Xolair® 150 mg solution for injection
Omalizumab
Each pre-filled syringe of 1 ml solution contains 150 mg of omalizumab*.
*Omalizumab is a humanised monoclonal antibody manufactured by recombinant DNA technology in a Chinese hamster ovary (CHO) mammalian cell line.
For the full list of excipients, see section 6.1.
Solution for injection.
Clear to opalescent, slightly yellow to brown solution.
Allergic asthma
Xolair is indicated in adults, adolescents and children (6 to <12 years of age).
Xolair treatment should only be considered for patients with convincing IgE (immunoglobulin E) mediated asthma (see section 4.2).
Adults and adolescents (12 years of age and older)
Xolair is indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and who have reduced lung function (FEV1 <80%) as well as frequent daytime symptoms or night-time awakenings and who have had multiple documented severe asthma exacerbations despite daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist.
Children (6 to <12 years of age)
Xolair is indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and frequent daytime symptoms or night-time awakenings and who have had multiple documented severe asthma exacerbations despite daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist.
Chronic spontaneous urticaria (CSU)
Xolair is indicated as add-on therapy for the treatment of chronic spontaneous urticaria in adult and adolescent (12 years and above) patients with inadequate response to H1 antihistamine treatment.
Xolair treatment should be initiated by physicians experienced in the diagnosis and treatment of severe persistent asthma or chronic spontaneous urticaria.
Allergic 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
|
150
|
150
|
300
|
300
|
|
>100-200
|
150
|
150
|
150
|
300
|
300
|
300
|
300
|
300
|
450
|
600
|
|
>200-300
|
150
|
150
|
225
|
300
|
300
|
450
|
450
|
450
|
600
|
|
|
>300-400
|
225
|
225
|
300
|
450
|
450
|
450
|
600
|
600
|
|
|
|
>400-500
|
225
|
300
|
450
|
450
|
600
|
600
|
|
|
|
|
|
>500-600
|
300
|
300
|
450
|
600
|
600
|
|
|
|
|
|
|
>600-700
|
300
|
|
450
|
600
|
|
|
|
|
|
|
|
>700-800
|
|
|
|
|
|
|
|
|
|
|
|
>800-900
|
|
|
|
|
ADMINISTRATION EVERY 2 WEEKS
SEE TABLE 3
|
|
|
>900-1000
|
|
|
|
|
|
|
>1000-1100
|
|
|
|
|
|
|
|
|
|
|
Table 3: ADMINSTRATION EVERY 2 WEEKS. Xolair doses (milligrams per dose) administered by subcutaneous injection every 2 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
|
ADMINISTRATION EVERY 4 WEEKS
SEE TABLE 2
|
|
|
|
|
|
|
>100-200
|
|
|
|
|
|
|
>200-300
|
|
|
|
|
|
|
|
|
|
375
|
|
>300-400
|
|
|
|
|
|
|
|
|
450
|
525
|
|
>400-500
|
|
|
|
|
|
|
375
|
375
|
525
|
600
|
|
>500-600
|
|
|
|
|
|
375
|
450
|
450
|
600
|
|
|
>600-700
|
|
225
|
|
|
375
|
450
|
450
|
525
|
|
|
|
>700-800
|
225
|
225
|
300
|
|
