Nemluvio: Uses, Side Effects, Dosage, Cost, and More

Nemluvio (nemolizumab-ilto) is a prescription drug approved to treat certain skin conditions. Nemluvio comes in prefilled pens for giving as injections under the skin.

Specifically, Nemluvio is used to treat prurigo nodularis in adults. The drug is also used to treat moderate to severe atopic dermatitis in adults and children ages 12 years and older.

To learn more about Nemluvio’s uses, see the “Uses for Nemluvio” section.

Nemluvio basics

Nemluvio contains the active ingredient nemolizumab-ilto.

Nemluvio is a biologic medication. A biologic is made from parts of living organisms. Nemluvio is available only as a brand-name drug and not in a biosimilar form.

Biosimilars are like generic drugs. Just as generic drugs can be alternatives to brand-name medications, biosimilars are alternatives to biologics.

Biosimilars will have the same active ingredient core name as the brand-name drug, but with unique suffixes. This is why “-ilto” appears at the end of the name of Nemluvio’s active ingredient. This is to show it’s distinct from biosimilars that may be created in the future.

Nemluvio is used to treat certain skin conditions in adults and some children.

Nemluvio works to treat these skin conditions by targeting the immune system. This is its mechanism of action.

The immune system is the body’s natural defense against illness and infection. With certain skin conditions, the immune system can become overactive. This overactivity can lead to an increase in signals that cause inflammation, itching, and swelling. Nemluvio helps by blocking some of these signals, which results in reducing inflammation and easing symptoms.

Read on to learn more about the specific conditions Nemluvio is used to treat.

Prurigo nodularis

Nemluvio is approved for adults to treat prurigo nodularis, a long-term skin condition. Nemluvio is approved to be used as a standalone treatment for this condition.

With prurigo nodularis, intensely itchy bumps (called nodules) develop from repeatedly scratching the skin. These nodules can develop anywhere on the skin, and you may scratch, pick, or rub them. They can vary in color, size, and number. Sometimes they cause a burning or stinging sensation. The cause of the nodules and why they itch is not known.

Moderate to severe atopic dermatitis

Nemluvio is approved for adults and children ages 12 years and older to treat moderate to severe atopic dermatitis, a long-term skin condition. Nemluvio is approved to be used in combination with other medications. These include topical corticosteroids and calcineurin inhibitors.

This condition is a type of eczema. Nemluvio is typically prescribed when medications applied to the skin aren’t working well to manage symptoms of atopic dermatitis. It may also be prescribed for people who cannot tolerate other medications for atopic dermatitis.

The primary symptom of atopic dermatitis is itchy skin. Other symptoms may include dry skin and discolored skin (often redness). Sometimes the dry, itchy skin may flare up into rashes that can develop on any part of the body.

Atopic dermatitis typically develops in early childhood and resolves before adulthood. But it can continue into adulthood in certain people. The cause of atopic dermatitis is not known.

Like most drugs, Nemluvio may cause mild to serious side effects. The following lists contain some of the more common side effects Nemluvio may cause, but they don’t include all side effects possible.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Nemluvio. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you develop a side effect while using Nemluvio and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that Nemluvio can cause. These side effects can vary depending on the condition being treated. To learn about other mild side effects, talk with your doctor or pharmacist or read Nemluvio’s prescribing information.

Mild side effects in adults using Nemluvio for prurigo nodularis include:

• headache
• certain other skin conditions that include the following: eczema atopic dermatitis (a type of eczema) nummular eczema
• eczema
• atopic dermatitis (a type of eczema)
• nummular eczema

Mild side effects in adults and children using Nemluvio for atopic dermatitis include:

• headache, including migraine
• hives
• muscle aches
• joint pain

Mild side effects may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Nemluvio can occur, but they aren’t common. If you have serious side effects from Nemluvio, call your doctor right away. If you think you’re having a medical emergency, call 911 or your local emergency number.

Allergic reaction For some people, Nemluvio can cause an allergic reaction, as reported in the drug’s studies. In general, symptoms of an allergic reaction can be mild or serious. What might help If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They can also determine whether you should continue Nemluvio treatment. If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care. Your doctor can confirm whether you’ve had a serious allergic reaction to Nemluvio. If you have, they may switch you to a different treatment.

The Nemluvio dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Nemluvio to treat
• your age
• other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strength

Nemluvio comes in prefilled pens. Each pen contains the drug as a dry powder along with sterile water for mixing. Before use, the powder is dissolved to create a solution, which is then injected under the skin.

Nemluvio is available in only one strength of 30 milligrams (mg). After mixing, each prefilled pen contains 30 mg of the drug in 0.49 milliliters of sterile water (30 mg/0.49 mL).

Recommended dosages

Your doctor will prescribe the dosage of Nemluvio that’s right for you. Keep reading to learn more.

Before starting Nemluvio, it’s important to complete all age-appropriate vaccinations as recommended by your doctor.

Dosage for prurigo nodularis in adults

For treatment of prurigo nodularis, your doctor will likely prescribe a dosage based on your weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb).

Weight in kg Weight in lb Recommended dosage Less than 90 kg less than 198 lb • first dose: 60 mg given as two 30-mg injections

• later doses: 30 mg every 4 weeks

90 kg or more 198 lb or more • first dose: 60 mg given as two 30-mg injections

• later doses: 60 mg every 4 weeks

Dosage for atopic dermatitis in adults

For treatment of atopic dermatitis in adults, your doctor will likely prescribe the following dosage:

• initial dose: 60 mg given as two 30-mg injections
• later doses: 30 mg every 4 weeks

If Nemluvio works well in treating your atopic dermatitis, your doctor may reduce your dosage to 30 mg every 8 weeks after the initial 16-week period. They also may consider stopping your other topical treatments.

