Omalizumab (Xolair)

What is omalizumab?

Omalizumab (Xolair) is an injectable biologic medication used for chronic spontaneous urticaria in patients whose hives remain active despite antihistamine treatment. It has been an important treatment option for chronic hives and is still one of the best-established next-step therapies when antihistamines alone are not enough.

How does omalizumab work?

Omalizumab targets immunoglobulin E, commonly called IgE. By reducing IgE-related signaling, it can help calm mast-cell activity and decrease the hives-and-swelling cycle in appropriate patients.

What are possible side effects of omalizumab?

Possible side effects can include:

  • Injection site reactions

  • Headache

  • Fatigue in some patients

  • Allergic reactions, including rare serious reactions

Because of the possibility of allergic reactions, treatment planning and observation protocols should be reviewed with your provider.

How is omalizumab used?

Omalizumab is given by injection on a schedule directed by your provider. It is usually considered for chronic spontaneous urticaria that remains active despite appropriate antihistamine use.

It is one of several current options for chronic hives, alongside antihistamines and treatments such as dupilumab (Dupixent) or remibrutinib (Rhapsido) in selected patients.

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