Nemolizumab at a glance
Medicine class
Humanised monoclonal antibody targeting interleukin-31 receptor alpha
How it is given
Injection under the skin using a single-use pre-filled pen
Self-administration
Possible after assessment and training by a healthcare professional
Safety monitoring
Subject to additional monitoring; suspected adverse reactions should be reported
What is Nemolizumab used for?
Nemolizumab is licensed for:
Moderate-to-severe atopic dermatitis in adults and adolescents aged 12 years or older who weigh at least 30 kg and are candidates for systemic therapy. The licence specifies use with topical corticosteroids and/or topical calcineurin inhibitors.
Moderate-to-severe prurigo nodularis in adults who are candidates for systemic therapy.
How does Nemolizumab work?
Interleukin-31 is involved in itch, inflammation and impaired skin-barrier function. Nemolizumab binds selectively to its receptor alpha subunit and reduces this signalling. Its complete mechanism has not been definitively established.
Nemolizumab preparations and strengths
Injection
Route: Parenteral
Strengths: 30 mg
How to take Nemolizumab
Nemolizumab is injected under the skin using the supplied pen. Self-injection or caregiver administration should begin only after appropriate training.
Use the front of the thigh or abdomen, avoiding the area around the navel. A caregiver or healthcare professional may use the upper arm.
Rotate sites. Avoid tender, inflamed, swollen, damaged, bruised or scarred skin and open wounds.
Follow the in-pack preparation instructions. Do not use a solution that is cloudy, unusually coloured or contains particles.
Do not expose the pen to heat or direct sunlight. Follow the product instructions about shaking.
Put the used pen promptly into an appropriate sharps container.
Nemolizumab side effects
Common or expected effects
- Headache, reported in prurigo nodularis studies
- Hives, reported in atopic dermatitis studies
- New or worsened eczematous skin reactions, reported in prurigo nodularis studies
Get urgent medical advice
- Breathing difficulty, facial or airway swelling, fainting or severe dizziness may indicate a serious allergic reaction
- Facial, lip, mouth, throat or tongue swelling may be angioedema
- New large or fluid-filled blisters may indicate bullous pemphigoid and need prompt medical assessment
Nemolizumab in pregnancy
Experience during pregnancy is limited. UK product information advises avoiding nemolizumab as a precaution unless the prescriber considers it appropriate. Discuss pregnancy or plans to conceive with the specialist team.
Nemolizumab while breastfeeding
It is unknown whether nemolizumab enters human milk. Transfer of IgG antibodies may be greatest during the first few days after birth, when risk to the newborn cannot be excluded. The prescriber should assess the timing of breastfeeding, clinical need and treatment uncertainties.
Nemolizumab interactions
No clinically significant effect on medicines processed by the main cytochrome P450 pathways was found in a small study. Vaccination plans still require review.
Live vaccines
Avoid during treatment because their safety and effectiveness with nemolizumab are unknown.
Non-live vaccines
Response data are unavailable, so vaccination status should be reviewed before treatment where possible.
CYP450 substrates, including warfarin, midazolam, omeprazole, metoprolol and caffeine
Clinically significant changes in exposure were not observed, and a pharmacokinetic interaction is not expected.
Common questions about Nemolizumab
Answers are fully visible for fast scanning and source review.
Is nemolizumab a steroid?
No. It is a targeted monoclonal antibody that blocks signalling through the interleukin-31 receptor.
Can adolescents use nemolizumab?
The atopic dermatitis indication includes adolescents aged 12 years or older who weigh at least 30 kg. The prurigo nodularis indication is for adults.
Can nemolizumab be self-injected?
Yes, if a healthcare professional considers it appropriate and the patient or caregiver has received practical training.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.