Sotrovimab (Xevudy)

What is sotrovimab?

Sotrovimab, known by the brand name Xevudy, is a biological medicine known as a neutralising monoclonal antibody (nMAb). It is a synthetic protein designed to mimic the immune system’s natural antibodies. It specifically targets the spike protein of the SARS-CoV-2 virus (which causes COVID-19), preventing the virus from entering human cells and causing infection[1].  

If you are eligible for COVID-19 treatment, you will likely be offered an antiviral called Paxlovid as a first treatment, but if it’s not suitable for you, you may be offered sotrovimab. It's given to you through a drip, usually in your arm (infusion). It will be given in hospital or at a local centre[1]. 

What is sotrovimab used for?

Sotrovimab is used to treat symptomatic, mild to moderate COVID-19 in adults and adolescents (aged 12 and over, weighing at least 40kg) who are at high risk of developing severe illness[1]. 

How does sotrovimab work?

Sotrovimab binds to the spike protein on the surface of the coronavirus. This blocks the virus from entering lung cells, reducing the risk of severe illness. It also helps the immune system clear the virus more effectively[1]. 

Who can take sotrovimab?

You may be eligible for treatment with sotrovimab if you meet certain criteria. It may be prescribed if you[1]: 

• Are 12 years or older and weigh at least 40kg 

• Have tested positive for COVID-19 

• Have had symptoms for 5 days or fewer 

• Are in a high-risk group, such as those with: 

• Down’s syndrome 

• Certain cancers or blood disorders 

• Chronic kidney disease (stage 4 or 5) 

• Certain lung conditions 

• Autoimmune or neurological conditions like HIV, AIDS, multiple sclerosis, muscular dystrophy, motor neurone disease, myasthenia gravis, Huntington’s disease, Parkinson’s disease, or dementia 

The prescribing of sotrovimab depends on local clinical guidelines, the circulating COVID-19 variants, and current national guidance. Please refer to up to date government and NHS sources for the latest information. 

You should speak to your doctor first if you[1]: 

• Have ever had an allergic reaction to sotrovimab 

• Are pregnant, trying to get pregnant, or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of sotrovimab?

Sotrovimab is administered as a single dose of 500mg, and only one dose is needed[1]. 

How do you take sotrovimab?

Sotrovimab is given as an intravenous infusion (drip) into a vein, usually in the arm. The infusion takes about 30 minutes, and patients are monitored during and after treatment for possible side effects[1]. 

Can you stop taking sotrovimab?

As it is a one-time treatment, there is no ongoing course to stop. Once administered, no further doses are needed[1]. 

What do you do if you take too much sotrovimab?

Overdose is unlikely because sotrovimab is given under medical supervision as a one-time dose. However, if you suspect an overdose, or feel like you are experiencing severe side effects, seek medical attention immediately[1]. 

What do you do if you forget to take sotrovimab?

If you miss your scheduled infusion, contact your healthcare provider as soon as possible. Treatment is most effective within 5 days of symptom onset[1].  

How do I store sotrovimab?

Sotrovimab is stored by healthcare professionals. It requires controlled conditions and is not meant for home storage[1]. 

What medicines can’t you take with sotrovimab?

There are no known interactions with other medicines, but there are still precautions to consider. You should discuss timing with COVID-19 vaccination, as sotrovimab may affect vaccine effectiveness[1]. 

You should also always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2].

What are the side effects of sotrovimab?

Like all medicines, sotrovimab may cause side effects. Common side effects (up to 1 in 10 people) include[1]: 

• Nausea 

• Dizziness 

• Itchy rash 

• Redness or warmth on the skin (this may be less visible on darker skin tones) 

You should tell the healthcare professional if you experience these side effects whilst being observed, or if you experience these symptoms days later and believe they are linked to the medication, contact your GP. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about sotrovimab

How quickly does sotrovimab work? 
It starts working soon after infusion and helps reduce the risk of severe illness[1]. 

Is it effective against all COVID-19 variants? 
Effectiveness may vary by variant. Your healthcare provider will assess suitability[1]. 

Can I have sotrovimab if I’ve been vaccinated? 
Yes, but timing with vaccines should be discussed[1]. 

Can I drive after treatment? 
Avoid driving if you feel dizzy after the infusion[1]. 

Can I drink alcohol? 
There are no known food or drink restrictions[1]. 

Does it affect contraception? 
No, it does not interfere with contraceptive methods[1]. 

Can I take sotrovimab at home? 
No, it must be administered by a healthcare professional[1]. 

Can I have it more than once? 
Yes, but only if you get COVID-19 again after 28 days[1]. 

Is it safe in pregnancy? 
Only if advised by a healthcare professional[1]. 

For the official NHS guide to sotrovimab, visit their website.