Xolair

Xo·lair (zlâr)

A trademark for the drug omalizumab.

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Xolair,

a trademark for omalizumab.

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omalizumab

Xolair

Pharmacologic class: Recombinant DNA-derived immunoglobulin G subclass 1 (IgG1) monoclonal antibody

Therapeutic class: Monoclonal antibody

Pregnancy risk category B

Action

Inhibits binding of IgE to high-affinity IgE receptors on surface of mast cells and basophils

Availability

Powder for injection: 150 mg/vial

⊘Indications and dosages

➣ Persistent asthma in patients with positive skin tests or in vitro reactivity to perennial allergens whose symptoms aren't adequately controlled by inhaled corticosteroids

Adults and adolescents ages 12 and older: 150 to 375 mg subcutaneously q 2 to 4 weeks, with dosing frequency determined by serum IgE level and weight

Dosage adjustment

• Significant weight change

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 12.

Administration

☞ Be aware that omalizumab isn't a rescue drug and isn't intended for acute asthma attacks or status asthmaticus.
☞ Don't discontinue abruptly.
• Don't administer more than 150 mg per injection site.
• Prepare injection only with sterile water for injection.

Route	Onset	Peak	Duration
Subcut.	Unknown	7-8 days	Unknown

Adverse reactions

CNS: headache, fatigue, dizziness

EENT: sinusitis, pharyngitis, earache

Musculoskeletal: arthralgia, fracture, leg or arm pain

Respiratory: upper respiratory infection

Skin: pruritus, dermatitis

Other: injection-site reaction, viral infection, pain, cancer, anaphylaxis

Interactions

Drug-diagnostic tests. Serum IgE: elevated level

Patient monitoring

☞ Monitor patient for severe hypersensitivity reactions, including anaphylaxis.
☞ Watch for signs and symptoms of cancer (rare).

Patient teaching

☞ Tell patient to take exactly as prescribed and not to change dosage or stop drug abruptly (unless hypersensitivity reaction occurs).
☞ Instruct patient to discontinue drug and notify prescriber immediately at first sign of hypersensitivity reaction, such as rash, hives, or itching.
• Inform patient that asthma symptoms may not improve immediately after starting drug.
• Tell patient drug isn't intended for acute asthma attacks.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.