Chronic Spontaneous Urticaria (CSU) Treatment: Starting XOLAIR (omalizumab)

Steps to Getting XOLAIR

You and your specialist have decided on XOLAIR to treat your Chronic Spontaneous Urticaria. But, there are some steps that take place before you can get your first XOLAIR injection. This can take about 2 weeks. Let’s break it down.

Getting Access to XOLAIR, Step By Step

1) Complete the Patient Consent Form for XOLAIR (omalizumab) Access Solutions to work with you

XOLAIR Access Solutions is a patient assistance program from Genentech that helps people who are taking XOLAIR. To apply, you must complete and submit the Patient Consent Form in your doctor's office. You can also access and submit the form online. Your doctor must also complete a form called the XOLAIR Prescriber Service form. Once XOLAIR Access Solutions has the Patient Consent Form and the XOLAIR Prescriber Service Form, it can begin working with you and your doctor’s office.

2) Doctor's office and XOLAIR (omalizumab) Access Solution can check coverage for XOLAIR (omalizumab)

Your doctor's office will work with XOLAIR Access Solutions or a Specialty Pharmacy to check:

  • If your health plan covers the cost for XOLAIR and how much your co-pay will be
  • If a pre-approval is needed

Someone from XOLAIR Access Solutions or your specialty pharmacy might call to talk about XOLAIR. Due to privacy laws, if they leave a message to call back, they will not say it is about XOLAIR. 

Make sure you return all calls from Access Solutions or the specialty pharmacy, in order to get XOLAIR without any delays. 

What is a Specialty Pharmacy? 

A Specialty Pharmacy supplies certain medicines for patients. Some plans require you to use a certain Specialty Pharmacy to receive your medicine. Specialty Pharmacies send your medicine to your doctor’s office. They may also offer other services, such as referrals to patient assistance.

3) Apply for Financial Assistance

Even with health insurance, you may still have concerns about the treatment cost.

If you need help paying for XOLAIR, there may be options to help. Access Solutions can refer you to the right financial assistance option.

4) Schedule your XOLAIR (omalizumab) appointment

XOLAIR Access Solutions works with your doctor's office and specialty pharmacy to deliver XOLAIR to your doctor's office or injection location. You should make an appointment to receive XOLAIR. Your specialty pharmacy might call you to confirm shipping details. After you've established treatment in a doctor's office or infusion center, your doctor will determine if you or your caregiver may inject XOLAIR. If your doctor decides that you or a caregiver may be able to give your own XOLAIR prefilled syringe injections, you should receive training on the right way to prepare and inject XOLAIR.

Please note: Your XOLAIR might not come from a specialty pharmacy. Instead, your doctor might buy XOLAIR and get paid by your health plan for the cost of the medicine. This process is called “buy and bill.”


What is XOLAIR? XOLAIR® (omalizumab) for subcutaneous use is an injectable prescription medicine used to treat chronic spontaneous urticaria (CSU, previously referred to as chronic idiopathic urticaria (CIU), chronic hives without a known cause) in people 12 years of age and older who continue to have hives that are not controlled with H1 antihistamine treatment. It is not known if XOLAIR is safe and effective in people with CSU under 12 years of age.

XOLAIR is not used to treat other forms of hives.

What is the most important information I should know about XOLAIR? Severe allergic reaction. A severe allergic reaction called anaphylaxis can happen when you receive XOLAIR. The reaction can occur after the first dose, or after many doses. It may also occur right after a XOLAIR injection or days later. Anaphylaxis is a life-threatening condition and can lead to death. Go to the nearest emergency room right away if you have any of these symptoms of an allergic reaction:

  • wheezing, shortness of breath, cough, chest tightness, or trouble breathing
  • low blood pressure, dizziness, fainting, rapid or weak heartbeat, anxiety, or feeling of “impending doom”
  • flushing, itching, hives, or feeling warm
  • swelling of the throat or tongue, throat tightness, hoarse voice, or trouble swallowing

Your healthcare provider will monitor you closely for symptoms of an allergic reaction while you are receiving XOLAIR and for a period of time after treatment is initiated. Your healthcare provider should talk to you about getting medical treatment if you have symptoms of an allergic reaction.

Do not receive and use XOLAIR if you are allergic to omalizumab or any of the ingredients in XOLAIR.

Before receiving XOLAIR, tell your healthcare provider about all of your medical conditions, including if you:
  • have a latex allergy or any other allergies (such as food allergy or seasonal allergies). The needle cap on the XOLAIR prefilled syringe contains a type of natural rubber latex
  • have ever had a severe allergic reaction called anaphylaxis
  • have or have had a parasitic infection
  • have or have had cancer
  • are pregnant or plan to become pregnant. It is not known if XOLAIR may harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if XOLAIR passes into your breast milk. Talk with your healthcare provider about the best way to feed your baby while you receive and use XOLAIR.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

How should I receive and use XOLAIR?
  • When starting treatment XOLAIR should be given by your healthcare provider in a healthcare setting.
  • If your healthcare provider decides that you or a caregiver may be able to give your own XOLAIR prefilled syringe injections, you should receive training on the right way to prepare and inject XOLAIR.
  • Do not try to inject your XOLAIR prefilled syringe until you have been shown the right way to give XOLAIR injections by a healthcare provider. Use XOLAIR exactly as prescribed by your healthcare provider. For children 12 years of age and older, XOLAIR prefilled syringe may be self-injected under adult supervision.
  • See the detailed Instructions for Use that comes with XOLAIR for information on the right way to prepare and inject XOLAIR.
  • XOLAIR is given in 1 or more injections under the skin (subcutaneous), 1 time every 4 weeks.
  • In people with chronic hives, a blood test is not necessary to determine the dose or dosing frequency.
  • Do not decrease or stop taking any of your other hive medicine unless your healthcare providers tell you to.
  • You may not see improvement in your symptoms right away after XOLAIR treatment.
  • If you inject more XOLAIR than prescribed, call your healthcare provider right away.
What are the possible side effects of XOLAIR?
XOLAIR may cause serious side effects, including:
  • Cancer. Cases of cancer were observed in some people who received XOLAIR.
  • Fever, muscle aches, and rash. Some people get these symptoms 1 to 5 days after receiving a XOLAIR injection. If you have any of these symptoms, tell your healthcare provider.
  • Parasitic infection. Some people who are at a high risk for parasite (worm) infections, get a parasite infection after receiving XOLAIR. Your healthcare provider can test your stool to check if you have a parasite infection.
  • Heart and circulation problems. Some people who receive XOLAIR have had chest pain, heart attack, blood clots in the lungs or legs, or temporary symptoms of weakness on one side of the body, slurred speech, or altered vision. It is not known whether these are caused by XOLAIR.

The most common side effects of XOLAIR in people with chronic spontaneous urticaria: nausea, headaches, swelling of the inside of your nose, throat or sinuses, cough, joint pain, and upper respiratory tract infection.

These are not all the possible side effects of XOLAIR. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at (800) FDA-1088 or You may also report side effects to Genentech at (888) 835-2555 or Novartis Pharmaceuticals Corporation at (888) 669-6682.

Please see full Prescribing Information, including Medication Guide for additional Important Safety Information and Instructions for Use.