Xolair Dosage, forms & strengths
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Get started todayXolair (omalizumab) is a biologic monoclonal antibody that is manufactured by Genentech, Inc and Novartis Pharmaceuticals. It is an anti-IgE antibody that is FDA-approved to treat:
- Moderate to severe persistent asthma in adults and pediatric patients 6 years of age and older who did not have adequate asthma control with medications such as oral corticosteroids. These patients should also have a positive skin test for a perennial aeroallergen.
- Nasal polyps in adults who failed therapy with nasal corticosteroids such as Flonase (fluticasone).
- Chronic spontaneous urticaria (CSU), which used to be called chronic idiopathic urticaria (CIU), in adults and adolescents 12 years of age and older who did not have symptom control with H1 antihistamine treatment.
Xolair is not indicated to treat acute asthma exacerbations, bronchospasms, status asthmaticus, or other allergic conditions such as atopic dermatitis.
What is the mechanism of action of Xolair?
Xolair is a recombinant humanized monoclonal antibody that binds to immunoglobulin E (IgE) and prevents it from binding to IgE receptors in mast cells and basophils. This inhibits them from releasing histamine and other substances that are involved in inflammation and your body’s response to allergens. Xolair can reduce free IgE levels by over 90%, which leads to a reduction in symptoms from severe allergic asthma as well as other conditions.
Xolair dosage forms and strengths
- 75mg/0.5ml single-dose prefilled syringe
- 150mg/ml single-dose prefilled syringe
- 150mg of powder in a single-dose vial for reconstitution
Xolair dosage
Xolair is given by subcutaneous (under the skin) injection only. Doses over 150mg should be divided among more than 1 injection site.
- Asthma: The recommended dose of Xolair is 75 mg to 375 mg injected under the asking every 2 or 4 weeks. Your dose determination and dosing frequency will be based on your baseline or pretreatment total IgE level (IU/mL) and body weight (kg).
- Nasal polyps: The recommended dose of Xolair is 75 mg to 600 mg injected under the skin every 2 or 4 weeks. Your total dose and dosing frequency will be determined by your baseline total IgE level (IU/mL) and body weight (kg).
- Chronic spontaneous urticaria (CSU): Administer Xolair 150 mg or 300 mg as an injection under the skin every 4 weeks. Your dose of Xolair is not determined based on your serum IgE level or body weight.
Xolair dosage restrictions
There are no dosage adjustments recommended for patients with kidney or liver impairment.
How to take Xolair
- Read the Full Prescribing Information, Instructions for Use, and Medication Guide that comes with Xolair.
- Your first dose of Xolair should be given in a healthcare setting as the administration of Xolair can sometimes cause serious allergic reactions. If your healthcare provider determines you or a caregiver can give your dose at home, they should show you how to prepare and inject Xolair before you give your first dose.
- Use this medication exactly as your doctor tells you to. Do not change your dose or stop this medication without discussing it with them.
- Children ages 6 to 11 years should be administered an injection by an adult caregiver. Children 12 years and older can inject themselves under adult supervision.
- Xolair is administered as 1 or more subcutaneous injections (under the skin), once every 2 or 4 weeks.
- You should have a blood test for IgE to determine your dose and frequency of Xolair if you are being treated for nasal polyps or asthma. This blood test is not necessary if you are being treated for chronic hives.
- If your asthma symptoms do not improve or worsen with Xolair treatment, call your doctor immediately.
Xolair dosage FAQs
What are the most common possible side effects of Xolair?
The most common side effects of Xolair in clinical trials include:
- Arthralgia (joint pain)
- Injection site reactions
- Leg pain
- Dizziness
- Sinus infections
- Headache
- Fatigue
- Fever
- Nausea
- Abdominal pain
- Upper respiratory tract infection
- Rash
- Pruritus (itching)
- Common cold symptoms
- Nose bleeds
Xolair can sometimes cause more serious side effects, including:
- Severe hypersensitivity reactions (hives, angioedema, and shortness of breath)
- Increased risk of heart attack, blood clots, and chest pain
- Increased risk of malignancies
- Fracture
- Inflammation of the blood vessels
- High risk of parasitic infections
Contact your healthcare professional for medical advice about any possible side effects you experience while taking Xolair. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What drug interactions occur with Xolair?
When Xolair is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. No formal drug interaction studies have been performed with Xolair. However, you should discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication.
Are there any contraindications or precautions with Xolair?
Xolair should not be taken if you have a known hypersensitivity to omalizumab or any inactive ingredients in Xolair. You should make sure your doctor is aware of your medical conditions including a latex allergy, a history of anaphylaxis, a history of cancer, a current or previous parasitic infection, or if you are pregnant, plan on becoming, pregnant, or are breastfeeding.
Can you take Xolair while you are pregnant or breastfeeding?
According to the manufacturer, a clinical study of Xolair use in pregnant women showed no increase in the incidence of major birth defects or loss of pregnancy. While it is not known whether Xolair is found in breast milk, the majority of the infants in the study were breastfed and no major adverse effects were seen. 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 for Xolair to start working?
Although some symptom improvement in asthma patients may be noted after a few weeks, it may take several months before you see the full benefits of Xolair. These benefits should last for as long as you continue to receive regular injections of this medication. If you stop Xolair, these benefits will go away in 6 months to a year.
How effective is Xolair in the treatment of chronic hives?
According to the manufacturer, patients on 300mg of Xolair saw a 66% decrease in their itch severity and 67% fewer hives. More than 1 in 3 patients at this dose were itch and hive free at 12 weeks. Patients taking Xolair 150mg saw a 47% decrease in their itch severity and 50% fewer hives. More than 1 in 6 patients at this dose were itch and hive free at 12 weeks.
Can I inject Xolair myself?
After your first dose of Xolair, your healthcare provider may decide that you or a caregiver can give your doses with Xolair prefilled syringe injections. They should show you how to prepare and inject Xolair before you give your first dose. Children ages 6 to 11 years on Xolair should be given an injection by an adult caregiver. Children 12 years and older can give themselves injections under adult supervision.
Related resources for Xolair dosage:
- https://reference.medscape.com/drug/xolair-omalizumab-343444
- https://www.xolairhcp.com/
- https://www.gene.com/download/pdf/xolair_prescribing.pdf
- https://my.clevelandclinic.org/health/drugs/19805-omalizumab-injection
- https://www.medicalnewstoday.com/articles/326828
- https://www.pdr.net/drug-summary/Xolair-omalizumab-448
- https://www.healthline.com/health/drugs/xolair
