Omalizumab Treatment: Uses, Dosage, Side Effects & Cost

Summary of Key Points

Omalizumab is a prescription medication used to manage various allergic conditions, including asthma, chronic hives, and nasal polyps. It works by targeting a specific antibody in the immune system to help reduce allergic reactions. Omalizumab is typically administered as an injection under the skin. Always consult your healthcare provider before starting or adjusting your dose. You can also speak with one of our providers through telemedicine for more information about Omalizumab treatment.

Names of Medication

US Brand Name: Xolair

Generic Name: Omalizumab

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.

Pharmacologic Category

Anti-IgE Monoclonal Antibody

Omalizumab Dosage and Treatment

Omalizumab is used to treat several conditions, and the dosage varies depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with us for personalized advice on Omalizumab treatment.

Omalizumab for Asthma

For adults with moderate to severe persistent asthma, the dose of Omalizumab is based on body weight and IgE levels. It is typically administered every 2 to 4 weeks. The duration of treatment depends on the patient’s response and the severity of the condition.

Omalizumab for Chronic Idiopathic Urticaria (Hives)

For adults with chronic idiopathic urticaria (hives), the recommended dose is 150 mg or 300 mg every 4 weeks. The length of treatment depends on how well symptoms are controlled and the patient’s response to therapy.

Omalizumab for Allergic Rhinitis

Omalizumab is sometimes used off-label for allergic rhinitis. The dose and frequency are determined by the healthcare provider based on the individual patient’s needs.

Omalizumab for Nasal Polyps

For adults with nasal polyps, Omalizumab is typically given at a dose ranging from 75 mg to 600 mg every 2 to 4 weeks, depending on the severity of the condition and the patient’s weight.

Omalizumab for Atopic Dermatitis

For adults with atopic dermatitis, Omalizumab may be used off-label. The dosing and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Omalizumab for Food Allergies

Omalizumab is sometimes used off-label for food allergies. The dose and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Omalizumab for Exercise-Induced Bronchoconstriction

Omalizumab may be used off-label for exercise-induced bronchoconstriction. The dose and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Omalizumab for Hypersensitivity Reactions

Omalizumab may be used off-label for hypersensitivity reactions. The dose and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Omalizumab for Eosinophilic Esophagitis

Omalizumab may be used off-label for eosinophilic esophagitis. The dose and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Omalizumab for Allergic Conjunctivitis

Omalizumab may be used off-label for allergic conjunctivitis. The dose and frequency are determined by the healthcare provider based on the patient’s weight and IgE levels.

Dosage Forms and Strengths of Omalizumab

Omalizumab is available in the following injection forms:

1. Injection: 75 mg/0.5 mL
2. Injection: 150 mg/1 mL

Administration Instructions for Omalizumab Injection

Omalizumab is administered as a subcutaneous injection (under the skin). It is usually given in a healthcare setting by a trained professional. In some cases, patients may be trained to self-administer the injection at home. Always follow your healthcare provider’s instructions on how to properly inject the medication. If you experience any issues or have questions about administering Omalizumab, consult your doctor or schedule a telemedicine appointment with us for guidance.

Contraindications for Omalizumab Treatment

A contraindication is a specific situation or condition where a particular treatment or medication should not be used because it may be harmful. If you have any of the following conditions, Omalizumab may not be safe for you:

1. Severe allergic reaction to Omalizumab or its ingredients: If you have had a severe allergic reaction (anaphylaxis) to Omalizumab in the past, it is not safe to take it again. Anaphylaxis is a life-threatening condition that can cause difficulty breathing, swelling, and a dangerous drop in blood pressure.
2. Hypersensitivity to latex: Some Omalizumab prefilled syringes contain latex. If you have a latex allergy, using these syringes could trigger an allergic reaction.
3. Active parasitic infections: Omalizumab may weaken your immune system’s ability to fight off parasitic infections. If you currently have a parasitic infection, it should be treated before starting Omalizumab.

Always discuss your medical history with your healthcare provider before starting any new medication, including Omalizumab. If you have any concerns, one of our telemedicine providers can help you determine if Omalizumab is right for you.

