nucala if you have a known hypersensitivity reaction to mepolizumab or any of the inactive ingredients in this product.

What should you tell your doctor before starting Nucala?

Before starting Nucala, you should make sure your doctor knows if you have an active parasitic infection (helminth infection), are taking oral corticosteroids (OCS) such as prednisone, are pregnant, plan on becoming pregnant, or are breastfeeding.

Is it safe to use Nucala while pregnant or breastfeeding?

There are no clinical studies on the possible effects Nucala may have on your unborn baby. There is a pregnancy exposure registry that monitors outcomes in pregnant women using Nucala. You can enroll by calling 1-877-311-8972 or visiting www.mothertobaby.org/asthma. It is not known whether Nucala is found in breast milk during lactation or the effects it may have on your infant. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

How long does it take Nucala to start working?

Nucala typically starts reducing eosinophil levels within 48 hours but it can take up to 4 weeks before the full effects are seen in asthma and eosinophilic granulomatosis with polyangiitis (EGPA) patients.

How is Nucala different from Dupixent?

Nucala (mepolizumab)and Dupixent (dupilumab) are monoclonal antibodies used to treat asthma. Nucala is also used to treat nasal polyps and other conditions that are due to high eosinophil levels. Dupixent is also used to treat moderate-to-severe atopic dermatitis. They are different classes of medications that have different side effects. Nucala can cause headaches, back pain, fatigue, urinary tract infection, and stomach pain. Dupixent can cause pink eye, swollen, puffy, or itchy eyelids, herpes infections, and inflammation of the cornea. The other major difference is how often these medications are taken. Dupixent is given as an injection every 2 weeks while Nucala is an injection given every 4 weeks.

How often is Nucala given?

Depending on your age and the condition being treated, you will receive 40mg to 300mg of Nucala via a subcutaneous injection every 4 weeks.

What is the average price of Nucala?

Currently, there is no generic Nucala available on the market. The average cost of 1 prefilled autoinjector of Nucala 100mg/1ml is almost $6,000.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.