Usual Adult Dose for Asthma - Maintenance

Injectable:
Dose preparation is based on weight and pre-treatment IgE levels:

30 to 60 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 300 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 300 to 400 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 400 to 600 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 600 to 700 international units/mL: 375 mg subcutaneously every 2 weeks

60 to 70 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 200 to 400 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 400 to 500 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 500 to 600 international units/mL: 375 mg subcutaneously every 2 weeks
• IgE greater than 600 international units/mL: Do not dose

70 to 90 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 200 to 300 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 300 to 400 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 400 to 500 international units/mL: 375 mg subcutaneously every 2 weeks
• IgE greater than 500 international units/mL: Do not dose

90 to 150 kg:

• IgE 30 to 100 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 200 to 300 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE greater than 300 international units/mL: Do not dose

Comments:

• Interruptions lasting less than 1 year: Dose based on serum IgE levels obtained at the initial dose determination.
• Interruptions lasting 1 year or more: Retest total serum IgE levels for dose determination.
• Periodically reassess the need for continued therapy based on the patient's disease severity and level of asthma control.

Use: Management of moderate to severe persistent asthma in patients inadequately controlled with inhaled corticosteroids and with a positive skin test or in vitro reactivity to a perennial aeroallergen

Usual Adult Dose for Urticaria

Injectable: 150 to 300 mg subcutaneously every 4 weeks

Comments:

• Dosing not dependent on IgE levels or body weight.
• Avoid administering more than 150 mg per injection site.

Use: Chronic idiopathic urticaria in patients remaining symptomatic after H1 antihistamine treatment

Usual Pediatric Dose for Asthma - Maintenance

Less than 12 years: Not recommended.
12 years and older:
Injectable: Dose preparation is based on weight and pre-treatment IgE levels:

30 to 60 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 300 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 300 to 400 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 400 to 600 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 600 to 700 international units/mL: 375 mg subcutaneously every 2 weeks

60 to 70 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 200 to 400 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 400 to 500 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 500 to 600 international units/mL: 375 mg subcutaneously every 2 weeks
• IgE greater than 600 international units/mL: Do not dose

70 to 90 kg:

• IgE 30 to 100 international units/mL: 150 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 200 to 300 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 300 to 400 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE 400 to 500 international units/mL: 375 mg subcutaneously every 2 weeks
• IgE greater than 500 international units/mL: Do not dose

90 to 150 kg:

• IgE 30 to 100 international units/mL: 300 mg subcutaneously every 4 weeks
• IgE 100 to 200 international units/mL: 225 mg subcutaneously every 2 weeks
• IgE 200 to 300 international units/mL: 300 mg subcutaneously every 2 weeks
• IgE greater than 300 international units/mL: Do not dose

Comments:

• Interruptions lasting less than 1 year: Dose based on serum IgE levels obtained at the initial dose determination.
• Interruptions lasting 1 year or more: Retest total serum IgE levels for dose determination.
• Periodically reassess the need for continued therapy based upon the patient's disease severity and level of asthma control.

Use: Management of moderate to severe persistent asthma in patients inadequately controlled with inhaled corticosteroids and with a positive skin test or in vitro reactivity to a perennial aeroallergen

Usual Pediatric Dose for Urticaria

Less than 12 years: Not recommended.
12 years and older:
Injectable: 150 to 300 mg subcutaneously every 4 weeks

Comments:

• Dosing not dependent on IgE levels or body weight.
• Avoid administering more than 150 mg per injection site.

Use: Chronic idiopathic urticaria in patients remaining symptomatic after H1 antihistamine treatment

Renal Dose Adjustments

Data not available; use with caution.

Liver Dose Adjustments

Data not available; use with caution.

Dose Adjustments

Dose adjustments may be required based on significant changes in weight. The manufacturer product information should be consulted.

Precautions

US BOXED WARNING:

• ANAPHYLAXIS: Bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat of tongue have been reported in patients administered this drug and may occur beyond 1 year after beginning treatment.
• Patients should be monitored after administration and anaphylaxis treatments should be available for use in the event of occurrence.
• Inform patients of signs/symptoms of anaphylaxis and advise them to seek immediate medical care in the event of a reaction.

Safety and efficacy have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Avoid administering more than 150 mg per injection site. Divide doses of greater than 150 mg among at least 2 injection sites.
• Adjust dosing if patient weight significantly changes.
• May take 5 to 10 seconds to inject.

Storage requirements:

• Refrigerate, protect from light.
• Once reconstituted, use within 8 hours (refrigerated) or 4 hours (room temperature).

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

General:

• This drug is not indicated for the treatment of acute bronchospasm, status asthmaticus, other forms of urticaria, and other allergic conditions.
• This drug should be administered by a health care provider experienced in treating severe asthma or chronic spontaneous urticaria.

Monitoring:

• Retest serum IgE levels for dosing if this drug is interrupted for 1 year or longer
• Signs and symptoms of anaphylaxis or anaphylactoid reactions
• Assess asthma control or urticaria symptoms periodically

Patient advice:

• Do not discontinue current asthma or chronic urticaria therapy when beginning this drug.
• Instruct patients to notify their healthcare provider upon signs and symptoms of worsening asthma or allergic reaction.
• Advise patient to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding.

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