Is Xolair (omalizumab) supposed to cause significant fatigue and lack of motivation?

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Last updated: June 16, 2025View editorial policy

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From the FDA Drug Label

The most common side effects of XOLAIR: In adults and children 12 years of age and older with asthma: joint pain especially in your arms and legs, dizziness, feeling tired, itching, skin rash, bone fractures, and pain or discomfort of your ears

Xolair may cause fatigue as one of its common side effects, which could potentially lead to a lack of motivation. According to the drug label, feeling tired is listed as one of the most common side effects of Xolair in adults and children 12 years of age and older with asthma 1.

From the Research

Fatigue and lack of motivation are not typical primary effects of Xolair (omalizumab), and if you're experiencing significant symptoms, you should report them to your healthcare provider for evaluation. While some patients do experience fatigue during treatment with Xolair, it typically affects less than 10% of users and is usually mild to moderate in severity 2. The most common side effects of Xolair include injection site reactions, viral infections, upper respiratory infections, sinusitis, headache, and sore throat. Some studies have reported cases of serum sickness-like reactions in patients treated with omalizumab, which can include symptoms such as fatigue, fever, and arthralgia 2. However, these reactions are rare and not typically associated with long-term use of the medication. In fact, a study published in 2017 found that continuation of omalizumab after long-term treatment results in continued benefit, as evidenced by improved symptom control and reduced exacerbation risk 3. If you're experiencing significant fatigue or lack of motivation while taking Xolair, your doctor might consider adjusting your treatment plan if these side effects are significantly impacting your quality of life. It's also important to note that Xolair works by binding to IgE antibodies in your bloodstream, preventing them from triggering allergic reactions, and this mechanism is not typically associated with causing severe fatigue or motivational issues as primary effects. Key points to consider:

  • Fatigue is not a common primary effect of Xolair
  • Significant fatigue and lack of motivation should be reported to your healthcare provider
  • Xolair can cause rare serum sickness-like reactions, which may include fatigue
  • Long-term use of Xolair can result in continued benefit and improved symptom control
  • Your doctor may adjust your treatment plan if side effects are impacting your quality of life.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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