What to Know About Dupixent (Dupilumab)

An Injectable Medication for Severe Atopic Dermatitis (Eczema)

Woman with Eczema

BSIP / UIG / Getty Images 

In This Article

Dupixent (dupilumab) is the first and only injectable medication approved by the U.S. Food and Drug Administration (FDA) for treating moderate to severe atopic dermatitis, also known as eczema, in adults. It is injected every two weeks into the thigh or lower abdomen within the fatty layer just below the skin—this is called a subcutaneous injection. This medication can be used in combination with topical steroid therapies, or it can be used by itself.

Uses

Dupixent (dupilumab) is a biologic medication, which means that it works on the whole body to change the way your immune system works. It is a human monoclonal antibody—a type of antibody created in a laboratory.

Once injected and absorbed into the bloodstream, it binds to a specific docking site that ultimately blocks the action of two messenger proteins (interleukin-4 and interleukin-13). These proteins are known to play a major role in the formation of eczema patches.

Research has revealed not only a reduction in the body surface area and severity of eczema patches but also a significant reduction in scratching, which can be extremely debilitating for people with atopic dermatitis. In addition, in two 16-week phase three trials, the medication was found to reduce symptoms of anxiety and depression and improve quality of life.

Before Taking

The precise cause of atopic dermatitis is still being debated and studied, but likely entails a complex interplay between a person's genes, their immune system, and an impaired function of the epidermis—the outermost layer of a person's skin. Atopic dermatitis can usually be managed with good skin care, removal of triggers and aggravating factors, and topical treatments like prescription steroid creams and ointments.

In some adults with moderate to severe eczema, however, their disease doesn't improve with traditional therapies (or they are unable to take these therapies), so a genetically engineered injectable may be needed.

Dupixent (dupilumab) provides an option for those adults who have moderate to severe disease but have not received the relief they deserve with conventional therapies like steroid creams and ointments.

Before you start taking Dupixent, it's important to share with your doctor all your medications, including any over-the-counter drugs, vitamins, or supplements.

On a final note, this medication is not for everyone, and at this time, it's really reserved for those who have no other options.

Precautions and Contraindications

Talk to your doctor about all of your health conditions, especially if you have eye problems, a parasitic infection, or asthma. Also, be sure to tell your doctor whether you are pregnant, breastfeeding, or scheduled to receive any vaccinations.

Dupixent is not approved for use in children younger than 12 years old.

The big picture here is to be prepared when visiting your allergist. By being thorough and sharing all your medical history with your doctor, she can determine if this is the right treatment for you.

Other Biologics

As of 2019, Dupixent is the only FDA-approved biologic used to treat atopic dermatitis. Two more biologics, nemolizumab and lebrikizumab, are working their way through clinical trials and toward FDA-approval. Research continues to evolve on injectable biologics for eczema.

Dosage

According to the manufacturer, you will receive an initial "loading" dose of two injections (given at different sites). For teens less than 132 pounds (60 kilograms), the initial dose is 400 milligrams (mg) given in two-200 mg injections.

For teens more than 132 pounds and for all adults, the initial dose is 600 mg given in two-300 mg injections.

After the initial dose, Dupixent is taken once every other week, 200 mg in one injection for teens less than 132 pounds, and 300 mg for teens more than 132 pounds and all adults.

How To Take and Store

The medication is injected subcutaneously, which means under the skin into the fatty layer beneath.

Your doctor or nurse can teach you or a loved one how to give the injection, so you can do it from the comfort of your home.

First, wash your hands and clean the injection area with an alcohol swab. Remove the needle cap from the syringe. Don't touch the needle.

Pinch a fold of skin around the injection site. This can be the thigh or abdomen (more than 2 inches away from the belly button) for self-administration, or upper arm if a loved one is giving the injection.

Insert the needle at a 45-degree angle into the skin fold. Release the fold and slowly push the plunger on the syringe to administer the entire amount of medication. Dupixent is pre-measured.

Release the plunger and remove the syringe. Discard of the syringe in an approved container.

While these are the basic steps to follow, you should always follow, and defer to, the specific instructions given to you by your healthcare provider.

It's normal to feel nervous about self-administering an injection, or giving an injection to your loved one. Your healthcare provider will help you understand exactly how to do so. Once it's been done a few times, most people become very comfortable with the process.

Storage

Dupixent should be stored in the refrigerator and allowed to come to room temperature before injecting. Dupixent can be kept unrefrigerated for up to 14 days. Any medication that has been unrefrigerated for more than 14 days should be thrown away.

Side Effects

The injectable may cause skin irritation at the site of injection. Sores on or around the lips and throughout the mouth (called oral herpes) have also been reported.

Although rare, it can cause eye problems like:

It's important to contact your doctor right away if you experience vision problems, eye pain, or severe eye irritation.

It's also important to stop administering the medication and seek medical attention if you experience symptoms of an allergic reaction like hives, skin rash with or without a fever, swollen lymph nodes, joint pain, scratching, or a general ill feeling.

Of course, what is mentioned above are not all the potential side effects a person may experience, so be sure to contact your doctor with any problems or worries.

Warnings and Interactions

Due to the effects on a person's immune system, it is advised that no one taking this medication receive any live vaccinations (e.g., the nasal spray flu vaccine or zoster vaccine).

Some people develop antibodies to the drug, which occurs when the body produces a protein to neutralize or inhibit its biological effect. This may be suspected if a person stops responding to the medication, and can be confirmed with a blood test.

Was this page helpful?

Article Sources