A 35-year-old woman with chronic spontaneous urticaria remains symptomatic despite fourfold updosing of second-generation antihistamines. She is started on omalizumab. What is the standard recommended dose and interval for this indication?

• A 150 mg every 4 weeks
• B 300 mg every 4 weeks ✓
• C 300 mg every 2 weeks
• D 600 mg every 4 weeks

Explanation

For chronic spontaneous urticaria refractory to antihistamines, the standard dose of omalizumab is 300 mg subcutaneously every 4 weeks. Dosing for asthma is calculated based on weight and serum IgE levels, but the CSU indication uses a fixed 300 mg dose regardless of these parameters. The 150 mg dose is used for some asthma patients, and 600 mg is not a standard approved dose.

Reference: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

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