What is Nucala (mepolizumab) used for and how is it given?

Nucala (mepolizumab) is a biologic therapy used for the treatment of severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis (EGPA), and hypereosinophilic syndrome (HES). It is given by subcutaneous injection every four weeks. It works as an interleukin-5 (IL-5) antagonist monoclonal antibody, helping to control eosinophil levels and reduce symptoms.

Indications for Nucala:

• Severe eosinophilic asthma (ages 6+): Add-on maintenance treatment for uncontrolled asthma, reducing exacerbations but not intended for acute asthma attacks.
• Chronic rhinosinusitis with nasal polyps (CRSwNP) (ages 18+): Helps manage nasal congestion, discharge, and polyp size while reducing the need for oral corticosteroids and surgery.
• Eosinophilic granulomatosis with polyangiitis (EGPA) (ages 18+): Reduces symptoms, flares, and oral corticosteroid dependence.
• Hypereosinophilic syndrome (HES) (ages 12+): Helps prevent disease flares and manage symptoms.

How is Nucala administered?

Nucala is an injectable medication given by subcutaneous injection (under the skin) every 4 weeks.

Nucala is available as a vial, single-dose prefilled autoinjector, or a single-dose prefilled syringe. The injection may be administered by a health care provider or patient caregiver, or self-administered by patients who are 12 years of age and older.

Injection Sites:

• Self-injection: Patients should inject Nucala into their thigh or stomach (abdomen).
• A health care provider or patient caregiver may also give the injection in the upper arm.

You and your caregiver should be trained on how to prepare and perform your injection before trying to give the injection.

Instructions for Use: Prefilled Autoinjector

1. Prepare Your Injection

• Remove the carton from the refrigerator and ensure security seals are intact.
• Let the autoinjector sit at room temperature for 30 minutes (no longer than 8 hours).
• Inspect the medicine: It should be clear to pale yellow/brown without particles (air bubbles are normal).

2. Choose & Clean Your Injection Site

• Select your thigh or abdomen (or upper arm if injected by another person).
• Avoid injecting within 2 inches of a previous site.
• Clean the area with an alcohol swab and let it air dry.

3. Inject Nucala

• Remove the clear needle cap (inject within 5 minutes after removal).
• Press the autoinjector firmly against the skin until the first click is heard.
• Hold in place for up to 15 seconds until you hear the second click and the yellow indicator fills the window.

4. Dispose of the Autoinjector

• Discard the used device in an FDA-cleared sharps disposal container.

Related questions

• How does the Nucala copay card work and do I qualify?
• How long does it take for Nucala to work?
• Can Nucala cause weight gain?

Instructions for Use: Prefilled Syringe

1. Prepare Your Injection

• Remove the carton from the refrigerator and ensure security seals are intact.
• Let the prefilled syringe sit at room temperature for 30 minutes (no longer than 8 hours).
• Inspect the medicine: It should be clear to pale yellow/brown without particles (air bubbles are normal).

3. Choose & Clean Your Injection Site

• Wash your hands with soap and water.
• Clean your injection site by wiping your skin with an alcohol swab and allowing your skin to air dry.
• You can inject in your thighs or abdomen.
• If you are giving the injection to someone else as a caregiver or healthcare provider, you can also inject into their upper arm.
• If you need more than 1 injection to complete your dose, leave at least 2 inches between each injection site.

3. Inject Nucala

• Remove the gray needle cap from the prefilled syringe by pulling it straight off, away from the needle (as shown). It may take some force to remove the gray needle cap.
• You may see a drop of medicine at the end of the needle. This is normal.
• Make sure you inject within 5 minutes after you remove the gray needle cap.
• Use your free hand to pinch the skin around your injection site. Keep pinching the skin throughout your injection.
• Insert the entire needle into the pinched skin at a 45° angle, as shown.
• Move your thumb to the white plunger and use your other fingers to hold onto the white finger grip.
• Slowly push down on the white plunger to inject your full dose.
• Release the skin and allow the needle to retract automatically.

4. Dispose of the Syringe

• Discard in an FDA-cleared sharps disposal container.

Important Notes:

• Do not reuse an autoinjector or syringe.
• If you miss a dose, take it as soon as possible and return to your normal schedule.
• Contact your healthcare provider if you experience any unusual symptoms after injection.

This is not all the information you need to know about Nucala (mepolizumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.