Drug to Drug Interactions

Omalizumab has relatively few known drug interactions, but it’s essential to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products. Some medications that may interact with Omalizumab include:

1. Live vaccines: Omalizumab may weaken your immune system, so live vaccines (e.g., MMR, varicella) should be avoided while on this medication.
2. Corticosteroids (e.g., prednisone): Omalizumab can be used alongside corticosteroids, but your doctor may need to adjust the dosage of either medication to minimize side effects.

Always consult your healthcare provider before starting or stopping any medication. If you’re unsure about potential interactions, our telemedicine providers can help review your current medications.

Omalizumab in Pregnancy

Is it Safe to Take Omalizumab During Pregnancy?

The safety of Omalizumab during pregnancy is not fully established. While animal studies have shown no harm to the fetus, data on its use in pregnant women is limited. Omalizumab should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, discuss this with your healthcare provider to determine if Omalizumab is the right choice for you. Our telemedicine team is available to help you make an informed decision.

Omalizumab While Breastfeeding

Is it Safe to Take Omalizumab While Breastfeeding?

There is limited information on whether Omalizumab passes into breast milk. However, due to its large molecular size, it is unlikely to be absorbed by the infant in significant amounts. If you are breastfeeding, consult your healthcare provider to weigh the potential risks and benefits of continuing Omalizumab. You can also schedule a telemedicine appointment with one of our providers to discuss your options.

Estimated Cost of Omalizumab

The cost of Omalizumab varies depending on your location and the pharmacy you use. Without insurance, the estimated cost for a 30-day supply of Omalizumab (using a GoodRX coupon) ranges from $1,000 to $3,000. Check with your pharmacy for the most accurate pricing, and consider discussing financial assistance programs with your healthcare provider if cost is a concern.

Possible Alternatives to Omalizumab Treatment

Omalizumab is commonly prescribed for several conditions, but alternative treatments and lifestyle changes may also help manage these conditions. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to discuss these options with you.

1. Asthma: Alternatives include inhaled corticosteroids, long-acting beta-agonists (e.g., salmeterol), and leukotriene modifiers (e.g., montelukast). Lifestyle changes, such as avoiding asthma triggers and using air purifiers, may also help.
2. Chronic idiopathic urticaria: Antihistamines (e.g., cetirizine) and H2 blockers (e.g., ranitidine) are common alternatives. Avoiding known triggers like certain foods or stress can also reduce symptoms.
3. Allergic rhinitis: Nasal corticosteroids (e.g., fluticasone) and antihistamines (e.g., loratadine) are frequently used. Reducing exposure to allergens like pollen or dust mites can also be beneficial.
4. Nasal polyps: Nasal corticosteroids and surgery are common treatments. Avoiding allergens and using saline nasal rinses may help reduce symptoms.
5. Atopic dermatitis: Topical corticosteroids and calcineurin inhibitors (e.g., tacrolimus) are often prescribed. Moisturizing regularly and avoiding irritants can also help manage symptoms.
6. Food allergies: Avoiding trigger foods and carrying an epinephrine auto-injector (e.g., EpiPen) are essential. Immunotherapy may be an option for some patients.
7. Exercise-induced bronchoconstriction: Short-acting beta-agonists (e.g., albuterol) are commonly used before exercise. Warming up before physical activity and avoiding cold air can also help.
8. Hypersensitivity reactions: Antihistamines and corticosteroids are often used to manage symptoms. Avoiding known allergens is key to preventing reactions.
9. Eosinophilic esophagitis: Proton pump inhibitors (e.g., omeprazole) and dietary changes (e.g., elimination diets) are common treatments. Avoiding trigger foods can also help.
10. Allergic conjunctivitis: Antihistamine eye drops (e.g., ketotifen) and avoiding allergens like pollen can help manage symptoms.

Recent Updates on Omalizumab Research

Recent studies suggest Omalizumab may have benefits beyond its current approved uses. Ongoing research is exploring its potential in treating other allergic conditions, such as food allergies and eosinophilic esophagitis. Additionally, some studies indicate Omalizumab may help reduce the severity of COVID-19 symptoms in patients with asthma, though more research is needed to confirm these findings. As always, consult your healthcare provider to discuss the latest research and how it may impact your treatment plan. Our telemedicine providers are available to answer any questions you may have.

James Kingsley

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