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This information outlines critical safety considerations for the use of Nucala (mepolizumab). It is important to read and understand these warnings, and consult your healthcare provider if you have any questions or concerns.

• Allergic Reactions: Nucala (mepolizumab) has the potential to cause severe allergic reactions, such as hives, wheezing, breathing difficulties, or swelling of the face, mouth, tongue, or throat (anaphylaxis). These reactions may occur within hours or even days after administration. Therefore, initial treatments should be conducted under medical supervision, with close monitoring following each dose to ensure no serious reactions occur. If you experience any symptoms of an allergic reaction outside a healthcare facility, seek emergency medical help immediately by calling 911.

• Not for Acute Asthma Attacks: Nucala (mepolizumab) is designed to be an adjunctive maintenance therapy for asthma, meant to be used alongside other asthma medications for long-term management. It is not suitable for treating acute asthma attacks; for immediate relief during an asthma attack, use a rescue inhaler such as albuterol.

• Corticosteroid Use: If you are on oral or inhaled corticosteroids, do not abruptly discontinue them without consulting your healthcare provider, even if you notice improvements with Nucala (mepolizumab). Stopping corticosteroids suddenly can lead to withdrawal symptoms such as dizziness, extreme fatigue, body aches, and vomiting. Your healthcare provider will guide you on how to safely reduce or discontinue corticosteroid use if necessary.

• Infection Risk: There is a rare risk of developing herpes zoster (shingles) while on Nucala (mepolizumab). Discuss with your healthcare provider whether you should receive the herpes zoster vaccine (Shingrix) before starting this medication.

Nucala (mepolizumab) is a medication used to treat certain inflammatory conditions, including severe eosinophilic asthma. Generally, Nucala does not have known interactions with other medications, supplements, or alcohol. However, it's important to be aware of specific considerations:

• Vaccines: Nucala may reduce the effectiveness of certain vaccines, such as the cholera and COVID-19 vaccines. This is because Nucala can weaken the immune system, leading to a lower-than-desired response to these vaccines. Your doctor may recommend receiving these vaccines before starting Nucala treatment. Additionally, cases of shingles (herpes zoster) have been reported in individuals using Nucala. Therefore, your doctor might suggest getting the shingles vaccine prior to beginning Nucala therapy.

• Parasitic Infections: If you have a parasitic (helminth) infection, it's important to inform your healthcare provider before starting Nucala. Nucala may make it harder for your body to fight off certain infections called helminth infections. If you have this type of infection, you should have it treated before starting Nucala. If you get this type of infection while taking Nucala, your healthcare provider will consider stopping Nucala until the infection gets better.

• Alcohol: While there are no known direct interactions between Nucala and alcohol, consuming alcohol may worsen some side effects of Nucala, such as headache and fatigue. If you drink alcohol, your doctor may advise you to avoid or limit it during Nucala treatment.

It's essential to inform your healthcare provider about all medications, supplements, and vaccines you are currently using or plan to use. This ensures that any potential interactions are identified and managed appropriately. Always consult your doctor or pharmacist before making any changes to your medication regimen.