If you or your child has recently been prescribed Xolair for asthma treatment, you may be worried about its strict storage instructions.
Indeed, as your doctor or pharmacist must have warned you, Xolair prefilled syringes must be kept refrigerated and can only stay at room temperature for 48 hours.
Temperature conditions are essential for preserving your fragile medicine's efficiency. The success of your asthma treatment and, ultimately, your good health depend on it.
So, how exactly should you store your Xolair prefilled syringes at home? How to keep them cold while traveling? How to tell if they've gone bad?
Related article: Safety tips for traveling with mild or severe asthma.

What is Xolair? 

Xolair is an FDA-approved drug for treating moderate to severe allergic asthma, chronic hives, nasal polyps, and related conditions.
Its active ingredient, omalizumab, is a monoclonal antibody that works by neutralizing the action of the IgE. This protein is responsible for developing asthma and allergic reactions when produced in excess by the body.
Unlike most asthma medications, Xolair is not inhaled. Instead, it’s injected subcutaneously (under the skin). Depending on your needs and your doctor’s prescription, it is usually administered every 2 or 4 weeks. 
Xolair is available as prefilled syringes and lyophilized powder for reconstitution. The prefilled syringe is intended for at-home self-injection by the patients, whereas the lyophilized powder must be administered by a healthcare professional.
Xolair is a prescription drug only. Never use it without your doctor’s advice.

Xolair Storage Instructions 

Omalizumab, the active ingredient in Xolair, is a biological drug. Biological drugs, also called biologics or biopharmaceuticals, are made from living cells (immune system cells in the case of Xolair). They’re extremely fragile and unstable when not refrigerated. Refrigeration is often the only mean to stabilize them and guarantee they stay effective before use.
Similar biological injection drugs used to treat asthma and allergic conditions include Dupixent, Nucala, and Fasenra. All these medications, Xolair included, require specific storage conditions.
Related article: How long can Dupixent stay out of the fridge?

Xolair refrigeration 

According to Novartis Pharmaceuticals Corporation and Genentech, the co-manufacturers of Xolair, the prefilled syringes available for patient self-administration "should be stored in the refrigerator, between 36°F and 46°F (2°C and 8°C)” in their original packaging and protected from light.
You must also make sure your Xolair syringe does not freeze, which could occur if stored near the freezer compartment of your fridge or forgotten outside overnight. Freezing temperatures deteriorate the medicine, so never use Xolair that has frozen, even if it has thawed afterward.
Related article: At what temperature should you keep refrigerated medicines?
Injecting cold medicine can cause pain and discomfort at the injection site. Therefore, after taking a new syringe from the fridge, you may wait for 20 minutes until it warms up on its own at room temperature before the injection.

Xolair stability at room temperature

Xolair prefilled syringes for self-administration can only be left at room temperature for a maximum of 48 hours (unlike Dupixent, which can be left out for up to 14 days).
Manufacturers warn that the syringe should not be used after 48 hours out of the fridge. So, if that happens, you must throw your Xolair syringe away and get a new one from the refrigerator. 
By room temperature, you must understand any temperature below 77 ̊F (25 ̊C). In no case should Xolair be exposed to temperatures above that threshold. It risks quick deterioration and partial or total loss of efficiency, which could be dangerous for your health.
And that brings us to the following question: how do you keep your Xolair syringes cool (or refrigerated) away from home?

How to Keep Xolair Syringes Cool when not at home?

If your or your child’s next Xolair injection will occur during a holiday or time away from home, you must pay special attention to the temperature conditions in which you transport the syringes.
Two scenarios may happen:
  1. The next injection will occur in less than 48 hours.
In that case, you do not necessarily need to refrigerate your Xolair syringe (although it is still preferable). However, if the outside temperature is above 77 ̊F (25 ̊C), you must protect your injection from the heat.
A simple cooling bag like the Companion model from 4AllFamily would be ideal.

  1. The next injection will occur in more than 48 hours.

In that case, you must refrigerate your Xolair syringes while traveling. We recommend using a medical-grade travel fridge.


4AllFamily specializes in cooling solutions for refrigerated drugs like Xolair. Do not hesitate to reach out if you need help deciding which of our products would be best for you.

Related article: How to travel with refrigerated medication?

How to tell if Xolair has gone bad?

The liquid inside your Xolair syringe is supposed to look clear to pale-brownish yellow. Any signs of cloudiness, discoloration, or participles in it can indicate Xolair has gone bad. When in doubt, throw the syringe away and get a new one for the refrigerator.
Never use Xolair after the expiration date printed on the pen.
Related article: Does asthma affect Travel Insurance?

February 20, 2023

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