Omalizumab (Subcutaneous)

Omalizumab is given by injection to patients whose bodies are overproducing IgE, a naturally occurring substance that causes attacks of asthma, allergies and CIU.


What is Omalizumab?

Omalizumab is known more commonly under its marketing name of Xolair. This medication was created to lower the level of free immunoglobulin E that is present when non-seasonal allergens are introduced to asthma patients. Omalizumab is typically given to patients who don't experience complete control of their symptoms with corticosteroid inhalers and those who have persistent symptoms.

Patients must be older than six years of age to receive treatment with Omalizumab and must be allergic to allergens that are non-seasonal in nature such as animal dander.

Omalizumab is considered to be a monoclonal antibody type of medication. This drug is given as an injection by a medical professional such as a physician or a nurse.

How does Omalizumab work?

Omalizumab bonds itself to a substance found in the body known as Immunoglobulin E, which is overproduced when a patient is sensitive to certain non-seasonal allergies. For an asthma patient, a hypersensitive reaction to a non-seasonal allergen can prompt them to have an attack of their asthma, which can lead to serious health complications.

What is Immunoglobulin E?

When a patient with hypersensitivity is exposed to an allergen, their bodies create antibodies which grow in number to fight off the invasion of the substance, causing the sensitivity. Immunoglobulin E is one type of antibody that has been isolated in asthmatics at an increased level just before an attack of their asthma occurs. By lowering the level of this antibody to be more normal, Omalizumab prevents the symptoms of attack in asthma patients.

While the levels of Immunoglobulin E are not elevated in patients with chronic idiopathic urticaria that appears spontaneously, and it is not a disease that is associated with hypersensitivity, the reason why Omalizumab is so effective for this use is under study.

Conditions Treated

  • Severe Asthma
  • Chronic Idiopathic Urticaria
  • Moderate Asthma

Type Of Medicine

Recombinant IgG1k monoclonal antibody

Side Effects

As Omalizumab goes to work on the elevated levels of IgE in asthma patients, it may also cause unwanted effects on the patient that can require immediate attention by medical staff. Alert your physician if you have the following symptoms:

  • Difficulty swallowing
  • Coughing
  • Dizziness
  • Rapid heart rhythm
  • Itchy skin
  • Skin rash or hives
  • Tumors that are malignant
  • Swollen, puffy face, eyes, tongue or lips
  • Chest tightness
  • Fatigue
  • Weak muscles

Other health effects may be annoying in nature but are typically not dangerous in the long-term and may even disappear over time with continued use of Omalizumab. Nonetheless, you should let your healthcare professional know if you have these symptoms, as there may be a way to lessen or eliminate them:

  • Aches or pains
  • Blisters
  • Bleeding
  • Burning sensation
  • Chills
  • Flu or cold symptoms
  • Feeling cold
  • Congestion
  • Skin is discolored
  • Throat is sore or dry
  • Pressure feeling
  • Fever
  • Headache
  • Hoarse voice
  • Itchy skin
  • Pain in leg
  • Lumps
  • Pain in joints or muscles
  • Numb sensation
  • Pain around cheekbones or eyes
  • Red, flushed appearance
  • Nasal congestion, stuffiness, running or sneezing
  • Scars
  • Throat is sore
  • Stinging sensation
  • Swollen neck glands
  • Tender feeling
  • Tingling
  • Ulcerations on skin
  • Vocal changes
  • Warm sensation
  • Pain in arm
  • Skin is red or is itchy or irritated with blistering and crusting
  • Skin appears dry or cracks and is scaly
  • Ear ache

Other patients have adverse effects that aren't on this list. If you experience any changes to your health after being treated with Omalizumab, alert your physician right away.


Omalizumab will be administered to you via an injection underneath your skin, given to you by a medical professional such as a doctor or nurse. Asthma patients will be required to provide a blood sample for testing the level of IgE in your system and this level along with your body mass and other factors will determine how much Omalizumab you will be given. CIU patients will not be required to test for IgE levels.

Typically patients are treated with Omalizumab injections once every two to four weeks and you will require up to three injections for your dose. The general dosage for asthmatic adults is from 75 to 375 milligrams every four weeks. For patients with chronic idiopathic urticaria, they should expect 150 or 300 milligram amounts every four weeks for treatment. Your prescribed dosage may vary from this based on many factors as listed above.

Read and understand the information provided to you by your physician including the printed guide about Omalizumab. Ask your doctor or nurse any questions you may have prior to your treatment.


Inform your physician if you have ever experienced sensitivity to Omalizumab or any other medications. You will also need to remember to disclose any sensitive reactions you've had to foods, animals, preservatives, dyes or perfumes prior to being treated with Omalizumab.

Pediatric patients under six years of age that are diagnosed with asthma and pediatric patients who have chronic hives and are under twelve should not be treated with Omalizumab. Safety and effectiveness has not been established for these age groups.

Geriatric patients have not been studied specifically for data that would prevent them from being safely, effectively treated with Omalizumab.

