Xolair® injection

Xolair® injection

This product is manufactured by Novartis using the ingredient omalizumab.

This product is taken via subcutaneous injection.

Why is it prescribed?

Omalizumab is used to decrease the incidence of asthma flare-ups and improve control of asthma symptoms in adults and children over 6 years of age with moderate to severe persistent asthma not well-controlled with inhaled corticosteroids.

  • Xolair® is injected just under the skin.
  • Based on your dose, you may need more than one injection (up to four) per dose; these should be given in different areas of the body, but at least 2.5 cm from other injection sites.
  • If taking for asthma, you will probably need to continue taking your current asthma medications during Xolair® treatment but after 16 weeks you may be able to reduce or stop your current asthma medications. Your doctor will discuss this with you. You should not reduce the dose of other asthma medications without first discussing this with your doctor, even if you are feeling better.
  • You will receive Xolair® on a regular schedule. Continue receiving Xolair® injections even when you are feeling well.
  • Xolair® is supplied as a powder in a small glass vial, as a solution in a prefilled syringe, and as a solution in a prefilled pen.  A doctor or nurse will administer Xolair® from a vial. You or someone else can administer Xolair® from the prefilled syringe or prefilled pen after the first three doses, which should be given by or under the supervision of your healthcare provider.
    • Prefilled syringe
      • Remove Xolair® from refrigerator and allow it to reach room temperature (about 20-30 minutes).
      • When you are ready to use the syringe, wash your hands thoroughly with soap and water.
      • Clean the injection site with an alcohol swab.
      • Carefully remove the needle cap from the syringe. Discard the needle cap. You may see a drop of liquid at the end of the needle. This is normal.
      • Gently pinch the skin at the injection site and insert the needle. Push the needle all the way in to ensure that the medicine can be fully administered.
      • Slowly depress the plunger as far as it will go so that the plunger head is completely between the syringe guard wings.
      • Keep the plunger fully depressed while you carefully lift the needle straight out from the injection site.
      • Slowly release the plunger and allow the syringe guard to automatically cover the exposed needle. There may be a small amount of blood at the injection site. You can press a cotton ball or gauze over the injection site and hold it for 30 seconds. Do not rub the injection site. You may cover the injection site with a small adhesive bandage, if needed.
      • Dispose of the used syringe immediately in a sharps container (closable, puncture resistant container).
    • Prefilled pen
      • Take the carton containing the pen out of the refrigerator and leave it unopened so that it reaches room temperature (minimum 30 minutes). Each carton contains one pen. If you need more than one pen for your dose, remove all the cartons from the refrigerator at the same time.
      • When you are ready to use the syringe, wash your hands thoroughly with soap and water.
      • Clean the injection site with an alcohol swab.
      • Pull the cap straight off in the direction of the arrow and throw away.
      • Hold the pen comfortably with the needle guard directly against the skin. The pen should be at a 90° angle to the skin.
      • Push and hold the pen firmly against the skin. Listen for the 1st click which indicates that the injection has started.
      • Keep holding the pen firmly down against the skin. The green indicator shows the progress of the injection.
      • Listen for the 2nd click. This indicates the injection is almost complete. Keep holding the pen in position until the green indicator has stopped moving to make sure the injection is complete. Remove the pen from the skin. The needle is automatically covered by the needle guard. The injection is now complete.
      • If the green indicator has not completely filled the viewing window, contact your doctor or nurse.
      • Put the used pen in a sharps disposal container immediately after use.
  • Notify your doctor immediately if you experience symptoms of an allergy (e.g. rash, itching, and swelling of the tongue and throat).
  • Store Xolair® in the refrigerator (2 to 8°C).

Alternatives

Other products that have the same ingredient as Xolair® injection are •Omlyclo® injection •

See other products used in the treatment of •asthma •

The usual recommended dose is between 75 mg to 600 mg subcutaneously (injected under the skin) every 2 or 4 weeks.  Doses (mg) and dosing frequency are determined by condition being treated, serum total IgE level (IU/mL), measured before the start of treatment, and body weight (kg). 


Omalizumab blocks a substance called immunoglobulin E (IgE) which is produced by your body. If you have allergic asthma, your body makes more IgE when you breathe in an allergen that triggers your asthma. Omalizumab helps stop the allergic-inflammatory process in allergic asthma.


Along with its needed effects, omalizumab may cause some unwanted or undesirable effects. Often, people using omalizumab never experience any unwanted effects. The severity and duration of these effects are dependant on many factors including duration of therapy, dose, and individual response. Possible unwanted effects include:

  • injection-site reactions (bruising, redness, warmth, burning, stinging, or other discomfort around the injection site)
  • viral and respiratory tract infections
  • sinus infections
  • headache
  • sore throat

Less common:

  • pain
  • dizziness
  • hair loss

Rare but serious side effects - seek medical help if you experience:

  • Sudden severe allergic reaction (sudden signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other parts of the body, fast heartbeat, dizziness and light headedness, shortness of breath, wheezing or trouble breathing)
  • bleeding or bruising more easily than normal
  • Pain, numbness or tingling in the arms and legs, lumps or raised patches in the skin, weakness and fatigue, loss of appetite and weight loss 
  • Joint pain, stiffness, rash, fever, swollen/enlarged lymph nodes 

 

 

 

 

 


Omalizumab is not a rescue medication and should not be used to treat sudden asthma attacks.
It is not a substitute for the medicines you are already taking.
Adding omalizumab to treatment with inhaled steroids (e.g. fluticasone) has been shown to reduce the number of asthma attacks. It has not been proven to work in other allergic conditions.
Oral or inhaled corticosteroids (e.g. prednisone, fluticasone) should not be abruptly stopped upon starting omalizumab therapy.
Use is not recommended in the following situations:

  • allergy to omalizumab or any component of the formulation

Caution is recommended in the following situations:

  • diabetes
  • glucose-galactose malabsorption syndrome

Use in pregnancy and breastfeeding: At this time there is limited information on use in pregnant and breastfeeding women. Consult your doctor or pharmacist before using.