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(res LIZ ue mab)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous [preservative free]:

Cinqair: 100 mg/10 mL (10 mL) [contains mouse (murine) and/or hamster protein]

Brand Names: U.S.

  • Cinqair

Pharmacologic Category

  • Interleukin-5 Receptor Antagonist
  • Monoclonal Antibody, Anti-Asthmatic


Reslizumab is an interleukin-5 antagonist (IgG4 kappa). IL-5 is the major cytokine responsible for the growth and differentiation, recruitment, activation, and survival of eosinophils (a cell type associated with inflammation and an important component in the pathogenesis of asthma). Reslizumab, by inhibiting IL-5 signaling, reduces the production and survival of eosinophils; however, the mechanism of reslizumab action in asthma has not been definitively established.


Vd: ~5 L


Undergoes proteolytic degradation via enzymes into small peptides and amino acids.

Half-Life Elimination

~24 days

Use: Labeled Indications

Asthma: Add-on maintenance treatment of severe asthma in adults with an eosinophilic phenotype

Limitations of use: Not indicated for treatment of other eosinophilic conditions or for the relief of acute bronchospasm or status asthmaticus.


Hypersensitivity to reslizumab or any component of the formulation

Dosing: Adult

Asthma: IV: 3 mg/kg once every 4 weeks.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).


Remove vial from refrigerator; to minimize foaming, do not shake. Solution is clear to slightly hazy/opalescent, colorless to slight yellow liquid; proteinaceous particles may be present in the solution that appear translucent to white; do not administer if discolored. Withdraw calculated volume from vial and, to minimize foaming, add slowly to 50 mL NS infusion bag. Gently invert the bag; do not shake. Compatible bags are polyvinylchloride (PVC) or polyolefin. The time between preparation and administration should not exceed 16 hours. Do not mix with other drugs. Vials are single-use only; discard unused portion.


For IV infusion only. Allow diluted solution to reach room temperature. Use an infusion set with an in-line, low protein-binding filter (pore size: 0.2 micron); compatible filters are polyethersulfone (PES), polyvinylidene fluoride (PVDF), nylon, and cellulose acetate. Infuse over 20 to 50 minute period (may vary depending on total volume being infused) and then flush the IV administration set with NS after the infusion is finished. Do not administer as an IV push or bolus and do not infuse concomitantly in the same IV line with other agents. Observe patient during and for an appropriate time following infusion.

Dietary Considerations

Formulation may contain sucrose.


Stable in NS


Store intact vials in refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze or shake. Protect from light; store in original package. After dilution in NS in infusion bag, administer immediately or store in a refrigerator at 2°C to 8°C (36°F to 46°F) or at room temperature up to 25°C (77°F), protected from light, for up to 16 hours.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Immunologic: Antibody development (5%)

Neuromuscular & skeletal: Increased creatine phosphokinase (20%; transient), myalgia (1%)

Respiratory: Oropharyngeal pain (3%)

<1% (Limited to important or life-threatening): Anaphylaxis

ALERT: U.S. Boxed Warning


Anaphylaxis has been observed with reslizumab infusion in 0.3% of patients in placebo-controlled clinical studies. Anaphylaxis was reported as early as the second dose of reslizumab. Anaphylaxis can be life-threatening. Patients should be observed for an appropriate period of time after reslizumab administration by a health care professional prepared to manage anaphylaxis. Discontinue reslizumab immediately if the patient experiences signs or symptoms of anaphylaxis.


Concerns related to adverse effects:

• Anaphylaxis [US Boxed Warning]: Anaphylaxis was reported in 0.3% of asthma patients in placebo-controlled studies; these events were observed during or within 20 minutes after completion of infusion, and may occur as early as the second dose. Observe patients for an appropriate period of time after administration. Manifestations included dyspnea, decreased oxygen saturation, wheezing, vomiting, skin and mucosal involvement, including urticaria. If severe systemic reactions, including anaphylaxis occur, discontinue administration immediately and provide appropriate medical treatment.

• Malignancies: Malignancies were observed during clinical trials with the majority being diagnosed within less than 6 months of drug exposure; neoplasms observed were diverse with no predominant histologic type.

Disease-related concerns:

• Asthma: Not indicated for the treatment of acute asthma symptoms (eg, acute bronchospasm) or acute exacerbations, including status asthmaticus. Appropriate rescue medication should be available. Patients who experience continued uncontrolled asthma or worsening of symptoms following treatment initiation with reslizumab should seek medical attention.

• Helminth infections: It is unknown if administration of reslizumab will influence a patient's immune response against parasitic infections. Therefore, patients with preexisting helminth infections should undergo treatment of the infection prior to initiation of reslizumab therapy. Patients who become infected during reslizumab treatment and do not respond to anti-helminth therapy should discontinue reslizumab until the infection resolves.

Concurrent drug therapy issues:

• Corticosteroids: Do not discontinue systemic or inhaled corticosteroids abruptly upon initiation of reslizumab. Reductions in corticosteroid dose should be gradual, if appropriate. Clinicians should note that a reduction in corticosteroid dose may be associated with withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.

Other warnings/precautions:

• Limitation of use: Eosinophilic conditions: Reslizumab is not indicated for the treatment of other eosinophilic conditions.

Monitoring Parameters

Anaphylaxis/hypersensitivity reactions (during and after infusion); peak flow, and/or other pulmonary function tests; monitor for signs of infection

Pregnancy Considerations

Adverse events were not observed in animal reproduction studies. Monoclonal antibodies, including reslizumab, are expected to cross the placenta in a linear fashion as pregnancy progresses. The long half-life of reslizumab should be considered if required for a pregnant woman.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience throat pain. Have patient report immediately to prescriber signs of infusion reaction, shortness of breath, nausea, vomiting, dizziness, passing out, flushing, pale skin, confusion, or tachycardia (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.