Is Xolair effective for food allergies?
Yes, Xolair (omalizumab) works well to reduce allergic reactions in people 1 year and older with one or more food allergies. This may include peanut allergies, egg allergies, and cashew allergies. The medication has shown remarkable ability to increase tolerance thresholds for multiple food allergens. While taking Xolair, you must continue to avoid foods that you are allergic to.
Xolair was approved for reducing allergic reactions that may happen after accidentally eating one or more food allergens by the FDA in February 2024. Xolair is not for treating allergic reactions during an emergency, like anaphylaxis. Do not use this medication to treat an allergic reaction, like hives or sudden breathing problems.
How Well Does Xolair Work To Reduce Food Allergies?
In a phase 3 clinical trial, the efficacy of Xolair was studied in 168 patients (ages 1 year and older). Patients with a peanut allergy were given a dose of peanut protein after taking Xolair for 16-20 weeks. Researchers found that the 68% of patients who took Xolair were able to tolerate peanut protein without experiencing moderate-to-severe skin, breathing, or stomach symptoms. This is compared to 5% of patients who took a placebo (no active medication). More patients taking Xolair were also able to take cashew, milk, or egg protein without these symptoms compared to those who took a placebo.
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How Does Xolair Work To Reduce Food Allergies?
Xolair functions as a monoclonal antibody specifically targeting immunoglobulin E (IgE), the antibody responsible for triggering allergic reactions. By blocking IgE, Xolair interrupts the allergic cascade that would typically lead to symptoms when a person with food allergies is exposed to their allergen.
This mechanism provides a protective buffer against accidental exposures, which remain one of the most common concerns among patients and families managing food allergies. Despite this protective effect, it's critical to understand that Xolair is not a cure—patients must continue strict allergen avoidance practices even while undergoing treatment.
What Is The Dosing Of Xolair For Food Allergies?
The recommended dose of Xolair when taken to reduce food allergies is 75 mg to 600 mg injected under the skin every 2 to 4 weeks. Your healthcare provider will determine your dose based on your blood IgE level.
This is not all the information you need to know about Xolair (omalizumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
References
- Xolair [package insert]. Updated November 2024. Genentech, Inc. Accessed 03/12/2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7f6a2191-adfb-48b9-9bfa-0d9920479f0d
- US Food and Drug Administration. 2024. FDA Approves First Medication to Help Reduce Allergic Reactions to Multiple Foods After Accidental Exposure. Accessed March 12, 2025 at https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-help-reduce-allergic-reactions-multiple-foods-after-accidental
- Wood, R., et. al. 2024. Omalizumab for the Treatment of Multiple Food Allergies. In: The New England Journal of Medicine. DOI: https://doi.org/10.1016/j.jaci.2023.11.909
Read next
How long before Xolair starts working?
Free serum IgE levels are decreased within an hour of Xolair administration. However it may take several months for the full effects of Xolair to be seen, although some symptom improvement may be noted after a few weeks. Significant improvements were noted after 4 months in those with allergic asthma, after 3 months in those with chronic urticaria, and after 16 to 20 weeks in those with Ig-E-mediated food allergies. Continue reading
Does Xolair cause hair loss?
Hair loss (alopecia), has been reported in Xolair clinical studies in at least 2% of people with chronic hives. Hair loss has also been noted in several case reports with Xolair. The hair loss effect appears to be transient, lasting from 3 to 4 months. Due to limited data, the exact cause of hair loss or how often it occurs is not known. Continue reading
How does Xolair affect IgA and IgE levels?
Xolair demonstrates a highly selective effect on immunoglobulin levels in the body, with significant impacts on IgE but no meaningful effect on IgA or other immunoglobulin classes. This selective action is central to omalizumab's therapeutic value in treating IgE-mediated allergic conditions while minimizing broader immune system disruption.
Continue readingSee also:
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