What is Benralizumab: Uses, Dosage, Side Effects and More

Benralizumab is a prescription medication that helps people with severe asthma breathe easier by targeting specific immune cells that cause inflammation in the airways. This injectable medicine belongs to a class of drugs called monoclonal antibodies, which work like guided missiles to find and block the cells responsible for your asthma symptoms.

If you're dealing with severe asthma that doesn't respond well to traditional inhalers, your doctor might suggest benralizumab as an add-on treatment. It's designed for people whose asthma is driven by high levels of certain white blood cells called eosinophils.

What is Benralizumab?

Benralizumab is a biologic medication that specifically targets and reduces eosinophils, a type of white blood cell that can make asthma symptoms worse. Think of eosinophils as overzealous security guards in your airways that create too much inflammation when they're trying to protect you.

This medication is given as a subcutaneous injection, which means it's injected just under the skin, similar to how people with diabetes give themselves insulin shots. The injection is typically given in your upper arm, thigh, or abdomen.

Benralizumab is what doctors call a "targeted therapy" because it doesn't affect your entire immune system. Instead, it focuses on one specific pathway that contributes to severe asthma symptoms.

What is Benralizumab Used For?

Benralizumab is primarily used to treat severe eosinophilic asthma in adults and children 12 years and older. Your doctor will likely recommend this medication if your asthma isn't well-controlled despite using high-dose inhaled corticosteroids plus another controller medication.

The medication is specifically helpful for people who have what's called "eosinophilic asthma," where blood tests show elevated levels of eosinophils. These cells can cause persistent inflammation in your airways, making it harder to breathe and increasing your risk of asthma attacks.

Sometimes doctors also prescribe benralizumab for a related condition called eosinophilic granulomatosis with polyangiitis (EGPA), a rare autoimmune disease that can affect multiple organs including the lungs.

How Does Benralizumab Work?

Benralizumab works by blocking a protein called interleukin-5 receptor, which is like a docking station that eosinophils use to receive signals. When this medication blocks these receptors, it prevents eosinophils from getting the messages they need to survive and multiply.

This is considered a strong and targeted medication because it doesn't just suppress symptoms temporarily. Instead, it actually reduces the number of eosinophils in your blood and tissues, which can lead to less inflammation in your airways over time.

The effects of benralizumab can last for several weeks after each injection, which is why you don't need to take it daily like traditional asthma medications. Most people start seeing improvements in their asthma symptoms within a few weeks to a few months of starting treatment.

How Should I Take Benralizumab?

Benralizumab is given as a subcutaneous injection every 4 weeks for the first three doses, then every 8 weeks after that. Your healthcare provider will teach you how to give yourself the injection at home, or you can have it administered at your doctor's office.

Before injecting, let the medication come to room temperature by taking it out of the refrigerator about 30 minutes beforehand. This helps reduce any discomfort from the injection. You can inject it into your upper arm, thigh, or abdomen, rotating injection sites each time.

You don't need to take benralizumab with food or avoid eating before your injection. However, you should continue taking your other asthma medications as prescribed, since benralizumab is meant to work alongside your existing treatment plan, not replace it.

Always wash your hands thoroughly before handling the injection, and never shake the medication. If you notice any particles or discoloration in the solution, don't use it and contact your pharmacy for a replacement.

How Long Should I Take Benralizumab For?

Most people take benralizumab for an extended period, often years, as long as it continues to help control their asthma symptoms. Your doctor will typically evaluate how well the medication is working after about 4 to 6 months of treatment.

If you're experiencing significant improvement in your asthma control, fewer symptoms, and reduced need for rescue medications, your doctor will likely recommend continuing benralizumab. Some people find they can reduce their other asthma medications while taking benralizumab.

The decision to stop benralizumab depends on several factors, including how well your asthma is controlled, any side effects you might experience, and your overall health status. Never stop taking benralizumab suddenly without discussing it with your doctor first.

