Nucala vs Xolair – Comparison of Uses & Side Effects

Nucala

It is the brand name of a drug called mepolizumab which belongs to the drug class called monoclonal antibodies.

Mechanism of Action

It works by reducing blood eosinophils, a type of disease-fighting white blood cells.

Uses

This prescription medication is used to treat asthma in patients age 12 years and older.

Note – it is not a rescue medicine. This medication will not work fast enough to treat an asthma attack.

Moreover, it is used to treat patients with eosinophilic granulomatosis with polyangiitis (a disorder which causes blood vessel inflammation).

It is not approved for use by anyone younger than 12 years old.

Dosage

This medication is administered in the thigh, upper arm, or abdomen. The usual recommended dose is 100 mg subcutaneously every 4 weeks. The need for continued therapy with this medication should be assessed at least annually.

Side Effects

Common side effects may include:

  • burning or itching where the medicine was injected;
  • headache;
  • back pain;
  • feeling weak or tired.

Rare side effects may include:

  • a red or blistering skin rash;
  • unusual pain or tiredness;
  • burning anywhere in your body.

Precautions

Before taking this monoclonal antibody, tell your healthcare provider if you have:

  • never had chickenpox or received a chickenpox vaccine
  • a history of herpes zoster;
  • a history of parasite infection;
  • use steroid asthma medication.

Alcoholalcohol

Avoid drinking alcoholic beverages while taking this monoclonal antibody since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • an oral or inhaled steroid medicine.

Pregnancy & Breastfeeding

It is not known whether this monoclonal antibody passes into breast milk or if it could harm a nursing infant. Tell your healthcare provider if you are breastfeeding an infant.

It is not known whether this monoclonal antibody will harm a developing fetus. Tell your healthcare provider if you are pregnant or plan to fall pregnant.

Xolair

It is the brand name of a drug called omalizumab that belongs to a group of drugs called monoclonal antibodies.

Mechanism of Action

It works by blocking IgE antibody, the least abundant, but the most potent antibody classes found in the human body.

Uses

This prescription medication is used to decrease asthma attacks in patients with asthma caused by pollen, dander, and dust mites.

Note – do not give this medication to a child younger than 12 years old.

Dosage

The usual recommended dose is 375 mg by subcutaneous injection every 2 or 4 weeks.

Side Effects

Common side effects may include:

  • nausea;
  • mild rash;
  • tired feeling;
  • itching;
  • ear pain;
  • bone fractures;
  • dizziness;
  • joint pain;
  • sore throat;
  • arm or leg pain;
  • sinus pain.

Rare side effects may include:

  • fast or weak heartbeats;
  • hives;
  • difficult breathing;
  • a feeling like you might pass out;
  • swelling of your face, lips, tongue, or throat;
  • anxiety;
  • wheezing;
  • chest tightness;
  • redness in one or both legs;
  • muscle weakness;
  • problems with vision or speech;
  • coughing up blood;
  • chest pain spreading to your jaw or shoulder;
  • swollen glands.

Precautions

Before taking this monoclonal antibody, tell your healthcare provider if you have:

  • if you have ever had a severe allergic reaction (anaphylaxis);
  • any signs of infection (swollen glands, fever, general ill feeling);
  • if you are receiving allergy shots;
  • a history of heart attack;
  • past or present cancer;
  • an infection caused by parasites (such as hookworm, pinworm, giardia, or toxoplasmosis).

Alcohol

Avoid drinking alcoholic beverages while taking this monoclonal antibody since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • echinacea;
  • vitamin e;
  • Zinc (zinc sulfate).

Pregnancy & Breastfeeding

It is not known whether this monoclonal antibody will harm a developing fetus. Tell your healthcare provider if you are pregnant or plan to fall pregnant.

It is not known whether this monoclonal antibody passes into breast milk or if it could harm a nursing infant. Tell your healthcare provider if you are breastfeeding an infant.

Bottom Line – Nucala vs Xolair

Nucala (active ingredient – mepolizumab) is a monoclonal antibody that is used together with other medications to help control severe asthma in adults and children who are at least 12 years old. It works by reducing levels of a certain type of white blood cell which may contribute to the symptoms of asthma.

Xolair (active ingredient – omalizumab) is an antibody that is used to treat moderate to severe asthma which is caused by allergies in adults and children who are at least 6 years old. It works by decreasing allergic responses in the body. This medication is not a rescue medicine for treating an asthma attack.

According to a 2018 study, the efficacy of omalizumab and mepolizumab was similar in the treatment of asthma which was not well controlled on at least high-dose inhaled corticosteroid.

References

https://www.nejm.org/doi/full/10.1056/NEJMoa1403290
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60988-X/abstract
https://www.ncbi.nlm.nih.gov/pubmed/28395936