Table 5 Summary of AAAAI/ACAAI OJTF Recommendations

Informed consent should be obtained from the patient after discussing the risks, benefits, and alternatives to Xolair (omalizumab).

The patient should be educated regarding the signs, symptoms, and treatment of anaphylaxis.

Patients should be prescribed and educated on the proper use of the epinephrine autoinjector and advised to carry this before Xolair (omalizumab) administration and for the next 24 hours after Xolair (omalizumab) administration.

An assessment of the patient's current health status should be made before each injection to determine whether there were any recent health changes that might require withholding treatment. This assessment should include vital signs and some measure of lung function (eg, peak expiratory flow or FEV₁).

The OJTF recommends that patients be kept under observation for 30 minutes after each injection. This time should be extended for 2 hours for the first 3 injections based on the data reviewed by the OJTF as well as suggested in the 2007 National Heart, Lung, and Blood Institute Expert Panel Report 3 "Guidelines for the diagnosis and management of asthma." However, this could be modified based on a physician's clinical judgment after discussing risks with the patient.