What is Nucala Uses, warnings & interactions
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Get started todayNucala (mepolizumab) is an injectable biologic medication that is manufactured by GlaxoSmithKline (GSK). It was approved by the FDA in 2015 to reduce the number of severe asthma attacks in people with severe eosinophilic asthma that is not controlled by other asthma medicines. It can also help with other inflammatory conditions that are due to high eosinophil levels. If your doctor has prescribed Nucala to you, you may want to know more about what it is and how it works. Here we’ll explain what Nucala is used for, how it works, its side effects, and more.
What is Nucala used for?
NUCALA is a monoclonal antibody that is used for:
- Add-on maintenance treatment of adult and pediatric patients 6 years of age and older with severe asthma that has an eosinophilic phenotype
- Add-on maintenance treatment of adult patients with chronic rhinosinusitis (inflammation of the nasal cavity and sinuses) with nasal polyps (CRSwNP)
- Treatment of adult patients with eosinophilic granulomatosis with polyangiitis (EGPA)
- Treatment of adult and adolescent patients aged 12 years and older with hypereosinophilic syndrome (HES)
Nucala should not be used to treat sudden breathing problems due to asthma exacerbations.
How does Nucala work?
Mepolizumab is a monoclonal antibody that binds to interleukin 5 (IL-5), which plays a role in inflammation. Binding to IL-5 stops it from attaching to receptors on the surface of eosinophils and reduces blood, tissue, and sputum eosinophil levels. This reduction in the eosinophil count helps reduce inflammation and swelling.
What are the most commonly prescribed doses of Nucala?
- 100mg in a single-dose vial for reconstitution
- 100mg/ml in a single-dose prefilled autoinjector or single-dose prefilled syringe
- 40mg/0.4ml in a single-dose prefilled syringe
Before taking Nucala
Before taking Nucala, make sure your doctor is aware of all your medical conditions, including:
- Parasitic infection
- Taking inhaled or oral corticosteroid medicines
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Nucala
- Read the Patient Information, Instructions for Use, and Medication Guide that comes with Nucala.
- You may receive Nucala as a subcutaneous injection (under your skin) by your doctor or at home by yourself or a caregiver every 4 weeks. If you are using Nucala at home, it may be administered by a single-dose prefilled autoinjector in patients aged 12 years and older or by a single-dose prefilled syringe in patients aged 6 years and older.
- Your doctor will demonstrate to you or your caregiver the proper way to administer Nucala injections at home.
- You can inject this medication under the skin of your stomach or thigh. A caregiver can also administer Nucala in your upper arm.
- If you are taking oral or inhaled corticosteroids, do not stop them unless your doctors tell you to. Suddenly stopping corticosteroids can cause symptoms to return.
Nucala contraindications
You should not use Nucala if you have a known hypersensitivity to the active ingredient mepolizumab or any inactive ingredients in its formulation.
Nucala warnings
- Severe hypersensitivity reactions have been reported with the use of Nucala. Stop using this medication if you develop symptoms of a severe allergic reaction, including hives, swelling of the face, tongue, or throat, chest tightness, trouble breathing, fainting, or lightheadedness due to low blood pressure.
- Do not use this medication to relieve sudden asthma symptoms. You should use a rescue inhaler during asthma attacks.
- Your doctor may recommend vaccination if you are at risk of developing a herpes zoster infection.
- You should be treated for any active parasitic infection before starting this medication. If you develop an infection while on Nucala and it doesn’t respond to treatment, you should stop taking Nucala until the infection is resolved.
What drugs should not be taken with Nucala?
When Nucala is taken with other medications, it may change how they work or increase the frequency and severity of side effects. You should ask your doctor if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may cause drug interactions with Nucala.
What are some possible side effects of Nucala?
Some common side effects of Nucala seen in clinical trials include:
- Injection site reactions
- Headache
- Unusual tiredness
- Back pain
- Joint pain
- Abdominal pain
- Flu
- Urinary tract infection
- Dizziness
- Rash and itching
- Muscle spasms
- Diarrhea
- Dry nose
Nucala can sometimes cause more serious side effects, including:
- Severe, life-threatening allergic reactions (hives, swelling of your face or throat, and shortness of breath)
- Increased risk of herpes zoster infections (shingles)
Contact your healthcare professional for medical advice about any possible adverse reactions you experience while taking Nucala. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Nucala alternatives
Your doctor can prescribe other medications if Nucala is not right for you. Some alternative options include:
- Fasenra (benralizumab)
- Cinqair (reslizumab)
- Xolair (omalizumab)
- Tezspire (tezepelumab)
- Dupixent (dupilumab)
Nucala FAQs
Can you take Nucala while you are pregnant or breastfeeding?
There is not enough information on the use of Nucala during pregnancy to know how it will affect the fetus. There is a 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 or the effects it may have on a breastfed 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.
Can I stop taking my other asthma medications while on Nucala?
No, Nucala is typically taken along with your current asthma medications to help reduce asthma attacks. Do not make changes to your severe asthma treatment without talking with your doctor first.
Does Nucala suppress the immune system?
Nucala reduces the number of eosinophils, a type of white blood cell in your body. White blood cells typically help you fight infections, so reducing their number can increase your risk of developing an infection.
How long can I take Nucala?
The recommended dose of Nucala is 40mg or 100mg given as a subcutaneous injection every 4 weeks. Nucala is typically taken as a long-term treatment. Your doctor may consider alternative medications if you have not responded after 24 weeks of treatment with Nucala.
Is Nucala a steroid?
No, Nucala is not a steroid. It can actually help reduce the use of corticosteroid medicines such as prednisone to manage your asthma.
How should I store Nucala?
You should store Nucala prefilled autoinjectors or prefilled syringes in their original carton in your refrigerator between 36°F to 46°F (2°C to 8°C). Unopened cartons of Nucala can be stored at room temperature up to 86°F (30°C) for 1 week. Autoinjectors and syringes should be thrown away if left at room temperature for longer than 1 week. After taking the Autoinjector or syringe out of their carton, you have 8 hours to use them before they should be discarded. It is important to keep all medications, including Nucala, out of the reach of children.
How much does Nucala cost?
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. However, you can save on brand-name drugs like Nucala through NiceRx if eligible for assistance.
