How does Nucala (mepolizumab) work? What is the MOA?
Nucala (mepolizumab) is a monoclonal antibody that reduces inflammation by targeting eosinophils, a type of white blood cell. Excess eosinophils can contribute to inflammation, leading to conditions such as severe eosinophilic asthma and hypereosinophilic syndrome. Nucala belongs to a drug class known as interleukin-5 (IL-5) antagonists.
FDA-Approved Indications
Nucala (mepolizumab) is a targeted biologic therapy designed to treat several eosinophil-driven inflammatory conditions. Its use is supported by strong clinical trial data and regulatory reviews, resulting in FDA approval for specific patient groups with asthma, nasal polyps, EGPA (eosinophilic granulomatosis with polyangiitis), hypereosinophilic syndrome (HES), and, most recently, COPD with elevated eosinophil counts.
| Condition | Age Group | Approval Year | Notes |
|---|---|---|---|
| Severe eosinophilic asthma | 6+ | 2015 (adults); 2019 (ages 6-11) | Add-on therapy, not for acute relief |
| Chronic rhinosinusitis with nasal polyps | 18+ | 2021 | Add-on maintenance treatment |
| Eosinophilic granulomatosis with polyangiitis (EGPA) | Adults | 2017 | Orphan indication, 300mg dose |
| Hypereosinophilic syndrome (HES) | 12+ | 2020 | Must be ≥6 months without secondary cause |
| Chronic obstructive pulmonary disease (COPD, "smoker's lung") | Adults | 2025 | For high eosinophil counts; add-on only |
Nucala is not indicated for the relief of acute bronchospasm or status asthmaticus. Always use rescue medication for asthma attacks.
Related questions
- How does the Nucala copay card work and do I qualify?
- How long does it take for Nucala to work?
- Can Nucala cause weight gain?
Mechanism of Action (MOA)
Nucala works by blocking interleukin-5 (IL-5), a cytokine responsible for the growth, activation, and survival of eosinophils. By inhibiting IL-5, Nucala lowers eosinophil levels in the body, helping to reduce inflammation and manage symptoms of eosinophil-related diseases.
How Is Nucala Administered?
Nucala is given as a subcutaneous (under-the-skin) injection once every four weeks. It is administered as single (100mg) or triple (300mg) injections, depending on condition. The medication comes as prefilled syringes and autoinjectors.
Where to inject:
Inject Nucala into the thigh, abdomen, or upper arm (if a caregiver is present). Rotate injection sites—never inject into tender, damaged, or scarred skin.
Always follow your healthcare provider’s instructions for safe and effective use. For complete prescribing information, consult your doctor or review the official medication guide.
References
- Nucala [package insert]. Revised March 2023. GlaxoSmithKline LLC. Accessed 05/29/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fefb887c-e4ac-431e-8893-e9d1a5a63fea
Read next
Can Nucala be self-administered? How is it injected?
Yes, Nucala can be self-administered. Nucala is available as a prefilled syringe or autoinjector that can be self-administered after a doctor has shown you how to administer it. 99% of people can successfully self-administer the Nucala prefilled syringe and 89-95% can successfully administer the Nucala autoinjector.
Continue reading
What is Nucala (mepolizumab) used for and how is it given?
Nucala (mepolizumab) is a biologic therapy used for the treatment of severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis (EGPA), and hypereosinophilic syndrome (HES). It is given by subcutaneous injection every four weeks. Continue reading
Can severe asthma lead to COPD?
Severe and poorly controlled asthma can lead to damaged lungs which may increase the risk of developing chronic obstructive pulmonary disease (COPD). Symptoms of asthma and COPD may frequently co-exist in smokers and the elderly. Continue reading
See also:
Related medical questions
- How long does an asthma attack last?
- How is severe asthma treated?
- Why is asthma worse at night?
- What is considered severe asthma?
- Which measure is the single best determinant of asthma severity?
- Does Cinqair treat all types of asthma?
- What's a good prednisone taper schedule?
- Prednisone: What are 12 Things You Should Know?
- Prednisone vs Prednisolone - What's the difference?
- What are the side effects of steroids?
- Can vitamin C prevent or treat COVID-19 (coronavirus)?
- What is Diprospan used for?
- Can asthma inhalers cause a sore throat?
- What is the difference between Breztri vs Trelegy?
- Trelegy vs. Breo: How does their use and cost compare?
- What is Quercetin and what are its health benefits?
- Is Dupixent an immunosuppressant?
- Why do insurance companies deny Dupixent?
- How does the Dupixent Myway copay card work?
- How does Dupixent work and what is its mechanism of action?
- Does coffee help with asthma?
- Can you drink alcohol on Dupixent?
- Can you take Symbicort and prednisone together?
- Is Wixela Inhub the same as Advair Diskus?
- Why is Breztri not for asthma?
- How do Rinvoq and Dupixent compare?
- Does Feverfew interact with any drugs?
- Can you take Trelegy and Symbicort together?
- Does Fasenra weaken your immune system?
Drug information
Related support groups
- Nucala (8 questions, 20 members)
- Mepolizumab (5 questions, 5 members)
- Asthma (128 questions, 474 members)
- Chronic Rhinosinusitis with Nasal Polyps (18 questions, 12 members)
- Hypereosinophilic Syndrome (8 questions, 11 members)