Allergy and Immunology Medications

Each medication is approved for its own conditions, and the prescriber decides which fits the patient:

• Allergic asthma, moderate to severe and persistent: Xolair, for patients 6 years and older with a positive skin or blood test to a year-round airborne allergen.
• Severe eosinophilic asthma (asthma linked to high eosinophil levels, a type of white blood cell): Nucala (mepolizumab) and Fasenra (benralizumab), for patients 6 years and older.
• Moderate to severe eosinophilic or oral-steroid-dependent asthma: Dupixent (dupilumab), for patients 6 years and older.
• Severe asthma: Tezspire (tezepelumab-ekko), for patients 12 years and older.
• Chronic rhinosinusitis with nasal polyps: Xolair, Nucala, Tezspire and Dupixent.
• Chronic spontaneous urticaria with symptoms despite H1 antihistamines: Xolair, from age 12, and Dupixent, from age 2.
• IgE-mediated food allergy: Xolair, from age 1, to reduce allergic reactions, including anaphylaxis, after accidental exposure, alongside avoiding the food; it is not an emergency treatment.
• Eosinophilic esophagitis and allergic fungal rhinosinusitis: Dupixent.
• Primary humoral immunodeficiency (PI), including common variable immunodeficiency (CVID): immune globulin replacement, given intravenously (IVIG) as Gammagard Liquid, Gammagard S/D, Gamunex-C, Gammaked, Octagam 5%, Panzyga or Privigen, or subcutaneously (SCIG) as Hizentra, Xembify, HyQvia, Gammagard Liquid or Gamunex-C. See IVIG for primary immunodeficiency.

None of the asthma biologics is for sudden breathing problems. Each medication has its own page, linked from the list at the end of this page.

Xolair, Nucala, Fasenra and Tezspire are subcutaneous injections given by a healthcare professional or, after training, by the patient or a caregiver; Dupixent is self-injected after training. MedRx delivers them to the patient's door at no charge, and a nurse can teach the injection technique.

Xolair's label carries a boxed warning about anaphylaxis, a severe allergic reaction that can follow any dose, and treatment starts in a healthcare setting. After at least three doses without a serious allergic reaction, the prescriber may allow the patient or a caregiver to give Xolair at home. The prescriber determines where each injection is given.

Immune globulin for PI can be given at home when the prescriber approves it. For IVIG, MedRx sends a skilled, trusted and licensed nurse from an accredited nursing agency to administer the infusion and monitor vital signs and adverse reactions. SCIG is infused under the skin with a small pump, and the nurse trains the patient or a caregiver to give it. See IVIG at home and SCIG at home.

1. The prescriber's office faxes the prescription to (844) 671-2601 or calls (844) 671-2600, with recent clinical notes and laboratory results.
2. For the asthma and allergy biologics, the office uses the Allergy and asthma referral form (PDF), which asks for the number of exacerbations in the past 12 months and a negative TB test date.
3. For immune globulin, it uses the Immunoglobulin referral form (PDF), which asks whether the patient has had IVIG or SCIG before and lets the prescriber name a brand or leave the choice to a MedRx pharmacist. Every form is also on Quick Referral.
4. MedRx's intake team confirms the patient's coverage and requests prior authorization where the plan requires it.
5. Medications are delivered to the patient's door at no charge. Next-day delivery is available; timing varies by location.
6. A MedRx pharmacist is available 24 hours a day, 7 days a week. MedRx's pharmacists include Ig Certified Pharmacists (IgCP), certified in immune globulin therapy.

Health plans commonly ask for prior authorization before covering asthma biologics and immune globulin. MedRx's intake team works through that approval with the prescriber's office before anything ships.

For patients facing high out-of-pocket costs, MedRx helps find and apply for copay assistance, grants and other aid. The manufacturers' programs include the Xolair Co-pay Program, Tezspire Together, Fasenra 360, Together with Nucala and Dupixent MyWay, and, for immune globulin, programs such as Hizentra Connect and Takeda Patient Support.

• Asthma, nasal polyps and chronic hives: Xolair, Nucala, Fasenra, Tezspire and Dupixent.
• Immune globulin for primary immunodeficiency: Gammagard Liquid, Gamunex-C, Octagam, Panzyga, Privigen, Hizentra, Xembify and HyQvia.

Each has its own page: what it is approved for, how it is given, and how to start. See every medication we fill.