Anti-TSLP (thymic stromal lymphopoietin) monoclonal antibody — broad-phenotype biologic Pregnancy: No or limited data (fewer than 300 pregnancy outcomes) in pregnant women; animal studies do not indicate reproductive toxicity. Human IgG antibodies such as tezepelumab cross the placenta, so it may be transmitted from mother to foetus — as a precautionary measure it is preferable to avoid use during pregnancy unless the expected benefit to the mother is greater than any possible risk to the foetus. Breast-feeding: excretion in human milk unknown; a risk to the breast-fed child cannot be excluded in the first few days after birth, after which it could be used if clinically needed.

Tezepelumab

Brand names: Tezspire (210 mg/1.91 mL prefilled syringe)

Tezepelumab is a human monoclonal antibody given by subcutaneous injection that targets thymic stromal lymphopoietin (TSLP), used as add-on maintenance therapy for severe asthma.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 210 mg tezepelumab

Route: Subcutaneous injection (thigh or abdomen, excluding the 5 cm around the navel; the upper arm may also be used if given by a healthcare professional or caregiver — a patient should not self-inject in the arm)

Frequency: Every 4 weeks

eMC SPC §4.2 (Tezspire). Asthma — adults and adolescents aged 12 years and older: the recommended dose is 210 mg of tezepelumab by subcutaneous injection every 4 weeks. CRSwNP (chronic rhinosinusitis with nasal polyps) — adults: 210 mg by subcutaneous injection every 4 weeks. Treatment should be initiated by physicians experienced in the diagnosis and treatment of the indicated conditions. Intended for long-term treatment; a decision to continue should be made at least annually based on the patient's level of disease control. Missed dose: administer as soon as possible, then resume the scheduled day; if the next dose is already due, administer as planned; a double dose must not be administered. Elderly (65 years and over): no dose adjustment. Renal and hepatic impairment: no dose adjustment. Paediatric: safety and efficacy in children under 12 years for asthma have not been established (no data); safety and efficacy in children under 18 years for CRSwNP have not been established (no data). The 210 mg dose is a fixed dose and is not weight-based, so no per-kg paediatric dose is recorded. §4.4: should not be used to treat acute asthma exacerbations; do not discontinue corticosteroids abruptly on initiation. No maximum dose beyond the stated regimen is given in §4.2.

Dose adjustments

Renal

No dose adjustment is required for patients with renal or hepatic impairment

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Pharyngitis (common; 4.1% in asthma, 5.4% in CRSwNP)
Arthralgia (common; 3.8% in asthma)
Rash (common)
Injection site reactions — e.g. injection site erythema, swelling, pain (common; 3.8% with 210 mg every 4 weeks in pooled PATHWAY/NAVIGATOR data)
Hypersensitivity including anaphylactic reaction (frequency not known)

Interactions

No formal drug interaction studies have been performed with tezepelumab (US labelling §7 — verify against UK SPC; eMC §4.5 was not retrieved in this bundle)

Clinical monograph

How it works

It binds TSLP, an upstream epithelial cytokine, and blocks its interaction with its receptor, interrupting multiple downstream inflammatory pathways irrespective of asthma phenotype.

Prescribing in practice

It is an add-on preventer for severe asthma and must not be used to treat acute bronchospasm or exacerbations; usual inhaled therapy must continue.
Hypersensitivity reactions can occur, and treatment is initiated within specialist severe-asthma services per NICE guidance.
Treat any pre-existing helminth infection before starting, and avoid administering live vaccines during treatment without specialist advice.

Monitoring

Monitor asthma control and exacerbation frequency, and observe for hypersensitivity reactions after administration.

Counselling the patient

This injection helps prevent asthma attacks over time and is not a rescue treatment.
Keep taking your usual inhalers and reliever.
Report any rash, swelling or breathing difficulty after a dose.

Evidence & guidelines

The NAVIGATOR trial showed that tezepelumab reduces exacerbations across a broad severe-asthma population, supporting NICE-recommended add-on use.

Reference: NICE TA954 (2024); NAVIGATOR Trial (Menzies-Gow et al, NEJM 2021); SOURCE Trial; GINA 2024; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways