Omalizumab: Uses, Dosage, Side Effects, Warnings

Omalizumab (brand name Xolair) is a groundbreaking medication used to treat moderate-to-severe allergic asthma, chronic hives, and nasal polyps. As a monoclonal antibody, it targets immunoglobulin E (IgE), the antibody involved in allergic reactions. By blocking IgE, omalizumab reduces the body’s allergic response and helps patients gain better symptom control.

At Empower Allergy Treatment, we provide personalized, science-backed solutions like omalizumab to help you breathe easier and live healthier.

What Is Omalizumab?

Omalizumab is a biologic therapy, administered via injection, that binds to free IgE antibodies in your bloodstream. This action prevents IgE from attaching to receptors on mast cells and basophils, which are responsible for triggering allergic reactions. In doing so, omalizumab helps reduce inflammation, flare-ups, and severe allergic symptoms.

Often prescribed under the brand name Xolair (omalizumab), this medication is commonly used when traditional allergy medications such as antihistamines or inhaled corticosteroids are no longer effective.

Conditions Treated by Omalizumab

Omalizumab is approved by the FDA to treat the following conditions:

• Moderate-to-severe allergic asthma in patients 6 years and older
• Chronic spontaneous urticaria (chronic hives) in patients 12 years and older who don’t respond to antihistamines
• Nasal polyps in adults with an inadequate response to intranasal corticosteroids

It is also being studied and used off-label for certain food allergies and eczema. When combined with options like Oral Immunotherapy and Sublingual Immunotherapy, omalizumab can play a central role in comprehensive allergy management plans.

Omalizumab Dosage and Administration

Omalizumab is given as a subcutaneous injection, typically once every 2 to 4 weeks. The dosage is based on two main factors:

• Your body weight
• Your baseline serum IgE level

Most patients receive the injection in a clinical setting. However, select patients may qualify for at-home administration under a provider’s supervision. The injection process usually takes less than 15 minutes, but you may be monitored for a short period afterward due to rare risks of allergic reaction.

Common Side Effects and Serious Warnings

Like all medications, omalizumab may cause side effects. Common side effects include:

• Injection site reactions (bruising, redness, swelling)
• Headaches
• Fatigue
• Joint or muscle pain

Serious side effects are rare but can include:

• Anaphylaxis, a severe allergic reaction (usually within 2 hours of injection)
• Fever or rash
• Churg-Strauss syndrome (rare inflammation of blood vessels)

Because of these risks, patients receiving omalizumab are monitored closely, especially during the first few injections. A black box warning on Xolair emphasizes the risk of anaphylaxis.

We carefully assess each patient to determine if omalizumab is appropriate and to ensure safe administration as part of our Services and Programs.

Who Should or Shouldn’t Take Omalizumab?

Ideal candidates for omalizumab include those who:

• Have moderate-to-severe allergic asthma unresponsive to traditional therapies
• Suffer from chronic hives despite antihistamine use
• Have nasal polyps with ongoing inflammation

Patients with a history of severe anaphylaxis, parasitic infections, or hypersensitivity to ingredients in omalizumab may need an alternative treatment approach. Pregnant or breastfeeding individuals should consult their healthcare provider to weigh benefits and risks.

At Empower Allergy Treatment, we perform thorough evaluations and incorporate Avoidance Planning to ensure omalizumab is part of a personalized care strategy.

Omalizumab vs Other Allergy Treatments

Compared to allergy shots or over-the-counter medications, omalizumab is a targeted, long-acting solution that addresses underlying allergic inflammation. It is especially effective for patients who have not found relief through standard therapies or who experience severe flare-ups that interfere with daily life.

Other biologics such as dupilumab or mepolizumab also target allergic conditions but work through different immune pathways. Your allergy specialist will help you determine whether omalizumab or another biologic best fits your condition.

Learn more about our Sublingual Immunotherapy and how it can complement biologic treatments.

Cost, Insurance, and Accessibility

Omalizumab can be costly without insurance, with individual injections sometimes exceeding $1,000. However, many insurance providers cover it when medically necessary. Manufacturer co-pay assistance programs are also available for eligible patients.

At Empower Allergy Treatment, we help you navigate insurance approvals and offer cost-effective access through our comprehensive Services and Programs.

How Empower Allergy Treatment Can Help

Our team of board-certified allergists provides individualized care using the latest evidence-based therapies. Whether you are managing asthma, food allergies, or chronic hives, we help determine if omalizumab is right for you. We also offer supportive education, monitoring, and progress tracking.

Learn more about our philosophy and approach on our About Us page.

Conclusion

Omalizumab (Xolair) is a transformative medication for patients suffering from moderate-to-severe allergic conditions. With its targeted approach and proven effectiveness, it offers new hope for those who haven't found relief with standard treatments.

If you're struggling with uncontrolled asthma, hives, or nasal polyps, schedule a consultation with Empower Allergy Treatment to explore whether omalizumab fits into your allergy management plan.

Contact us and let us help you breathe easier and live better—with science, care, and compassion guiding every step.