Biologics at Home

Most people on biologics have the option to self-administer their medication at home. (The first dose is typically done in the doctor’s office. The biologics benralizumab, dupilumab, mepolizumab, omalizumab, tezepelumab-ekko and tralokinumab are approved by the U.S. Food and Drug Administration (FDA) for home use. Reslizumab is FDA-approved as an infusion for home use, but it must be given by a healthcare provider.

How are biologics administered at home? 

Most biologic drugs for allergic conditions are given as an injection under the skin. They are injected in the upper arm, stomach or thigh. Reslizumab is available as an infusion. It can take 20-50 minutes for the infusion. A trained healthcare provider can administer reslizumab at home.

Do I need to measure out the biologics into a syringe?

You do not need to measure out biologic medicine into a syringe.

Biologics for severe allergic asthma, allergies and skin conditions come in the following forms:

A trained healthcare provider can give you reslizumab at home. You would not be responsible for measuring out the correct dosage form of the solution.

How do you give yourself an injection? 

Before giving yourself an injection, ask for training at your doctor’s office. You may have to show you can give yourself the injection the right way. Most biologics have medication websites with videos showing how to give yourself the injection.

In general, here are the steps to taking biologic medications:

  • Take the medication from the refrigerator. Let it warm to room temperature.
  • Once at room temperature, decide where you want to inject it. Typical spots for injections include the stomach, upper arms or the thigh. Do not repeat sites or administer to damaged skin.
  • Clean the area with an alcohol prep pad and let it dry for a few seconds.
  • Follow the directions provided to you for properly injecting the medicine.
  • You can dab the area with a cotton ball if it’s bleeding.
  • Dispose of the device.

What should I do if I miss a dose of my biologic med?  

This will depend on how often you should receive your medication. It will also depend on how long you are overdue for your dose.

If you miss a dose, it’s recommended you take the dose right away. Then speak with your doctor and/or check the package instructions for information on how to proceed.

What are the common side effects of biologics?

Potential side effects of an injection may include fatigue, headache, bruising, back pain, fever, and dry or itchy skin. You may also have minor irritation at the injection site.

Some people may have a severe allergic reaction, or anaphylaxis, after a biologic injection. Your doctor should prescribe epinephrine to you as the first-line treatment for anaphylaxis. Use it at the first sign of symptoms. Go to the hospital or urgent care if symptoms persist.

What would be a situation that would require emergency care? 

In the event of an over-dosage, contact Poison Control at 800-222-1222. Then keep watch for signs of adverse reactions.

If you experience a severe allergic response, administer epinephrine. (Your doctor should prescribe you epinephrine devices.) Then, seek emergency medical care.

Anaphylaxis symptoms include:

  • Difficulty breathing or wheezing
  • Hives
  • Tight throat
  • Feeling sick to your stomach or having diarrhea
  • Feeling light headed
  • Racing heartbeat
  • Cool or clammy skin
  • Loss of consciousness

If you have a severe allergic reaction following a biologic injection, administer epinephrine right away. Then call 9-1-1.

How do you store your biologic medication at home?

It is important to make sure your medication is in a safe and secure place at home. This way it can retain effectiveness until you’re ready to administer it.

Be sure to read the package instructions for your biologic for storage information. You should store the medication in its carton in the refrigerator. Don’t freeze it. Don’t expose it to high temperatures or direct sunlight.

Specific medication storage instructions:

  • Benralizumab (Fasenra®) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 30 minutes. It may be kept at room temperature for up to 14 days.
  • Dupilumab (Dupixent®) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 30 minutes. It may be kept at room temperature for up to 14 days.
  • Lebrikizumab (Ebglyss™) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 30 minutes. It may be kept at room temperature for up to 7 days.
  • Mepolizumab (Nucala®) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 30 minutes. It may be kept at room temperature for up to 7 days.
  • Omalizumab (Xolair®) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 30 minutes. It may be kept at room temperature for up to 2 days.
  • Reslizumab (Cinqair®) – Store it in the refrigerator. Before use, the healthcare provider who comes to your home should take it out of the refrigerator and mix it in a saline solution. If unused, the diluted medication may go back in the refrigerator for up to 16 hours.
  • Tezepelumab (Tezpire®) – Store it in the refrigerator. Before use, bring it to room temperature. This takes about 60 minutes. It may be kept at room temperature for up to 30 days.
  • Tralokinumab (Adbry®) – Store it in the refrigerator. Before use, bring it to room temperatures. This takes about 30 minutes. It may be kept at room temperature for up to 14 days.

Are biologics dangerous for other people?  

Do not give your biologic medication to anyone else to take. It is prescribed specifically for you and your medical condition.

If someone at your home accidentally self-injects a biologic medicine, that person is at risk for the same side effects as people who are prescribed it. This includes minor side effects, as well as irritation at the injection site. It also includes potentially serious side effects such as a severe allergic reaction.

In the event of an accidental injection, call your doctor right away. If there’s a severe reaction, call 9-1-1 for an ambulance and request epinephrine be available. Or go to the nearest urgent care clinic or emergency department.

Biologic therapy can weaken the immune system. But a one-time accidental injection is unlikely to have a significant impact on this.

Tips for home administration of biologics

 Biologics are different from other medications. Injections can sometimes be difficult to self-administer at home. The needle itself can cause anxiety for many patients. Ask your doctor to demonstrate how to take your biologic at home so you can build confidence. Ask a family member to assist you.

Here are some tips to get you started:

1. Always clean the injection site

It’s important that the area of your injection is clean. You don’t want dirt or bacteria at the place of injection.

2. Ensure medication is at room temperature

Make sure your dose is at room temperature before you self-inject. Take your medication out of the refrigerator about 30 minutes (60 minutes for tezepelumab-ekko) before you use it. If you find it is a bit cold, use your hands to warm it up quicker.

3. Try numbing the injection site

Some patients find the injections to be uncomfortable or slightly painful. Use an ice cube on the injection site to help numb the area.

4. Don’t forget to breathe

Try your best not to tense your muscles. It’s helpful to take a deep breath when giving yourself the injection. This can help release any tension. It may make taking your biologics an easier experience.

5. Switch up the injection location

You can administer your biologic treatment in the same body location each time. It may help to switch up the injection site, so you don’t get scarring. It’s recommended you inject in either the upper arm, stomach or thigh area.

6. Keep a close eye for side effects

When you get a biologic injection at the doctor’s office, you are routinely monitored for side effects. At home, it’s just as important to pay attention to any side effects or changes in your body after taking a biologic. Tell your doctor about any side effects or changes that you experience.

If you’re feeling symptoms in multiple body systems, it could be a severe allergic reaction. Use epinephrine right away and seek medical care.