NUCALA (MEPOLIZUMAB) 100MG 1ML INJ

WHAT IS THIS MEDICINE AND WHAT IS IT USED FOR?

Nucala contains mepolizumab, a biological medicine (a medicine made from living cells) that targets a specific protein in the immune system called interleukin-5 (IL-5).

IL-5 is a signalling molecule that drives the production and survival of eosinophils — a type of white blood cell that is central to the inflammation underlying certain severe forms of asthma and other conditions.

By blocking IL-5, mepolizumab reduces eosinophil levels in the blood and airways, which in turn reduces inflammation, makes asthma easier to control, and significantly reduces the risk of serious asthma attacks (called exacerbations).

Your specialist may prescribe Nucala for: severe eosinophilic asthma — uncontrolled despite high-dose inhaled medicines and other treatments, where blood eosinophil counts are elevated; eosinophilic granulomatosis with polyangiitis (EGPA — a rare autoimmune condition causing inflammation of blood vessels, previously called Churg-Strauss syndrome); and hypereosinophilic syndrome (HES — a rare condition of persistently very high eosinophil counts causing organ damage).

3. HOW TO TAKE THIS MEDICINE

For severe asthma and EGPA: 100mg injected under the skin (subcutaneous injection) once every 4 weeks (once a month).

For HES: 300mg (three 100mg injections at separate sites) once every 4 weeks. The injection is given by a healthcare professional in a clinic, or you or a carer may be trained to self-inject at home after proper training. Inject into the upper arm, thigh, or abdomen. Rotate injection sites.

Nucala is a long-term add-on treatment — it does not replace your existing inhalers. Continue all your regular asthma inhalers and medicines as prescribed. Nucala reduces the frequency and severity of asthma attacks over time, but it is not a rescue inhaler and will not provide immediate relief during an acute attack. Always keep your reliever inhaler (usually salbutamol/albuterol) with you at all times.

4. POSSIBLE SIDE EFFECTS

5. WHO SHOULD NOT TAKE THIS MEDICINE

Nucala should not be used during an acute asthma attack or for acute worsening of asthma — it is a preventative medicine, not a rescue treatment. It should not be used in people with known hypersensitivity to mepolizumab.

Use with caution in people with pre-existing helminth (parasitic worm) infections, as blocking IL-5 may reduce the body's ability to fight these parasites. Pregnancy and breastfeeding: discuss with your specialist — limited data available.

6. MEDICINES THAT INTERACT WITH THIS TREATMENT

No significant drug interactions have been identified with mepolizumab. It is a biological medicine targeting a specific immune pathway and does not interact with most conventional medicines. However, always tell your respiratory specialist and pharmacist about all medicines you take, including over-the-counter products and other biological medicines.

7. HOW TO STORE THIS MEDICINE

Store in a refrigerator at 2–8°C. Do not freeze or shake. Protect from light. Once removed from the fridge, allow to reach room temperature before use (approximately 30 minutes). Use within the time specified after removal from fridge. Keep out of reach of children.

8. PRESCRIPTION REQUIREMENT

9. GUIDANCE FOR PATIENTS & CAREGIVERS

Nucala is given as a monthly injection under the skin — either in clinic or at home once you are trained. Remove from the fridge 30 minutes before injecting and allow to warm to room temperature.

Continue all your regular inhalers and medicines as prescribed — Nucala works alongside them, not instead of them. Always carry your reliever inhaler with you. After each injection, check the site for any unusual swelling or reaction and report it. Attend all monthly injection appointments — consistency is important for the medicine to work. If you notice your asthma worsening between injections, contact your respiratory team promptly.

10. PHARMACIST & PRESCRIBER NOTES

11. FREQUENTLY ASKED QUESTIONS

Q: Will Nucala replace my inhalers?

No — Nucala works alongside your inhalers, not instead of them. Keep using all your regular inhalers as prescribed. Over time, your specialist may be able to reduce your steroid tablets if your asthma improves, but this will be done gradually and only under supervision.

Q: How long before I notice it working?

Many patients notice fewer asthma attacks and improved day-to-day breathing within the first 3 to 6 months. Some improvement in symptoms can be noticed earlier, but give it time — biological medicines like mepolizumab build their effect gradually.

Q: Can I inject it myself at home?

Yes — once you have been trained by a nurse and are comfortable with the technique, home self-injection is an option. Your specialist team will organise training before setting you up for home injections.

Q: What do I do if I have an asthma attack between injections?

Use your reliever (blue) inhaler immediately. If it is not working, call emergency services. Nucala prevents attacks, but cannot stop one that is already happening — your reliever inhaler is still essential.

Q: How long will I need to take Nucala?

Severe eosinophilic asthma is a long-term condition, and most patients benefit from ongoing mepolizumab treatment. Your specialist will review whether the medicine is still working and needed at regular intervals.