Children’s dosage

Nemluvio is used to treat atopic dermatitis in children ages 12 years and older.

The dosage used in children is the same as the dosage for adults. See the “Dosage for atopic dermatitis in adults” section for details.

How to inject

Your doctor will explain how you should inject Nemluvio. They’ll also explain how much to inject and how often. Be sure to follow your doctor’s instructions. Your doctor or another healthcare professional will show you how to give yourself these injections at home.

For children prescribed Nemluvio, a caregiver or an adult trained in administering Nemluvio should give the injections.

Nemluvio comes in prefilled pens. Each pen contains the drug as a dry powder along with sterile water for mixing. Before use, you dissolve the powder in the sterile water to create a solution. Then you inject it under the skin.

Recommended injection sites for Nemluvio include:

• front of the upper thigh
• abdomen (but avoid areas within 2 inches of the belly button)
• outer part of the upper arm (use this site only when the injection is given by a caregiver or trained adult)

When selecting an injection site, avoid areas of skin that are bruised, scarred, tender, or otherwise irritated. It’s also important to rotate injection sites to help prevent skin reactions.

In some cases, your healthcare professional may prescribe two Nemluvio pens to complete a full dose. After injecting with the first pen, use the second one immediately. Be sure to choose a different injection site that’s at least 1 inch from where you gave the first injection.

See Nemluvio’s instructions for use for detailed information about injecting the drug.

About using Nemluvio

The following are some common questions about using Nemluvio.

• What should I know about storing Nemluvio? You should store Nemluvio in its original container in the refrigerator at 36°F to 46°F (2°C to 8°C). Do not freeze the Nemluvio pen. Do not heat or put the Nemluvio pen in direct sunlight. Once you mix the Nemluvio powder and sterile water, you must inject it within 4 hours or dispose of it.
• How long can Nemluvio stay out of the refrigerator? Nemluvio can be kept at room temperature (up to 77°F or 25°C) for no more than 90 days. After that, dispose of it.
• What should I do if Nemluvio has been frozen? Do not use Nemluvio pens that have been frozen. Dispose of any frozen pens, and use a new one.
• Should I inject my Nemluvio dose with a meal? Nemluvio can be given without regard to meals.
• Is there a best time of day to inject Nemluvio? You can inject Nemluvio at any time of day, but it’s best to inject it on a consistent schedule. This helps keep a steady level of the drug in your body, which helps Nemluvio work effectively.
• What if I miss a dose of Nemluvio? If you miss a dose of Nemluvio, inject it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and inject the next dose at its usual time. You should not inject two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
• Will I need to use Nemluvio long term? Nemluvio is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely use it long term.

Nemluvio is not known to interact with other medications, herbs, supplements, foods, or alcohol. The manufacturer did not list any interactions in the drug’s prescribing information.

Before starting Nemluvio treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Whether or not you have health insurance, cost may be a factor when you’re considering Nemluvio. What you’ll pay for Nemluvio may depend on several things, such as your treatment plan and the pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may be eligible for the Galderma Patient Services for Nemluvio program.

The following is important information to consider and discuss with your doctor or pharmacist before using Nemluvio.

Pregnancy and Nemluvio

It’s not known whether Nemluvio is safe to use during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this drug.

Birth control and Nemluvio

It’s not known whether Nemluvio is safe to inject during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control options during Nemluvio treatment.

Nemluvio and breastfeeding

It’s not known whether Nemluvio should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this drug.

Before starting Nemluvio, discuss your health history with your doctor. Nemluvio may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• recent or scheduled vaccinations
• past allergic reaction to this or a similar drug
• pregnancy
• breastfeeding

Note: For more information about the potential negative effects of Nemluvio, see the “Side effects of Nemluvio” section.

The following drugs may be alternatives to Nemluvio for prurigo nodularis or atopic dermatitis. If you’d like to explore an alternative to Nemluvio, talk with your doctor. They can tell you about other medications that might work well for you.

Note that some of the drugs listed are used off-label for these conditions. This means that the drug is prescribed for a condition it isn’t approved to treat.

The following drugs are similar to Nemluvio and may be used to treat prurigo nodularis or atopic dermatitis:

• injectable biologics, including Dupixent (dupilumab)
• topical corticosteroids, such as: betamethasone Cortaid (hydrocortisone)
• betamethasone
• Cortaid (hydrocortisone)
• calcineurin inhibitors, such as: Elidel (pimecrolimus) Protopic (tacrolimus)
• Elidel (pimecrolimus)
• Protopic (tacrolimus)

Nemulvio (nemolizumab-ilto) and Dupixent (dupilumab) are biologic drugs approved to treat skin conditions. Both treat prurigo nodularis and atopic dermatitis. Dupxient also treats other conditions, including asthma and chronic obstructive pulmonary disease (COPD).

Both drugs work by targeting the immune system, which is the body’s natural defense against illness and infection. They help reduce the release of inflammatory signals that cause symptoms. But each drug blocks different inflammatory signals.

Due to blocking different signals, side effects differ between the two medications. Side effects commonly reported in people using Nemluvio to treat atopic dermatitis include:

• headache
• hives
• muscle aches

Side effects commonly reported in people using Dupixent for atopic dermatitis include:

• injection site reaction
• itchy eyes
• dry eyes

For more information about either drug, talk with your doctor or pharmacist.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.