Drug reference

Omalizumab

Monoclonal Antibody · Anti-asthmatic, Anti-urticarial, Immunomodulator

Monoclonal AntibodyAnti-asthmatic, Anti-urticarial, Immunomodulator

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

1 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactions

Live Attenuated VaccinesContraindicatedTextbookG&G 14e · p896

Mechanism

Omalizumab is a humanized monoclonal antibody that blocks the binding of IgE to high-affinity IgE receptors (FcεR1) on mast cells, thereby preventing their activation by allergens. It also blocks IgE binding to low-affinity IgE receptors (FcεRII, CD23) on other inflammatory cells, including T and B lymphocytes, macrophages, and possibly eosinophils, to inhibit chronic inflammation. Additionally, omalizumab reduces levels of circulating IgE.

Indications

Prophylaxis of severe persistent allergic asthma (adults and children over 6 years)Add-on therapy for chronic spontaneous urticaria in patients who have had an inadequate response to H1 antihistamine treatment (adults)Severe asthma to achieve control and reduce the use of oral corticosteroids (adults and children over 6 years)Allergic rhinitis (off-label)Protection against anaphylaxis during specific immunotherapy (off-label)Severe extrinsic asthma (reduces exacerbations and steroid requirement)Resistant asthma patients with positive skin tests or raised IgE levels who require frequent hospitalization

Dosing

Adult: Prophylaxis of severe persistent allergic asthma: Dose according to immunoglobulin E concentration and body-weight (consult product literature) by subcutaneous injection. Add-on therapy for chronic spontaneous urticaria: 300 mg every 4 weeks by subcutaneous injection.

Contraindications

Autoimmune disease
Susceptibility to helminth infection (discontinue if infection does not respond to anthelmintic)
No benefit noted in nonallergic asthma

Side effects

Common

HeadacheSkin reactionsCoughDiarrhoeaDizzinessDrowsinessDyspepsiaFatigueFlushingIncreased risk of infectionInfluenza-like illnessLimb swellingNauseaParaesthesiaPhotosensitivity reactionPostural hypotensionRespiratory disordersSyncopeWeight increased

Serious