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XOLAIR® (Omalizumab) for Injection NDC 50242-040-62

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XOLAIR® (Omalizumab) for Injection NDC 50242-040-62 measured before the start of treatment, and body weight (kg). See the HIGHLIGHTS OF PRESCRIBING INFORMATION dose determination charts. (2.3) These highlights do not include all the information needed to use • Chronic Idiopathic Urticaria: XOLAIR 150 or 300 mg SC every 4 weeks. XOLAIR safely and effectively. See full prescribing information for Dosing in CIU is not dependent on serum IgE level or body weight. (2.4) XOLAIR. ----------------------DOSAGE FORMS AND STRENGTHS--------------------­ ® XOLAIR (omalizumab) injection, for subcutaneous use • ® Injection: 75 mg/0.5 mL and 150 mg/mL solution in a single-dose XOLAIR (omalizumab) for injection, for subcutaneous use prefilled syringe (3) Initial U.S. Approval: 2003 • For Injection: 150 mg lyophilized powder in a single-dose vial for reconstitution (3) WARNING: ANAPHYLAXIS See full prescribing information for complete boxed warning. ------------------------------CONTRAINDICATIONS------------------------------­ Anaphylaxis, presenting as bronchospasm, hypotension, syncope, Severe hypersensitivity reaction to XOLAIR or any ingredient of XOLAIR (4, urticaria, and/or angioedema of the throat or tongue, has been reported 5.1) to occur after administration of XOLAIR. Anaphylaxis has occurred -----------------------WARNINGS AND PRECAUTIONS-----------------------­ after the first dose of XOLAIR but also has occurred beyond 1 year after • Anaphylaxis: Administer only in a healthcare setting prepared to manage beginning treatment. Closely observe patients for an appropriate period anaphylaxis that can be life-threatening and observe patients for an of time after XOLAIR administration and be prepared to manage appropriate period of time after administration. (5.1) anaphylaxis that can be life-threatening. Inform patients of the signs and • Malignancy: Malignancies have been observed in clinical studies. (5.2) symptoms of anaphylaxis and have them seek immediate medical care • Acute Asthma Symptoms: Do not use for the treatment of acute should symptoms occur. (5.1) bronchospasm or status asthmaticus. (5.3) ---------------------------RECENT MAJOR CHANGES--------------------------­ • Corticosteroid Reduction: Do not abruptly discontinue corticosteroids Indications and Usage (1.2) 11/2020 upon initiation of XOLAIR therapy. (5.4) Dosage and Administration (2.1, 2.3, 2.5) 11/2020 • Eosinophilic Conditions: Be alert to eosinophilia, vasculitic rash, Warnings and Precautions (5.4, 5.8) 11/2020 worsening pulmonary symptoms, cardiac complications, and/or neuropathy, especially upon reduction of oral corticosteroids. (5.5) ----------------------------INDICATIONS AND USAGE--------------------------­ • Fever, Arthralgia, and Rash: Stop XOLAIR if patients develop signs and XOLAIR is an anti-IgE antibody indicated for: symptoms similar to serum sickness. (5.6) • Moderate to severe persistent asthma in patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen ------------------------------ADVERSE REACTIONS-----------------------------­ and symptoms that are inadequately controlled with inhaled • Asthma: The most common adverse reactions (≥ 1% of patients) in clinical corticosteroids (1.1) studies with adult and adolescent patients ≥12 years of age were arthralgia, • Nasal polyps in adult patients 18 years of age and older with inadequate pain (general), leg pain, fatigue, dizziness, fracture, arm pain, pruritus, response to nasal corticosteroids, as add-on maintenance treatment (1.2) dermatitis, and earache. In clinical studies with pediatric patients 6 to <12 • Chronic idiopathic urticaria in adults and adolescents 12 years of age and years of age, the most common adverse reactions were nasopharyngitis, older who remain symptomatic despite H1 antihistamine treatment (1.3) headache, pyrexia, upper abdominal pain, pharyngitis streptococcal, otitis media, viral gastroenteritis, arthropod bites, and epistaxis. (6.1) Limitations of Use: • Nasal Polyps: The most common adverse reactions (≥ 3% of patients) in • Not indicated for acute bronchospasm or status asthmaticus. (1.1, 5.3) clinical studies with adult patients included the following: headache, • Not indicated for other allergic conditions or other forms of urticaria. (1.1, injection site reaction, arthralgia, upper abdominal pain, and dizziness. 