A monoclonal antibody treatment for COVID-19 in high-risk patients
Sotrovimab
A monoclonal antibody given by infusion to treat COVID-19 in people at high risk of becoming seriously unwell.
What is Sotrovimab?
Sotrovimab is a specialist medicine, a monoclonal antibody, used to treat COVID-19 in people who are at high risk of becoming seriously unwell, such as those with a weakened immune system. It is given as an infusion (a drip into a vein) early in the illness to help stop it getting worse. The main safety points are infusion reactions and allergic (hypersensitivity) reactions during or after the drip, so it is given where staff can watch for and treat these. Importantly, how well it works depends on which COVID-19 variants are circulating, so its use is guided by current advice. It is started early in the infection by a specialist service.
Education and reference only. This is a plain-language guide to Sotrovimab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Sotrovimab is a monoclonal antibody, a laboratory-made antibody that targets the virus that causes COVID-19. It is used to treat COVID-19 in people who are at high risk of becoming seriously unwell, for example people whose immune systems are weakened. It is given as an infusion, a drip into a vein, usually early in the illness, to help prevent the infection from progressing to severe disease. It is a hospital or specialist treatment, prescribed and given under medical supervision, and its use is guided by national advice that takes account of which virus variants are around.
How it works
Sotrovimab is an antibody designed to stick to the spike protein on the surface of the COVID-19 virus, which helps stop the virus from entering the body's cells and spreading. By blocking the virus early in the illness, it gives high-risk people a better chance of avoiding severe disease and hospital admission. Because it targets a specific part of the virus, changes in the virus over time (new variants) can make it more or less effective, which is why its use depends on current advice about circulating variants. It works best when given early, before the infection has progressed.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist treatment used in the UK for COVID-19 in certain high-risk people, given as an infusion into a vein.
Practical use
How to take Sotrovimab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as an infusion (a drip into a vein) by a specialist team, usually early in the illness.
- Have it as soon as advised after a positive test, as it works best when started early.
- Stay where staff can watch you during and after the infusion, in case of an infusion or allergic reaction.
- Tell the team straight away if you feel flushed, breathless, dizzy, itchy or unwell during the drip.
- Be aware that whether it is recommended depends on the COVID-19 variants circulating at the time.
Weighing it up
Advantages & disadvantages of Sotrovimab
Advantages
- Can help prevent COVID-19 from becoming severe in people at high risk, such as those with weakened immunity.
- Given as a one-off infusion early in the illness.
- Targets the virus directly, which can reduce the chance of hospital admission when it is effective.
Disadvantages
- Can cause infusion reactions or allergic (hypersensitivity) reactions during or after the drip.
- How well it works varies with the COVID-19 variants that are circulating.
- Must be given as an infusion by a specialist service, early in the illness.
Practical use
Good to know
Two things are particularly important to understand. First, sotrovimab is given as an infusion into a vein, and reactions can happen during or shortly after the drip, including infusion reactions (such as feeling flushed, breathless or unwell) and allergic (hypersensitivity) reactions; for this reason it is given where staff can monitor you and treat any reaction promptly. Second, because the COVID-19 virus changes over time, how well sotrovimab works can vary with the variants that are circulating, so whether it is recommended at a given time is guided by national advice rather than being a fixed choice. It is aimed at people at high risk of severe COVID-19 and works best when started early in the illness. Tell the team about your full medical history and any allergies before it is given.
Who should not take it / use with caution
- People who have had a serious allergic reaction to sotrovimab should not have it.
- Its use is guided by current advice on circulating variants, so it may not be recommended at some times.
- It should only be given under specialist supervision where reactions can be monitored and treated.
Monitoring
- Being watched during and after the infusion for infusion or allergic reactions.
- Reviewing whether it is appropriate based on current advice about circulating variants.
- Checking the illness responds and the person is recovering as expected.
Side effects
- Infusion reactions such as feeling flushed, breathless, dizzy or unwell during the drip.
- Allergic (hypersensitivity) reactions, including rash or itching, during or after the infusion.
- Rarely, a serious allergic reaction, which the team is prepared to treat.
Key interactions
- There are few well-established routine medicine interactions, but tell the team about all your medicines.
- It is used alongside other supportive care for COVID-19 as the team advises.
- Tell the team about any past reactions to infusions or antibody treatments.
Available as: A concentrate made up into an infusion given into a vein.
Answers
Sotrovimab: frequently asked questions
What is sotrovimab used for?
It is a monoclonal antibody used to treat COVID-19 in people at high risk of becoming seriously unwell, given as an infusion early in the illness to help stop it getting worse.
How is it given?
It is given as an infusion, a drip into a vein, by a specialist team, where staff can watch for any reaction during and after the treatment.
Why does it matter which variant is around?
Sotrovimab targets a specific part of the virus, so as the virus changes over time it can become more or less effective, which is why its use is guided by current advice.
What reactions should I watch for?
Tell the team straight away if you feel flushed, breathless, dizzy, itchy or unwell during or after the drip, as infusion and allergic reactions can occur.
When should it be given?
It works best when started early in the illness, so it is given as soon as advised after a positive test in people who are eligible.
Authoritative sources
- BNF
- NICE CKS
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