Overview:
Mepolizumab is an injection. It is a monoclonal antibody against interleukin-5. Severe types of asthma can be treated with this injection. The Food and Drug Administration (FDA) approved Mepolizumab in 2015. If you use this injection for asthma, it will reduce your stay at the hospital. If you are suffering from eosinophilic granulomatosis with polyangiitis (severe tissue damage), you can also use this injection. If you are an adult or your child is above twelve and is suffering from non-blood-related hypereosinophilic syndrome (a rise in your blood cells), you can use this injection and take advantage of it.
Dosage and Administration: Your doctor may give you a subcutaneous injection. The dose differs for every condition. Your doctor will check the disease you are suffering from and then administer an injection.
If you have asthma, your doctor will give you 100 mg (milligrams) of Mepolizumab. It is injected one time every four weeks. The locations are the thighs, upper arms, and stomach.
For Patients:
How Is Mepolizumab Used for Asthma?
During an asthma attack, your lungs and airway channels will swell up. There can be something wrong with your airway channels. If you have eosinophilic asthma, you may have shortness of breath. But in eosinophilic asthma, your complete respiratory system will swell up. The eosinophils or red blood cells will increase.
You can inject Mepolizumab when you have severe allergic and eosinophilic asthma. You can use this injection with other drugs, too. The clinical features will be no more. That tightness in your chest, a lot of coughing, and wheezing can also not be there. If you take Mepolizumab, your corticosteroid medication intake will also be decreased.
How Does Mepolizumab Work?
When Mepolizumab works, your symptoms will be no more. It reduces your main cells, which protects you from outsiders, like white blood cell activity that stimulates asthmatic attacks. When your doctor injects this, it will bind to interleukin-5. The work of interleukin-5 is to produce more eosinophils. When your doctor injects this injection, the attachment of interleukin-5 will reduce the effect of eosinophils.
Uses:
If you are an adult with eosinophilic granulomatosis with polyangiitis or if your child is above 12 years of age and has an eosinophilic phenotype, you can go for this injection.
What Is the Dosage of Mepolizumab?
Your doctor will give you this injection under your skin, 100 mg, every four weeks. This is good news. If you cannot, you can go to your doctor to get this.
How Effective Is Mepolizumab?
It is a very effective drug. It will manage your lung function. If you inject Mepolizumab for asthma, your corticosteroid intake will be reduced.
What Are the Things to Inform Your Doctor Before Taking Mepolizumab?
The things that you should inform your doctor about before taking Mepolizumab are as follows:
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If you are pregnant or have breastfed your child, you should inform your doctor before taking Mepolizumab. It will harm your child.
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Even if you're trying for a baby, you should tell your doctor.
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If you are taking some medicines, like corticosteroids, over-the-counter medicines, herbal supplements, and nutritional supplements, you should tell your doctor about every medicine you are taking.
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Most importantly, if you have been allergic to Mepolizumab in the past, you should also inform them of this.
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If you have suffered from shingles in the past or had a parasitic infection, you should go and tell your doctor.
How to Take Mepolizumab?
Two different people can give you this injection. One is your doctor, and the other is your caregiver. You can administer this injection with your own hands as well. If you want to inject this injection with your hands, you should ask your doctor about injecting Mepolizumab.
If your doctor is injecting, then they will inject Mepolizumab subcutaneously every four weeks.
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If it’s your choice to inject yourself at home, you should be careful about this. You should read the instructions mentioned on the package, or you can directly ask your doctor.
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You can inject this under your skin in the thighs, arms, and abdomen.
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If you want your doctor to inject Mepolizumab, they will give it in your arms.
What Are the Things to Do After Starting Mepolizumab?
There are some things that you should do after taking Mepolizumab. If you see that your asthma symptoms are deteriorating day by day after taking this drug, you should call your doctor. You should not stop taking asthma drugs without your doctor's consent.
Look Out for Side Effects:
The following side effects must be reported to the doctor immediately.
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Having something red or blisters on your skin is called an allergic reaction.
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Breathing problems.
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Dizziness.
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Fever or chills.
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Cough.
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Difficult urination.
The side effects that are not bothersome until they persist for a long time are
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Backache.
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Headache.
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Weakness.
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Pain, irritation, and redness at the injection site.
Dietary Alterations
No specific dietary alterations are required while taking Mepolizumab. However, some herbal and nutritional supplements can interact with Mepolizumab, so you should tell your doctor before taking this drug.
