Tralokinumab
Brand names: Adtralza
Tralokinumab is a fully human monoclonal antibody used as a subcutaneous biologic treatment for moderate-to-severe atopic dermatitis (eczema) in patients inadequately controlled by topical therapy.
Adult dose
Dose adjustments
No dose adjustment is needed in patients with renal impairment; very limited data are available in severe renal impairment. No dose adjustment is needed in 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
- Upper respiratory tract infections — very common (23.4%), mainly reported as common cold
- Injection site reactions — common (7.2%)
- Conjunctivitis — common (5.4%)
- Allergic conjunctivitis — common (2.0%)
- Eosinophilia — common
- Keratitis — uncommon
Interactions
- Live and live attenuated vaccines should not be given concurrently — clinical safety and efficacy have not been established; bring patients up to date with live/live attenuated immunisations before initiating treatment
- Inactivated / non-live vaccines may be given concurrently — antibody responses to tetanus and meningococcal vaccines were similar to placebo, with no adverse interactions noted
Clinical monograph
How it works
It specifically binds the cytokine interleukin-13 (IL-13), preventing it from engaging its receptors and thereby dampening the type 2 inflammatory signalling that drives atopic dermatitis.
Prescribing in practice
- Live vaccines should be avoided during treatment because of the immunomodulatory effect; ensure age-appropriate immunisations are up to date beforehand.
- Conjunctivitis and keratitis are recognised adverse effects; advise patients to report new or worsening eye symptoms.
- Reserve for moderate-to-severe disease in line with NICE criteria, and review response after an adequate trial as set out in current prescribing references.
Monitoring
Assess clinical response (such as disease severity scores) periodically and monitor for ocular adverse effects and signs of hypersensitivity.
Counselling the patient
- This is a long-term injection given under the skin; you may be taught to self-inject at home.
- Tell your clinician promptly if you develop sore, red or watery eyes.
- Continue your usual emollients and any prescribed topical treatments unless advised otherwise.
Evidence & guidelines
NICE has issued technology appraisal guidance supporting tralokinumab for moderate-to-severe atopic dermatitis where conventional systemic therapy is inadequate or unsuitable.
Reference: ECZTRA-3 Trial (Wollenberg et al. NEJM 2021); NICE TA869; SPC Adtralza; 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).
Related
Curated clinical cross-links plus same-class fallbacks.
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- DLQI — Dermatology Life Quality Index · Diagnosis
- EASI — Eczema Area and Severity Index · Diagnosis
- EASI Score (Eczema Area and Severity Index) · Atopic Dermatitis
- SCORAD — SCORing Atopic Dermatitis · Eczema / Atopic Dermatitis
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD