If you have a certain serious type of asthma, your doctor may recommend that you take mepolizumab (Nucala) along with your other asthma medicines. This prescription drug may lessen symptoms like wheezing, trouble breathing, coughing, and chest tightness. It can also reduce the number of asthma attacks you have and help keep you out of the hospital.
What Is Mepolizumab (Nucala)?
This injectable drug is used to manage severe eosinophilic asthma as well as other conditions that are caused by an increase in white blood cells known as eosinophils. When someone with asthma has too many of these white blood cells, it leads to inflammation in your lungs. That narrows your airways, creates more mucus, and makes it harder for you to breathe.
It’s meant to be taken in addition to other asthma medications like steroids and inhalers. You take it as an injection into your skin about once a month. Your doctor can give you the shot in their office, or you can learn to inject yourself or your child at home. Mepolizumab is safe for adults and children 6 years old and older.
What Is Mepolizumab (Nucala) Used For?
It treats asthma and other conditions caused by too many eosinophils. These white blood cells are part of your immune system and normally fight infections. But when they overreact, they cause inflammation that can lead to troublesome symptoms. Your doctor can tell if eosinophils are causing your asthma by doing a routine blood test.
Doctors also prescribe this drug to treat adults with other inflammatory diseases caused by too many eosinophils. They include:
- Inflammatory sinus disease that includes small, noncancerous growths in your nasal passage (called chronic rhinosinusitis with nasal polyps or CRSwNP)
- Swelling in your blood or tissue cells (known as eosinophilic granulomatosis with polyangiitis or EGPA)
- A blood disorder called hypereosinophilic syndrome or HES
How Does Mepolizumab (Nucala) Work?
While experts don’t completely understand how mepolizumab works, we know that it binds to a protein in the body that makes eosinophils. The drug blocks this protein from making new eosinophils and keeps existing ones from surviving. This reduces the inflammation that can lead to breathing trouble.
What Class of Drug Is Mepolizumab (Nucala)?
Mepolizumab is a type of biologic drug (meaning it’s made from living cells) known as an interleukin monoclonal antibody. Monoclonal antibodies are lab-made versions of the antibodies found naturally in your immune system. They’re designed to target certain proteins in your body.
Is There a Generic Version of Mepolizumab (Nucala)?
No generic or biosimilar version of mepolizumab is available. It’s sold only under the brand name Nucala.
How Much Does Mepolizumab (Nucala) Cost?
How much you pay for mepolizumab can vary greatly depending on whether you have insurance, what type it is, and whether you qualify for programs that offer assistance paying for medications.
The retail (before insurance) cost for each 100-milligram shot of the drug (the typical dose for an adult) can cost between $5,000 and $8,000. Doctors usually suggest you have a shot about every 4 weeks, so the retail costs could range from $60,000 to $96,000 a year out-of-pocket. But most people don’t pay the full price.
If you have insurance, your doctor’s office should be able to help you figure out how much your treatments will cost based on your insurance plan, copays, and deductibles.
The drugmaker offers assistance programs and coupons to help people without insurance pay for the drug and help those with insurance cover out-of-pocket copays and other costs.
Is Mepolizumab (Nucala) FDA-Approved for Asthma?
Yes. The FDA approved mepolizumab for severe eosinophilic asthma in 2015.
Will I Still Need to Use Other Medications When I Use Mepolizumab (Nucala)?
You need to keep taking your current asthma medications. Mepolizumab doesn’t help with symptoms that come on suddenly, such as wheezing or trouble breathing during an asthma attack or flare-up. You’ll still use your inhaler for sudden breathing problems.
If your asthma gets better over time when you take mepolizumab, your doctor may suggest lowering the dose of your steroid medicines or other treatments. Always talk to your doctor before making any changes to your current medication, including dose and frequency. Asthma and allergies can get worse if you stop taking steroids suddenly.
What Are the Most Common Side Effects of Mepolizumab (Nucala) ?
One of the most common side effects of mepolizumab (Nucala) is irritation, redness, or swelling of the skin where you had the shot. Other side effects include headaches, back pain, and fatigue.
If you take the drug for chronic rhinosinusitis with nasal polyps (CRSwNP), you may get a sore throat or joint stiffness and discomfort.
Serious allergic reactions and side effects with mepolizumab are rare. If you show signs of a severe allergic reaction, including intense swelling (especially in your mouth, tongue, and throat), serious dizziness, or trouble breathing, get medical help right away.
Tell your doctor if any side effects last a long time or get worse.
How Long Does It Take for Mepolizumab (Nucala) to Work?
Mepolizumab is different from asthma treatments like steroids or inhalers. It doesn’t work right away to treat breathing problems. Instead, it helps to improve your symptoms over time. So you may not notice a difference after your first mepolizumab treatment.
In clinical studies, people who took mepolizumab for about 8 months saw a 53% drop in serious asthma attacks that required them to increase their steroid medication or visit the hospital. In another study, participants were able to reduce their steroid medications when they took mepolizumab over a period of about 5 months. Some were able to reduce their steroid dosage in as little as 4 weeks after starting mepolizumab.
Can You Take Mepolizumab (Nucala) While Pregnant or Nursing?
If you’re pregnant or planning to get pregnant, talk to your doctor before you take mepolizumab. Experts don’t have enough information about the safety of this medication during pregnancy. Your doctor will weigh the risks and benefits of the drug before prescribing it to you. Tell your doctor right away if you get pregnant while on mepolizumab or within 4 months of stopping treatment.
Doctors also don’t know whether the drug can pass into breast milk. Talk to your doctor if you’re breastfeeding or plan to breastfeed.