Missed Dose:
In the hospital, your doctor will give the proper dose of this drug at the proper time. But if you are taking this drug on your own, you should inject it at the proper time. However, one thing to keep in mind is that the dose should be taken at the same time as prescribed by the doctor and only in the prescribed dosage. It should not be missed.
Overdose:
There is no treatment for Mepolizumab overdose. If you take an overdose of Mepolizumab, you should immediately go to your doctor.
Storage:
You should store the injection in the refrigerator at 36 to 46 degrees Celsius (96.8 to 114.8 Fahrenheit). Do not keep it in the freezer; it will freeze. If you mistakenly keep it outside the refrigerator and it is not open, do not use it. Also, keep it away from the hands of your children and pets.
Disposal:
In the hospital, the needle should be burned in a burner, and the injection should be disposed of in a container. At home, the injection should be disposed of in a tight-fitting, plastic, leak-proof, and puncture-proof container. You should label this container as a hazardous waste container.
Once the container is full, you can contact the disposal company to have it disposed of properly. Do not throw this injection in the household dustbin.
Avoid Self-Medication
You should not go for this injection without your doctor's advice. You also should not inject this injection without your doctor's consent.
Staying on Mepolizumab:
If you are taking this injection regularly at home, you should set an alarm to take this medication. If you set an alarm, your dose will not be missed. If your caregiver is giving you this injection, your caregiver must know how to use this drug. If you notice any redness or allergic reaction after taking Mepolizumab, you should call your doctor for immediate treatment.
For Doctors:
Indication: Healthcare professionals should be aware of when to prescribe this injection.
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The injection should be prescribed only to a child who is above 12 years of age with an eosinophilic phenotype and suffering from severe asthma.
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It can also be given to an adult with eosinophilic granulomatosis with polyangiitis.
Pharmacology:
Mechanism of Action
Mepolizumab is a humanized monoclonal antibody that binds to interleukin-5. This will block the attachment to interleukin-5R cells. These cells help in producing eosinophils. When your doctor gives this injection, it decreases the number of eosinophil cells and manages eosinophil disease. If you are suffering from mild asthma, Mepolizumab will not provide that benefit, as in the case of severe asthma.
Pharmacodynamics
If Mepolizumab 100 mg every four weeks for severe asthma is given, the eosinophil count is reduced to a mean of 40 cells per microliter. This reduction can be noticed in four weeks and maintained throughout the treatment. If Mepolizumab 300 mg every four weeks for eosinophilic granulomatosis with polyangiitis is given, the eosinophil count is reduced to a mean of 38 cells/microliter.
Ingredients:
Active Ingredient: Mepolizumab.
Inactive Ingredients: The vials contain sucrose, polysorbate 80, and sodium phosphate dibasic heptahydrate.
The prefilled autoinjectors and syringes contain ethylenediaminetetraacetic acid (EDTA), citric acid monohydrate, disodium dihydrate, sodium phosphate dibasic heptahydrate, polysorbate 80, and sucrose.
Absorption: When 100 mg of Mepolizumab is given under an adult's skin, the approximate bioavailability is 80 percent. When the dose is administered for four weeks, approximately a doubling of the drug accumulates at a constant rate.
Distribution: The volume of distribution of Mepolizumab is 3.6 liters in an adult asthma patient.
Metabolism: Mepolizumab undergoes proteolytic degradation (hydrolysis of peptide bonds of proteins) when distributed throughout the body.
Elimination: The mean half-life of Mepolizumab is around 16 to 22 days, and the systemic clearance is 0.28 liters per day.
Toxicity
Some researchers have suggested that the Mepolizumab drug contains carcinogenic material. However, this has yet to be proven because the results of various studies indicate different properties of tumor rejection and growth.
In a clinical study, Mepolizumab was given to monkeys, which showed no significant effects on their reproductive potential. No significant pathological findings in the monkeys’ reproductive organs are proof.
Warning and Precaution: The red sign says, be cautious! be careful!
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Hypersensitivity Reactions: You may have hypersensitivity reactions after Mepolizumab administration, such as hypotension (low blood pressure), anaphylaxis, bronchospasm, rash, and urticaria. You should note down the timings of an allergic reaction. If it occurs within hours or days after giving an injection, you should throw that drug away.
