omalizumab

o·ma·liz·u·mab (m-lzy-mb)

n.

A monoclonal antibody used as a parenteral drug to treat severe asthma.

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omalizumab,

a monoclonal antibody.

indications This drug is used to treat moderate to severe persistent asthma.

contraindication Known hypersensitivity to this drug prohibits its use.

adverse effects Adverse effects of this drug include earache, dizziness, fatigue, pain, viral infections, sinusitis, upper respiratory infections, pharyngitis, pruritus, dermatitis, injection site reactions, arthralgia, fracture, and leg and arm pain. A life-threatening side effect is malignancy.

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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.