Sotrovimab for in-patients

Recombinant human IgG1 mAb which binds to spike protein receptor binding domain of SARS-CoV-2.

Restricted: For patients with acute COVID-19 infection who do not require supplemental oxygen and are at risk of progressing to severe COVID-19 where Paxlovid^® is contraindicated or unsuitable.

• The list of patients eligible for treatment with sotrovimab may be found in NICE TA 878. (See section 5). 

Sotrovimab can be initiated by all consultants in acute general medicine areas, infectious diseases, respiratory HDU and Critical Care.

A Blueteq form must be completed.

Notable Interactions - There are no reported drug interactions with sotrovimab.

Standard Dose

• Patients aged 12 years and older (adolescents must weigh at least 40kg)
• Standard Dose - IV 500mg STAT

Renal Impairment

• No dose adjustment required.

Dosing in obesity

• No dose adjustment required.

Use in hepatic impairment

• No dose adjustment required.

Hypersensitivity reactions may occur within 24 hours of administering sotrovimab. Signs and symptoms include nausea, chills, dizziness/syncope, rash, urticaria, flushing.

• If signs and symptoms are severe- stop the infusion immediately and initiate appropriate treatment or supportive care.
• If symptoms are mild or moderate – consider slowing or stopping the infusion. Offer supportive care as appropriate.

The name and batch number of the administered product should be recorded for traceability of biological medicinal products.

Pregnancy – Discuss with pharmacy. No data available. May be used where the expected benefit to the mother justifies risk to the foetus.  Consent for use of Sotrovimab during pregnancy must be documented.

Breastfeeding –  No data available. Specialist Pharmacy Service advises use with caution. Negligible levels anticipated in milk. Monitor infant for adequate feeding and hypersensitivity reactions. Consent for use of Sotrovimab during breastfeeding must be documented.

Discharge letters to primary care, and other handovers of clinical care, should explicitly record the treatment that has been given, together with the dose and date of administration.

1. Xevudy 500mg concentrate for solution for infusion [online]. Manufacturer – GlaxoSmithKline UK Ltd. Last updated: 2023 May 11. Accessed via: www.emc.medicines.org.uk [Accessed 2023 Aug 04]
2. UK Teratology Information Service: Bumps. Sotrovimab. Last updated: 2021 Dec. Accessed via: www.medicinesinpregnancy.org. [Accessed 2023 Aug 04]
3. National Institute for Health and Care Excellence. Technology appraisal guidance 878: Casirivimab plus imdevimab, nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19. Last updated: 24 Mar 13. Accessed via: www.nice.org.uk. [Accessed 2024 Apr 24]
4. Specialist Pharmacy Service. Sotrovimab. Last updated 2021 Mar 31. Accessed via: www.sps.nhs.uk [Accessed 2023 Aug 04]
5. Department of Health and Social Care. Independent report: Defining the highest risk clinical subgroups upon community infection with SARS-CoV-2 when considering the use of neutralising monoclonal antibodies (nMABs) and antiviral drugs. Last updated: 2023 Apr 05. Accessed via: www.gov.uk [Accessed 2023 Aug 08]