1.2) (6.1) • ≥ -----------------------DOSAGE AND ADMINISTRATION----------------------­ Chronic Idiopathic Urticaria: The most common adverse reactions ( 2% of For subcutaneous (SC) administration only. (2.2, 2.3, 2.4) patients) included the following: nausea, nasopharyngitis, sinusitis, upper Divide doses of more than 150 mg among more than one injection site to limit respiratory tract infection, viral upper respiratory tract infection, arthralgia, injections to not more than 150 mg per site. (2.6, 2.7) headache, and cough. (6.1) • Asthma: XOLAIR 75 to 375 mg SC every 2 or 4 weeks. Determine To report SUSPECTED ADVERSE REACTIONS, contact Genentech at dose (mg) and dosing frequency by serum total IgE level (IU/mL), 1-888-835-2555 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. measured before the start of treatment, and body weight (kg). See the dose determination charts. (2.2) -------------------------------DRUG INTERACTIONS----------------------------­ • Nasal Polyps: XOLAIR 75 to 600 mg SC every 2 or 4 weeks. Determine No formal drug interaction studies have been performed. (7) dose (mg) and dosing frequency by serum total IgE level (IU/mL), See 17 for PATIENT COUNSELING INFORMATION and Medication Guide. Revised: 11/2020 5.4 Corticosteroid Reduction FULL PRESCRIBING INFORMATION: CONTENTS* 5.5 Eosinophilic Conditions WARNING: ANAPHYLAXIS 5.6 Fever, Arthralgia, and Rash 1 INDICATIONS AND USAGE 5.7 Parasitic (Helminth) Infection 1.1 Asthma 5.8 Laboratory Tests 1.2 Nasal Polyps 6 ADVERSE REACTIONS 1.3 Chronic Idiopathic Urticaria (CIU) 6.1 Clinical Trials Experience 2 DOSAGE AND ADMINISTRATION 6.2 Immunogenicity 2.1 Overview of Dosage Determination 6.3 Postmarketing Experience 2.2 Recommended Dosage for Asthma 7 DRUG INTERACTIONS 2.3 Recommended Dosage for Nasal Polyps 8 USE IN SPECIFIC POPULATIONS 2.4 Recommended Dosage for Chronic Idiopathic Urticaria 8.1 Pregnancy 2.5 Administration 8.2 Lactation 2.6 Preparation for Use and Injection of XOLAIR Prefilled 8.4 Pediatric Use Syringe 8.5 Geriatric Use 2.7 Preparation for Use and Injection of XOLAIR 10 OVERDOSAGE Lyophilized Powder 11 DESCRIPTION 3 DOSAGE FORMS AND STRENGTHS 12 CLINICAL PHARMACOLOGY 4 CONTRAINDICATIONS 12.1 Mechanism of Action 5 WARNINGS AND PRECAUTIONS 12.2 Pharmacodynamics 5.1 Anaphylaxis 12.3 Pharmacokinetics 5.2 Malignancy 13 NONCLINICAL TOXICOLOGY 5.3 Acute Asthma Symptoms 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility 1 Reference ID: 4709395 14 CLINICAL STUDIES 14.1 Asthma 14.2 Nasal Polyps 14.3 Chronic Idiopathic Urticaria 16 HOW SUPPLIED/STORAGE AND HANDLING 17 PATIENT COUNSELING INFORMATION * Sections or subsections omitted from the full prescribing information are not listed. 2 Reference ID: 4709395 FULL PRESCRIBING INFORMATION WARNING: ANAPHYLAXIS Anaphylaxis presenting as bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue, has been reported to occur after administration of XOLAIR. Anaphylaxis has occurred as early as after the first dose of XOLAIR, but also has occurred beyond 1 year after beginning regularly administered treatment. Because of the risk of anaphylaxis, observe patients closely for an appropriate period of time after XOLAIR administration. Health care providers administering XOLAIR should be prepared to manage anaphylaxis that can be life-threatening. Inform patients of the signs and symptoms of anaphylaxis and instruct them to seek immediate medical care should symptoms occur [see Warnings and Precautions (5.1) and Adverse Reactions (6.1, 6.3)]. 1 INDICATIONS AND USAGE 1.1 Asthma XOLAIR is indicated for patients 6 years of age and older with moderate to severe persistent asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids. XOLAIR has been shown to decrease the incidence of asthma exacerbations in these patients. Limitations of Use: • XOLAIR is not indicated for the relief of acute bronchospasm or status asthmaticus. • XOLAIR is not indicated for treatment of other allergic conditions. 1.2 Nasal Polyps XOLAIR is indicated for add-on maintenance treatment of nasal polyps in adult patients 18 years of age and older with inadequate response to nasal corticosteroids. 1.3 Chronic Idiopathic Urticaria (CIU) XOLAIR is indicated for the treatment of adults and adolescents 12 years of age and older with chronic idiopathic urticaria who remain symptomatic despite H1 antihistamine treatment. Limitations of Use: XOLAIR is not indicated for treatment of other forms of urticaria. 2 DOSAGE AND ADMINISTRATION 2.1 Overview of Dosage Determination Asthma and Nasal Polyps Determine dose (mg) and dosing frequency by serum total IgE level (IU/mL) measured before the start of treatment, and by body weight (kg). For patients with both asthma and nasal polyps, dosing determination should be based on the primary diagnosis for which 3 Reference ID: 4709395 XOLAIR is being prescribed. Adjust doses for significant changes in body weight during treatment (see Tables 1 and 2 for treatment of asthma and Table 3 for treatment of nasal polyps). Total IgE levels are elevated during treatment and remain elevated for up to one year after
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