Women who are pregnant or who may become pregnant should not be treated with Omalizumab, as it can have adverse health effects on their unborn child. If you are pregnant, inform your health care provider prior to receiving a dose of Omalizumab. Take precautions while you are being treated with this medication to prevent pregnancy.

Women who are breastfeeding should avoid treatment with Omalizumab, as it has been found to be present in their breast milk and passed on to their children. During your course of treatment with Omalizumab, it is not advised that you should breastfeed.

Omalizumab is not an emergency medication that works against severe attacks of asthma. Other medications maybe required for your treatment to alleviate all symptoms of your condition. Inform your health care provider of any medications you currently take and include those that are available over the counter as well as any herbal, holistic or vitamin supplements.

Consumption of alcoholic beverages or certain foods and the use of tobacco products while being treated with Omalizumab should be discussed with your physician prior to treatment.

If you have the following medical problems, be sure to disclose them to your physician prior to Omalizumab being given to you:

  • Acute bronchospams
  • Asthma attacks
  • Allergic reactions other than asthma conditions
  • Cancer
  • Infections that are parasitic

These conditions could become worse if you are treated with a dose of Omalizumab, putting your safety at risk.


Omalizumab works best when allowed some time to settle in your system and adjust to the way your body creates IgE. For this reason, it is best to continue your regularly scheduled treatments without missing a dosage. If you discontinue treatment, your symptoms will come back. Expect to have a blood sample tested at this visits to determine what effect the drug is having on you. You will be required to stay at your doctor's facility for at least two hours post-injection in case of any adverse affects on your health.

Use of Omalizumab can put you at risk for anaphylaxis, which is a severe hypersensitive reaction that can be life threatening. Seek emergency medical assistance if you have difficulty breathing, tightness in your chest, coughing, lightheaded, dizzy feelings or spells of fainting, rashes, itching or hives. Report any symptoms such as difficulty swallowing, tightness in your throat or chest or any swelling of your tongue or throat.

Eosinophilia, a condition that includes elevated white cells in your blood, can be a risk factor of taking Omalizumab. Report any increase in your asthmatic symptoms, skin rashes, bruising, chest pain, burning sensation, tingling feeling, fever or numbness in extremities after your dose of Omalizumab.

Vasculitis, which is an inflamed condition of the blood vessels, can also be a risk with treatment of Omalizumab. Any symptoms of this condition such as purple spots on skin, achy joints or muscles, abdominal pain, blood in stool or urine or any fever and loss of weight should be communicated to your doctor or emergency medical staff right away.

After your injection, if you have any skin rashes, pain in joints or muscles or an elevated body temperature, let your health care professional know of these immediately.

Use of Omalizumab may elevate your risk factor for certain infections or cancers. Your physician can speak to you about these risks prior to your treatment.

Women who are pregnant, those who may become pregnant and women who are breastfeeding should be notified that use of Omalizumab may have adverse health risks with regard to their unborn children or infants. Use of this medication is not recommended in these groups.


Omalizumab will be stored and administered in a hospital or medical clinic setting only, with storage according to the manufacturer's instructions carried out by the professional staff. This medication is provided by the manufacturer as a powder, which must be dissolved in a sterile solution prior to injection.

The manufacturer recommends that the vials of medication be stored in their original packaging under ambient conditions of 86 degrees F (30 degrees C) and below or refrigerated. Any opened Omalizumab vials should be used within eight hours after it is mixed with the injection solution if refrigerated or within 4 hours if at room temperature. Any expired doses of Omalizumab should be discarded per the manufacturer's safety instructions and following any appropriate local guidelines.


Omalizumab is an injected recombinant monoclonal antibody type of medication used in people who suffer from asthmatic symptoms associated with non-seasonal allergies. Omalizumab is also used in patients who suffer from chronic hives or CIU. By lowering the level of immunoglobin E found in asthmatic patients, Omalizumab alleviates symptoms that can lead to severe attacks of asthma. Omalizumab compliment other treatments in asthmatics that don't work on year-round allergen reactions but is not an emergency treatment.

Patients who are asthmatic and under 6 years of age should not be treated with Omalizumab, nor should patients who are under 12 and suffering from a chronic hive condition. Women who are pregnant, those who may become pregnant and women who are breastfeeding should not receive treatment with Omalizumab, as they could pass the medication on to their children and infants.

Patients being treated with Omalizumab typically experience mild effects on their health including pain in abdomen, headaches and reactions to the injection itself. Any symptoms that include signs of a white blood cell condition or a problem with the blood vessels should be communicated to your doctor immediately. Do not use Omalizumab if you have a hypersensitivity to it or any other mediations, preservatives, dyes or foods.

Omalizumab must be given time to go to work on your symptoms, so keep all appointments for your dosage schedule, which typically will be every two to four weeks. Dosage will vary in asthma patients based on the level of IgE found in their system as well as their body mass. CIU patients will receive a treatment every four weeks.

Last Reviewed:
March 26, 2018
Last Updated:
April 13, 2018
Content Source: