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EspañolNucala overview
BRAND NAMES:
Nucala
Generic Names:
Mepolizumab (this is the active ingredient; there is no generic available at this time)
Uses:
Treats:
Chronic rhinosinusitis with nasal polyps
Eosinophilic granulomatosis with polyangiitis (EGPA)
Hypereosinophilic syndrome (HES)
Therapeutic Classes:
Interleukin-5 antagonist; monoclonal antibody
Forms:
Injectable
How it’s taken:
By subcutaneous injection (under the skin) of the upper arm, thigh, or abdomen
What is Nucala used for?
Nucala (mepolizumab) is a prescription injection medication. It is part of a class of biologics known as a monoclonal antibody. Nucala works by decreasing eosinophil levels in the body. Eosinophils are a type of white blood cell that causes inflammation. Nucala is generally used when other asthma medicines have not been effective enough. It is FDA-approved for:
The add-on maintenance treatment of severe eosinophilic asthma (asthma associated with high levels of eosinophils) in adults and children 6 years and older, in combination with other treatments. Nucala helps prevent severe asthma attacks (exacerbations). Nucala does not treat acute asthma attacks or status asthmaticus.
The add-on maintenance treatment (in combination with other treatments) of chronic rhinosinusitis (sinus inflammation and infections) with nasal polyps in adults 18 years and older whose condition is not adequately controlled with nasal steroids. Nucala reduces symptoms, helps shrink nasal polyps, and reduces the need for oral corticosteroids such as prednisone. It also helps prevent the need for nasal polyp surgery.
Treatment of eosinophilic granulomatosis with polyangiitis (EGPA) in adults (a rare condition involving inflamed blood vessels). Nucala helps reduce flares and symptoms, and it may allow your healthcare professional to lower your dose of oral steroids.
Treatment of hypereosinophilic syndrome (a group of rare blood disorders caused by high levels of eosinophils) in adults and adolescents 12 years and older who have had the condition for 6 months or longer. Nucala helps prevent flares and improve symptoms.
Nucala is an injectable medication used to treat severe asthma due to high numbers of a type of white blood cell called eosinophils. It can also be used to treat other medical conditions associated with high eosinophils. Nucala is not used to treat acute asthma symptoms.
Nucala is injected under the skin once every 4 weeks. It can be injected by a healthcare provider or at home (after proper training). It is very important to stick to your dosing schedule.
Before taking Nucala, let your doctor know if you take steroid medicine, if you have a history of parasite infections (like roundworms or tapeworms), or if you are pregnant or breastfeeding. Also, let your doctor know if you have a history of shingles. You may need a shingles vaccine before you start using Nucala.
If your condition worsens or does not improve, consult your healthcare professional for medical advice.
What form(s) does Nucala come in
Injection
100 mg/mL as a prefilled autoinjector or syringe
Injection (powder for reconstitution)
100 mg per vial
What are common Nucala doses?
Severe eosinophilic asthma (adults and adolescents 12 years and older): 100 mg subcutaneously every 4 weeks
Severe eosinophilic asthma (children ages 6 to 11 years): 40 mg subcutaneously every 4 weeks
Chronic rhinosinusitis with nasal polyps: 100 mg subcutaneously every 4 weeks
EGPA: 300 mg (given as three separate 100 mg injections at least 2 inches apart) subcutaneously every 4 weeks
HES: 300 mg (given as three separate 100 mg injections at least 2 inches apart) subcutaneously every 4 weeks
Common Nucala prescriptions
Nucala
1ml of 100mg/ml penNucala
100mg solution reconstitutedNucala
1ml of 100mg/ml syringeNucala
1ml of 40mg/0.4ml syringe
How to take Nucala
Check the liquid in the prefilled syringe or autoinjector. It should be colorless to slightly yellow to slightly brown. Do not use the medicine if the liquid is cloudy, discolored, or has particles in it. Do not shake.
If you store this medicine at home, keep it in the refrigerator. Do not freeze. You may also store the unopened medicine at room temperature for up to 7 days. Throw away any unopened medicine if it has been left outside the refrigerator for more than 7 days. Throw away any unused, opened medicine after 8 hours.
Discard used needles in an FDA-cleared sharps container that the needles cannot poke through. Keep this container away from children and pets.
Allow the medicine to come to room temperature for about 30 minutes before using it. Do not warm it in any other way. Use the prefilled autoinjector or prefilled syringe within 8 hours after you take it out of the carton.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
Nucala is administered every 4 weeks. A nurse or other health provider may administer this medicine, or you may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
Use a new needle and syringe each time you inject your medicine.
Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin. It can be administered on the upper arm, stomach, or thigh.
You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. Do not inject into skin areas that are tender, bruised, red, or hard.
You might not use all of the medicine in each prefilled syringe or autoinjector. Use each prefilled syringe and autoinjector only one time. Do not save an open syringe or autoinjector.
What to do if you miss a dose of Nucala
If you give yourself the Nucala injection at home, administer the missed dose as soon as you remember, then continue your normal dosing schedule. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
If you get Nucala at a healthcare facility, it is important to keep your appointments so you do not miss a dose. If you are unable to keep your appointment, call your care team as soon as possible for medical advice.
Nucala contraindications
Do not use Nucala if you have had an allergic reaction to mepolizumab or if you are allergic to any ingredient in Nucala.
Do not use this medicine if you are having sudden breathing problems.
Nucala warnings
If you use a corticosteroid medicine (inhaled or taken by mouth) to control your asthma, keep using it unless your doctor tells you otherwise.
This medicine will not stop an asthma attack that has already started. Your doctor will prescribe another medicine (a rescue inhaler, such as albuterol) for you to use in case of an asthma attack.
Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
Tell your doctor if you are pregnant or breastfeeding or if you have a parasite infection.
Some people taking Nucala have gotten herpes zoster infection (shingles). You may receive a vaccine before you start treatment. Tell your doctor if you have not had either chickenpox or the chickenpox vaccine.
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Nucala interactions
There are no significant drug interactions reported with Nucala. Still, be sure to tell your healthcare provider about all the medications you take, including prescription and OTC drugs, vitamins, and supplements.
Nucala side effects
Serious side effects of Nucala:
If you have symptoms of a painful or blistering rash or unusual tiredness, contact your healthcare provider.
Hypersensitivity reactions such as anaphylaxis have occurred. Symptoms of an allergic reaction (hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat) require emergency medical attention.
Common side effects of Nucala:
Headache
Injection site reactions (pain, itching, burning, redness, or swelling where the shot was given)
Mouth and throat pain
Joint pain
Back pain
Fatigue
Flu
Urinary tract infection
Upper stomach pain
Itching/rash/eczema
Muscle spasms
Diarrhea
Dry nasal passages
Sources:
Nucala, National Library of Medicine DailyMed (2023)
Mepolizumab injection, Cleveland Clinic (2023)
Mepolizumab (Rx), Medscape (2023)
Nucala, Prescribers’ Digital Reference (2023)
Mepolizumab injection, National Library of Medicine MedlinePlus (2021)