What to Know About Dupixent (Dupilumab)

An injectable medication for severe atopic dermatitis (eczema)

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 those 12 years and older. It is injected subcutaneously in the thigh or lower abdomen every two weeks. This medication can be used in combination with topical steroid therapies or on its own.

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—i.e., 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 that dupilumab results in a reduction in the body surface area and severity of eczema patches, as well as scratching, which can be extremely debilitating for people with atopic dermatitis.

In addition, in two 16-week phase three trials, the drug was found to reduce symptoms of anxiety and depression and improve quality of life.

Before Taking

Atopic dermatitis can usually be managed with good skincare, removal of triggers and aggravating factors, and topical treatments like prescription steroid creams and ointments. Your doctor will try these treatments before considering Dupixent.

The precise cause of atopic dermatitis is still being debated and studied, but it likely entails a complex interplay between a person's genes, their immune system, and an impaired function of the epidermis—the outermost layer of skin. This may be part of the reason why some people don't see their disease improve with first-line therapies like steroid creams and ointments.

Dupixent is another option for such persistent moderate to severe eczema cases. It is also an alternative option for patients who cannot use certain other treatments. However, this medication is not for everyone and, at this time, it's really reserved for those who are experiencing significant symptoms and have no other options.

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

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.

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. With a complete medical history, they can determine if the drug is the right treatment for you.

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

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 who weigh more than 132 pounds, and for those over age 18 regardless of weight, the initial dose is 600 mg given in two-300 mg injections.

After the initial dose, Dupixent is injected once every other week: 200 mg in one injection for teens under 132 pounds, and 300 mg for teens over 132 pounds and those older than 18, regardless of weight.

While these are the most commonly prescribed dosages, your physician will decide the dose most appropriate for you. Your dosage may be adjusted over time.

How to Take and Store

The medication is injected under the skin into the fatty layer beneath (subcutaneously). Your doctor or nurse can walk you or a loved one through how to confidently do this from the comfort of your home.

Dupixent should be stored in the refrigerator. If necessary, Dupixent can be left unrefrigerated for up to 14 days. Thereafter, it must be refrigerated or discarded.

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.

  1. Remove the medication from the refrigerator (if applicable) and allow it to come to room temperature.
  2. Wash your hands and clean the injection area with an alcohol swab. Remove the needle cap from the syringe. Don't touch the needle.
  3. Pinch a fold of skin around the injection site. This can be the thigh or abdomen (more than two inches away from the belly button) for self-administration, or the upper arm if someone else is giving you the injection.
  4. 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 dose. (Dupixent is pre-measured.)
  5. Release the plunger and remove the syringe. Discard the syringe in an approved container.

Most people become very comfortable with the process after a few times.

Side Effects

You may experience skin irritation at the site of injection. Sores on or around the lips and throughout the mouth (oral herpes) have also been reported in Dupixent users.

Uncommon Eye Side Effects

Although rare, Dupixent can cause eye problems including:

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

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.

You may experience side effects not listed here, so be sure to contact your doctor with any problems or concerns.

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 the medication's biological effect. This may be suspected if a person stops responding to Dupixent and can be confirmed with a blood test.

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