Xolair is a drug approved for treating asthma, hives, and chronic rhinosinusitis with nasal polyps. Xolair is also approved to reduce the risk of allergic reactions from accidental exposure to food allergens.

The Food and Drug Administration (FDA) approved Xolair to treat allergic asthma, chronic hives, and chronic rhinosinusitis with nasal polyps in certain people. The FDA also approved Xolair to reduce the risk of allergic reactions, including anaphylaxis, due to accidental exposure to multiple food allergens.

This article looks at what Xolair is and how it may help in the treatment of food allergies.

Several clear glass food storage containers are stacked one on top of the other and contain nuts, seeds, and legumes.Share on Pinterest
Yuliya Pinkasevich/Getty Images

Xolair is a brand-name drug approved for the treatment of asthma, hives, and chronic rhinosinusitis with nasal polyps. Xolair has been available in the United States since 2003.

In February 2024, the FDA also approved Xolair for reducing the risk of type 1 allergic reactions, including anaphylaxis. Xolair may help prevent allergic reactions from accidental exposure to multiple food allergens.

Xolair comes as a subcutaneous injection that you self-inject every 2 to 4 weeks, depending on your reason for using the medication. Xolair is a biologic medication that contains the active ingredient omalizumab, which is a monoclonal antibody.

Xolair is not available in a biosimilar form. Biologic medications are made from living cells. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug).

It’s not possible to make an exact copy of a biologic. A generic drug, on the other hand, is an exact copy of the active drug in a brand-name medication. A generic drug is made from chemicals.

Biosimilars are considered just as safe and effective as their parent drugs. And, like generics, biosimilars tend to cost less than brand-name medications.

Xolair works by binding to immunoglobulin E (IgE), the type of antibody that causes allergic reactions. This prevents IgE from binding to receptors, which stops the release of chemicals that would cause an allergic reaction.

Xolair may help reduce the risk of a severe allergic reaction from accidental exposure to an allergen, such as through cross contamination.

Xolair and food allergy research

In one 2024 study, researchers looked at the effects of omalizumab in people with multiple food allergies. The study involved 180 participants ages 1 year through 55 years who had allergies to peanuts and at least two of the other foods within the trial, which were:

  • cashews
  • walnuts
  • hazelnuts
  • eggs
  • milk
  • wheat

The researchers divided the participants into 2 groups to receive either omalizumab or a placebo injection every 2 to 4 weeks over the course of 16 to 20 weeks.

The results showed that omalizumab was more effective than the placebo at reducing allergic reactions to food allergens.

In the omalizumab group, 67% of participants were able to ingest peanut protein in a single dose of 600 milligrams (mg) or more without allergic reaction symptoms, while only 7% of those in the placebo group could. Results were similar for the other allergens included in the study.

The occurrence of adverse events was similar in both groups, although the research does not specify what events these were. There were more injection-site reactions in people who received omalizumab than in those who received the placebo.

Xolair does not prevent allergic reactions completely, and it is not an emergency treatment. You’ll still need to avoid ingesting known allergens and keep an epinephrine auto-injector pen on hand for emergency treatment.

Xolair may cause a range of mild to serious side effects, such as:

There is also a risk of anaphylaxis with injecting Xolair. You’ll need to have the initial treatments under the supervision of a doctor in case of anaphylaxis.

Other considerations with Xolair

Xolair may not be suitable for you if you have a history of severe hypersensitivity to any of the medication’s ingredients.

Research has found cases of cancer in some people who received Xolair treatment.

There have also been cases of heart and circulation problems in people who have used Xolair, although the exact cause is unclear.

Xolair is a long-term treatment that you’ll need to keep using in order to benefit from its effects. You’ll need to take Xolair on a regular dosing schedule, every 2 to 4 weeks, depending on your reason for using it.

The cost of Xolair for food allergies may depend on various factors, such as whether you have insurance coverage, your treatment plan and dosage, and the pharmacy you use to fill your prescription.

You may be eligible for financial assistance programs to help you pay for Xolair. You can find details on the Xolair website.

For more information on the cost of Xolair, you can talk with your doctor, pharmacist, or insurance carrier (if you have one).

Xolair is available as a food allergy treatment for adults and children ages 1 year and older.

If you’re interested in using Xolair to help manage food allergies, you can talk with a doctor, such as an allergist. You may want to discuss the potential risks and benefits of the medication, the costs, and how to take it.

Your doctor can also evaluate your medical history and overall health to check for possible risk factors, such as a previous allergic reaction to the ingredients in Xolair.

Xolair is a drug prescribed to treat allergic asthma, chronic hives, and chronic rhinosinusitis with nasal polyps. In February 2024, the FDA also approved Xolair to reduce the risk of allergic reactions, including anaphylaxis, from accidental exposure to multiple food allergens.

Xolair may cause side effects — most commonly injection-site reactions and fever. One possible severe side effect is anaphylaxis. A doctor may monitor your first few doses to minimize the risk of anaphylaxis.

If you’re interested in using Xolair to help manage food allergies, you can talk with a doctor or allergist.