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Acute Asthma Symptoms: If you are having acute asthma, then don’t take this drug. If your asthma symptoms deteriorate, you should go to your doctor and inform them about the drug and your asthma symptoms.
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Opportunistic Infections: In a clinical trial, Mepolizumab caused herpes zoster infection in a few subjects. Vaccination can be considered in such cases.
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Corticosteroid Dosage Reduction: If you are taking corticosteroids and Mepolizumab, you should discontinue corticosteroids. Because taking both drugs at the same time will reduce the effect of corticosteroids and worsen the condition for which you are taking corticosteroids.
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Helminth Infection: Mepolizumab therapy should not be started before treating helminth infections. If you suffer from a helminth infection after taking the Mepolizumab injection, you should discontinue that drug and first treat your helminth infection.
Dosage and Forms
100 mg of white lyophilized powder is reconstituted in a single-dose vial. The resultant injection solution is colorless to pale brown and is injected using a single-dose auto-injector or prefilled syringe.
Mepolizumab 100 mg is used for asthma patients, and 300 mg (three 100 mg doses) for eosinophilic granulomatosis with polyangiitis once every four weeks.
Administration of the Drug
A 1 ml (milliliter) polypropylene syringe with a disposable needle is used for subcutaneous administration. Before administration, the reconstituted solution of Mepolizumab is made ready. The solution must not be shaken to avoid foaming or precipitation. Then, the 1 ml injection containing 100 mg of Mepolizumab can be administered subcutaneously into the upper arm, thigh, or abdomen.
Contraindications
Individuals hypersensitive or allergic to the drug's ingredients, such as sodium phosphate dibasic heptahydrate, polysorbate 80, and sucrose, are contraindicated from taking Mepolizumab.
Clinical Studies for Mepolizumab:
A clinical trial was conducted to assess the effectiveness of Mepolizumab for severe asthma. A randomized, placebo-controlled trial for 24 to 52 weeks was conducted. The subjects selected were positive for eosinophils in the airways. Mepolizumab was administered subcutaneously or intravenously every four weeks. The common adverse effects noticed in the subjects were headache, injection site reaction, back pain, fatigue, influenza, urinary tract infection, abdominal pain, pruritus, eczema, and muscle spasms. Post-marketing of Mepolizumab also resulted in a few adverse effects, which were not considered reliable, as the population size of the study was negligible, and various external factors might also induce those adverse events.
Drug Interactions: Some drugs may interact with Mepolizumab; please be careful.
1. The severity of adverse reactions can increase when the following drugs are administered with Mepolizumab.
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Abciximab.
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Adalimumab.
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BCG (Bacille Calmette-Guerin) vaccine.
2. The efficacy of anthrax immune globulin can decrease when administered with Mepolizumab.
Other Specifications:
Mepolizumab in Pregnant Women: Mepolizumab can be transmitted through the placenta to the fetus during pregnancy. Hence, they can cause adverse effects on the fetus during the second and third trimesters of pregnancy. The drug can cause low birth weight, infant prematurity, and preeclampsia (a pregnancy complication with high blood pressure) in the mother.
Mepolizumab in Lactating Women: No data indicates the presence of Mepolizumab in breast milk and its effects on the fetus. However, the following factors must be considered before injecting this drug.
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The clinical need of the mother for the drug.
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The beneficial effects of breastfeeding.
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Risks of potential adverse effects on the infant.
Mepolizumab in Pediatric Patients: The efficacy and safety of Mepolizumab use in pediatric patients have not been established yet.
In addition, no significant differences in dose alterations were identified between younger and older patients.
Mepolizumab in Geriatric Patients: No significant differences were identified between younger and older adults regarding the dosage of administration of Mepolizumab. However, older individuals are started with a lower drug dose, which is then altered depending on the need.
Mepolizumab in Renal Impairment Patients: No significant data have been collected regarding the effects of Mepolizumab on renal impairment patients. However, certain evidence shows that Mepolizumab is not really excreted renally.
Mepolizumab in Hepatic Impairment Patients: No clinical studies have been conducted to establish the use of Mepolizumab in hepatic impairment patients. Also, Mepolizumab is metabolized primarily by proteolytic enzymes, so hepatic functioning and the elimination of the drug do not correlate.
Key Takeaway From iCliniq
Mepolizumab injections are used to manage asthma. The most preferred route of administration is the subcutaneous route. You should take this injection under the supervision of your doctor. If you have any issues, you can reach out to our doctors at icliniq.com.
