Xolair treatment should be initiated by physicians experienced in the diagnosis and treatment of severe persistent asthma.
Posology
The appropriate dose and frequency of Xolair is determined by baseline IgE (IU/ml), measured before the start of treatment, and body weight (kg). Prior to administration of the initial dose, patients should have their IgE level determined by any commercial serum total IgE assay for their dose assignment. Based on these measurements, 75 to 600 mg of Xolair in 1 to 4 injections may be needed for each administration.
Patients with IgE lower than 76 IU/ml were less likely to experience benefit (see section 5.1). Prescribing physicians should ensure that adult and adolescent patients with IgE below 76 IU/ml and children (6 to < 12 years of age) with IgE below 200 IU/ml have unequivocal in vitro reactivity (RAST) to a perennial allergen before starting therapy.
See Table 1 for a conversion chart and Tables 2 and 3 for the dose determination charts in adults, adolescents and children (6 to <12 years of age).
Patients whose baseline IgE levels or body weight in kilograms are outside the limits of the dose table should not be given Xolair.
The maximum recommended dose is 600 mg omalizumab every two weeks.
Table 1: Conversion from dose to number of syringes, number of injections and total injection volume for each administration
Dose (mg)
|
Number of syringes
|
Number of injections
|
Total injection volume (ml)
|
|
75 mg
|
150 mg
|
|
|
75
|
1
|
0
|
1
|
0.5
|
150
|
0
|
1
|
1
|
1.0
|
225
|
1
|
1
|
2
|
1.5
|
300
|
0
|
2
|
2
|
2.0
|
375
|
1
|
2
|
3
|
2.5
|
450
|
0
|
3
|
3
|
3.0
|
525
|
1
|
3
|
4
|
3.5
|
600
|
0
|
4
|
4
|
4.0
|
Table 2: ADMINISTRATION EVERY 4 WEEKS. Xolair doses (milligrams per dose) administered by subcutaneous injection every 4 weeks
|
Body weight (kg)
|
Baseline IgE (IU/ml)
|
>20-25
|
>25-30
|
>30-40
|
>40-50
|
>50-60
|
>60-70
|
>70-80
|
>80-90
|
>90-125
|
>125-150
|
30-100
|
75
|
75
|
75
|
150
|
150
|
150
|
15 |
|