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Mepolizumab is available as a 40 mg/0.4 ml and 100 mg/ml injection for subcutaneous use.

Mepolizumab is an interleukin antagonist and is used for the following:

• Add-on maintenance treatment for severe asthma
• Add-on maintenance treatment for chronic rhinosinusitis with nasal polyps
• Eosinophilic granulomatosis with polyangiitis (EGPA; swelling of the blood vessels)
• Hypereosinophilic syndrome (HES; high eosinophils in the blood)

Mepolizumab is an interleukin antagonist. It blocks interleukin-5 (IL-5), which is a protein that normally makes immune cells called eosinophils. High levels of eosinophils in the body cause inflammation. And, inflammation plays a role in asthma and certain other conditions. By blocking IL-5, Mepolizumab lowers eosinophil levels in the body. This is thought to lower inflammation to help with symptoms, such as pain, swelling, or difficulty breathing (for people with asthma).

This medication is injected under the skin in your thigh, stomach, or back of the upper arms. The dose depends on what condition you’re using Mepolizumab for and your age

Severe asthma

• People 12 years and older: The typical dose is 100 mg injected under the skin once every month.
• Children 6 to 11 years old: The typical dose is 40 mg injected under the skin once every month.

Chronic rhinosinusitis with nasal polyps

• People 18 years and older: The typical dose is 100 mg injected under the skin once every month
• EGPA (adults only) or HES (people 12 years and older)
• The typical dose is 300 mg injected under the skin once every month. The dose is given as three separate 100 mg injections, given one right after the other

Mepolizumab is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication in the following:

• Hypersensitivity reactions (e.g., anaphylaxis, angioedema, bronchospasm, hypotension, urticaria, rash) have occurred after administration of Mepolizumab. Discontinue Mepolizumab in the event of a hypersensitivity
  reaction
• Do not use to treat acute bronchospasm or status asthmaticus
• Herpes zoster infections have occurred in patients receiving Mepolizumab. Consider vaccination if medically appropriate
• Do not discontinue systemic or inhaled corticosteroids abruptly upon initiation of therapy with Mepolizumab
• Decrease corticosteroids gradually, if appropriate
• Treat patients with pre-existing helminth infections before therapy with Mepolizumab. If patients become infected while receiving treatment with Mepolizumab and do not respond to anti-helminth treatment, discontinue Mepolizumab until parasitic infection resolve

Common side effects of Mepolizumab:

• Headache
• Injection-site reactions
• Back pain
• Fatigue
• Throat pain
• Joint pain

Serious side effects are rare with Mepolizumab. Contact your healthcare provider immediately if you experience any of the following.

• Allergic reactions: hives; wheezing; difficulty breathing; swelling of face, mouth, tongue, or throat

• Formal drug interaction trials have not been performed with Mepolizumab. However, always let your physician and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking

Various FDA-approved generic manufacturers

The data on the use of Mepolizumab during pregnancy is insufficient to inform on drug-associated risk. However, potential effects on a fetus are likely to be greater during the second and third trimester of pregnancy. If you become pregnant while receiving Mepolizumab, talk to your healthcare provider.

• Nucala