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Indications and Dosage
Subcutaneous
Eosinophilic asthma Adult: In patient with severe refractory case: 100 mg once every 4 weeks. Child: 6-11 years 40 mg once every 4 weeks; ≥12 years Same as adult dose. Subcutaneous Eosinophilic granulomatosis with polyangiitis Adult: 300 mg once every 4 weeks.
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Reconstitution
Add 1.2 mL of sterile water for injection to a vial labelled as containing 100 mg to provide a final concentration of 100 mg/mL. Gently swirl to dissolve. Do not shake. If a mechanical reconstitution device (e.g. swirler) is utilised, swirl at 450 rpm not longer than 10 minutes or 1,000 rpm not longer than 5 minutes.
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Special Precautions
Patient with parasitic/helminth infestation. Not indicated for the treatment of acute asthma, acute bronchospasm, status asthmaticus, and other eosinophilic conditions. Children. Pregnancy and lactation.
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Adverse Reactions
Significant: Hypersensitivity reactions (e.g. angioedema, bronchospasm, hypotension, urticaria, rash), herpes zoster infection.
Gastrointestinal disorders: Upper abdominal pain. General disorders and admin site conditions: Injection site reactions, fatigue, pyrexia. Musculoskeletal and connective tissue disorders: Back pain, muscle spasm. Nervous system disorders: Headache. Renal and urinary disorders: UTI. Respiratory, thoracic and mediastinal disorders: Lower respiratory tract infection, influenza, nasal congestion, pharyngitis. Skin and subcutaneous tissue disorders: Eczema, pruritus. |
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Monitoring Parameters
Monitor pulmonary function tests (e.g. FEV1, peak flow). Monitor marker for deteriorating asthma.
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Action
Description: Mepolizumab is a humanised immunoglobulin G1 kappa (IgG1k) monoclonal antibody that selectively inhibits cytokine interleukin-5 (IL-5) resulting to reduced growth, differentiation, recruitment, activation, production and survival of eosinophils, thereby decreasing eosinophil-mediated inflammation.
Pharmacokinetics: Absorption: Bioavailability: Approx 80%. Time to peak plasma concentration: 4-8 days. Distribution: Volume of distribution: Approx 3.6 L. Metabolism: Metabolised by proteolytic enzymes, widely distributed in the body and not restricted to hepatic tissues. Excretion: Nonrenal. Terminal half-life: 16-22 days. |
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Storage
Powder for Inj: Store between 2-8°C. Do not freeze. Protect from light. Reconstituted solution: Store below 30°C.
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MIMS Class
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ATC Classification
R03DX09 - mepolizumab ; Belongs to the class of other systemic drugs used in the treatment of obstructive airway diseases.
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References
Anon. Mepolizumab. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 04/03/2019. Anon. Mepolizumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/03/2019. Buckingham R (ed). Mepolizumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/03/2019. Joint Formulary Committee. Mepolizumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/03/2019. Nucala Injection, Powder, for Solution (GlaxoSmithKline LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/03/2019.
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