What Are the Side Effects of Benralizumab?

Like all medications, benralizumab can cause side effects, though many people tolerate it well. The most common side effects are generally mild and manageable.

Here are the side effects you're most likely to experience:

• Headache, which affects about 1 in 10 people
• Sore throat or throat irritation
• Injection site reactions like redness, swelling, or mild pain
• Fever, particularly in the first few days after injection
• Back pain or muscle aches

These common side effects usually improve on their own within a few days and rarely require stopping the medication.

More serious but less common side effects can include severe allergic reactions, which might cause difficulty breathing, swelling of your face or throat, or widespread rash. If you experience any of these symptoms, seek immediate medical attention.

Some people might also experience increased susceptibility to infections, since benralizumab affects part of your immune system. Watch for signs of infection like persistent fever, unusual fatigue, or symptoms that don't improve as expected.

Very rarely, some people might develop a condition called hypereosinophilic syndrome, where eosinophil levels become dangerously high. This is more likely to occur in people with underlying parasitic infections, so your doctor will check for these before starting treatment.

Who Should Not Take Benralizumab?

Benralizumab isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. You shouldn't take this medication if you've had a severe allergic reaction to benralizumab or any of its ingredients in the past.

People with active parasitic infections should not start benralizumab until the infection is completely treated. The medication can interfere with your body's ability to fight off certain types of parasites, potentially making the infection worse.

If you're pregnant or breastfeeding, discuss the risks and benefits with your doctor. While there's limited data on benralizumab use during pregnancy, it may cross the placenta and could potentially affect your baby's immune system.

Children under 12 years old should not take benralizumab, as its safety and effectiveness haven't been established in this age group. Your doctor will also be cautious about prescribing it if you have a history of certain autoimmune conditions.

People with compromised immune systems or those taking other medications that suppress immunity may need special monitoring or might not be good candidates for benralizumab treatment.

Benralizumab Brand Names

Benralizumab is sold under the brand name Fasenra in most countries, including the United States, Canada, and Europe. This is the only brand name currently available for this medication.

Fasenra comes in pre-filled syringes and auto-injector pens, making it easier for you to self-administer at home. The medication is manufactured by AstraZeneca and requires a prescription from your doctor.

Currently, there are no generic versions of benralizumab available, which means Fasenra is the only option if your doctor prescribes this medication.

Benralizumab Alternatives

If benralizumab isn't right for you, several other biologic medications can help treat severe asthma. Your doctor might consider mepolizumab (Nucala) or reslizumab (Cinqair), which also target eosinophils but work slightly differently.

For people whose asthma isn't specifically eosinophilic, other options include omalizumab (Xolair), which targets IgE antibodies, or dupilumab (Dupixent), which blocks different inflammatory pathways.

Non-biologic alternatives might include higher doses of inhaled corticosteroids, long-acting bronchodilators, or oral medications like montelukast or theophylline. Your doctor will help determine which approach is best based on your specific type of asthma and medical history.

Sometimes a combination of treatments works better than any single medication, so your doctor might adjust your entire treatment plan rather than simply switching from one biologic to another.

Is Benralizumab Better Than Mepolizumab?

Both benralizumab and mepolizumab are effective treatments for severe eosinophilic asthma, but they work in slightly different ways. Benralizumab tends to reduce eosinophil levels more dramatically and for longer periods between doses.

The main advantage of benralizumab is that you only need injections every 8 weeks after the initial loading doses, while mepolizumab requires injections every 4 weeks. This might make benralizumab more convenient for some people.

Studies suggest that both medications are similarly effective at reducing asthma attacks and improving lung function. However, some people might respond better to one medication than the other based on their individual immune system characteristics.

Your doctor will consider factors like your injection preference, insurance coverage, and how your body has responded to previous treatments when deciding between these options. Neither medication is universally "better" – it depends on what works best for your specific situation.