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Nucala

Generic Name: mepolizumab (MEP oh LIZ ue mab)
Brand Names: Nucala

Medically reviewed by Judith Stewart, BPharm. Last updated on Sep 28, 2020.

What is Nucala?

Nucala (mepolizumab) is a monoclonal antibody that affects the actions of the body's immune system. Mepolizumab works by reducing levels of a certain type of white blood cell that may contribute to certain disorders.

Nucala used together with other medicines to help control severe asthma in adults and children who are at least 6 years old.

Nucala is used in adults to help control symptoms and reduce flares of a rare autoimmune disorder called eosinophilic granulomatosis with polyangiitis (EPGA).

Nucala is also used to help reduce symptoms and prevent flares in patients 12 years of age and older who have a condition called hypereosinophilic syndrome (HES).

Nucala is given every four weeks by subcutaneous injection.

Important information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use Nucala if you are allergic to mepolizumab.

Nucala is not approved for use by anyone younger than 6 years old. Nucala should not be used to treat EPGA in anyone younger than 18 years old.

To make sure Nucala is safe for you, tell your doctor if:

  • you also use steroid asthma medication;

  • you have a history of parasite infection (such as roundworms or tapeworms);

  • you have a history of herpes zoster (also called shingles); or

  • you have never had chickenpox or received a chickenpox (varicella) vaccine.

You may be given a zoster vaccine before you start using Nucala.

If you also use an oral or inhaled steroid medication, you should not stop using it suddenly. Follow your doctor's instructions about tapering your dose.

Tell your doctor if you are pregnant. Your name may be listed on a pregnancy registry to track the effects of mepolizumab on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How is Nucala given?

Nucala is not a rescue medicine for asthma attacks. Use only fast-acting inhalation medicine for an attack. Seek medical attention if your breathing problems get worse quickly, or if you think your asthma medications are not working as well.

Your doctor may perform blood tests to make sure you do not have conditions that would prevent you from safely using this medicine.

Nucala is injected under the skin, usually once every 4 weeks. A healthcare provider may teach you how to properly use the medication by yourself. Follow all directions on your prescription label

Nucala must be mixed with a liquid (diluent) before using it. Read and carefully follow any Instructions for Use provided with your medicine. When using injections by yourself, be sure you understand how to properly mix and store the medicine.

Gently swirl but do not shake the mixed medicine. Prepare an injection only when you are ready to give it. Do not use Nucala if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

Store the vial (bottle) in its original carton at room temperature. Protect from light and do not freeze.

Store the prefilled syringe or autoinjector in the original carton in a refrigerator. Do not freeze or shake the medicine. After opening a carton, you must use the syringe or autoinjector within 8 hours.

You may store the prefilled syringe or autoinjector in the unopened carton at room temperature for up to 7 days. Throw away a syringe or autoinjector left out of the refrigerator for more than 7 days.

Each vial, prefilled syringe, or autoinjector is for one use only. Throw it away after one use, even if there is still medicine left inside.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Nucala dosing information

Usual Adult Dose for Asthma -- Maintenance:

100 mg subcutaneously every 4 weeks

Comments:
-This drug should be administered in the upper arm, thigh, or abdomen.

Use: Add-on maintenance treatment for severe asthma with an eosinophilic phenotype in adults and children 6 years of age and older

Usual Pediatric Dose for Asthma -- Maintenance:

6 to 11 years:
40 mg subcutaneously every 4 weeks

12 years or older:
100 mg subcutaneously every 4 weeks

Comments:
-This drug should be administered in the upper arm, thigh, or abdomen.

Use: Add-on maintenance therapy for severe asthma with an eosinophilic phenotype in children 6 years and older

Usual Adult Dose for Eosinophilic Granulomatosis with Polyangiitis (EGPA):

300 mg (as 3 separate 100 mg injections) subcutaneously every 4 weeks

Comments:
-This drug should be administered in the upper arm, thigh, or abdomen as 3 separate 100 mg injections at least 5 cm (approximately 2 inches) apart if more than 1 injection is administered at the same site.

Use: For eosinophilic granulomatosis with polyangiitis (EGPA)

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of Nucala.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Nucala?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Nucala side effects

Get emergency medical help if you have signs of an allergic reaction to Nucala: hives, rash; wheezing, chest tightness, difficult breathing; feeling like you might pass out; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • unusual pain or tiredness;

  • burning or tingling anywhere in your body; or

  • a red or blistering skin rash.

Common Nucala side effects may include:

  • headache;

  • feeling tired;

  • back pain; or

  • pain, swelling, redness, burning, or itching where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Nucala?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • an oral (taken by mouth) or inhaled steroid medicine.

Other drugs may interact with mepolizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Nucala only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Related questions

Nucala starts working within 48 hours; however, it may take up to 4 weeks before the maximum effect of Nucala is seen for both asthma and eosinophilic granulomatosis with polyangiitis (EGPA). In asthma, the greatest reductions in eosinophils were seen with higher dosages, for example, a 64% reduction in eosinophils was seen with a 12.5mg SC dose and a 90% reduction was seen with a 250mg SC dose after 48 hours. Read more

Weight gain has not been reported as a side effect of Nucala during clinical trials. Medications such as corticosteroids used to treat eosinophilic asthma are more likely to cause weight gain.  Read more

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. Read more

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