Dupixent (Dupilumab) - Subcutaneous

What Is Dupixent?

Dupixent (dupilumab) is a medicine given by injection to treat eczema, a condition also known as atopic dermatitis that causes red and itchy skin. Dupixent is a monoclonal antibody, or more specifically, an interleukin-4 antagonist. It works by blocking the release of certain proteins in your body that can cause inflammation. Blocking inflammation leads to decreased skin redness and irritation.

Dupixent is a prescription drug, which means you need an order for it from your healthcare provider. It is also considered a specialty drug, and it may require special approval from your insurance company. You will most likely receive it as a shipment from a specialty pharmacy.

Drug Facts

Generic Name: Dupilumab

Brand Name: Dupixent 

Drug Availability: Prescription

Therapeutic Classification: Monoclonal antibody

Available Generically: No

Controlled Substance: N/A

Administration Route: Subcutaneous

Active Ingredient: Dupilumab

Dosage Form: Solution

What Is Dupixent Used For?

The Food and Drug Administration (FDA) approved Dupixent to treat the following conditions:

  • Moderate to severe atopic dermatitis in people aged 6 years or older when topical prescription medicines (like steroid creams or ointments) are not working well enough. Atopic dermatitis is also called eczema and causes an itchy, red, dry, and scaly skin rash. The condition is more common in young children but can affect people of any age. Treatment options for eczema that healthcare providers may recommend first include moisturizers and steroid creams or ointments. If these are not causing sufficient relief, your healthcare provider may prescribe Dupixent.
  • Add-on treatment for certain types of moderate to severe asthma in people at least 6 years old. Dupixent can help with eosinophilic or oral steroid-dependent asthma by blocking the inflammatory proteins that can cause difficulty breathing in these types of asthma.
  • Chronic rhinosinusitis with nasal polyposis (CRSwNP) in adults at least 18 years old. CRSwNP is a disease of the upper airway where tissue forms into teardrop-shaped growths in the nostrils, causing congestion and/or loss of smell.

How to Take Dupixent

While it can be intimidating or scary to think about having to inject your medicine yourself, Dupixent comes in devices that make the process simple. It is available in prefilled syringes or pen injectors. Neither of these requires you to attach needles or draw up liquid. You will also be shown how to give the drug to yourself by a healthcare provider so that you feel comfortable with the process.

The drug is given subcutaneously, which means the medicine is injected right under your skin, as opposed to into a muscle or a vein. The needles are small, only about a quarter of an inch long. You can use your thighs, stomach area, or upper arms for subcutaneous injections, as these areas commonly have the most fat to work with. For your first dose, you will use two injections at different sites. Do not inject into cut, tender, bruised, or scarred skin, and do not inject through clothing.

How to Use Dupixent Prefilled Syringe:

  1. Remove the Dupixent syringe from your refrigerator and let it come to room temperature for about 30 minutes. This will make injecting more comfortable. Have your sharps container handy.
  2. Hold the syringe at the clear part where you can see the medicine. Take a quick look to make sure the medicine looks clear to slightly yellow in color but contains no visible particles or flakes.
  3. Wash your hands and clean the area of skin you plan to inject with an alcohol swab. Allow your skin to dry without blowing on it or touching it again.
  4. Remove the needle cap with the needle pointing away from yourself.
  5. Pinch a section of your skin between your thumb and other fingers, and insert the needle completely at about a 45-degree angle.
  6. Relax the hand that is pinching the skin and slowly push the plunger down all the way to inject the medicine.
  7. Remove the needle from your skin and let go of the plunger, which will cause the needle to retract into the syringe.
  8. Place the entire syringe into your sharps container.
  9. If you see any blood, you can lightly press a cotton ball over the injection site, but do not rub your skin.
  10. Keep track of where you inject each dose of Dupixent, as you’ll want to rotate sites each time you administer the drug.

How to Use Dupixent Pen Injector:

  1. Remove the Dupixent pen from your refrigerator and let it come to room temperature for about 30 minutes. This will make injecting more comfortable. Have your sharps container handy.
  2. Hold the pen injector in the middle of the pen body. You can take a look at the medicine through the small window to make sure it is clear to pale yellow in color and does not contain any visible particles or flakes.
  3. Wash your hands and clean the area of skin you plan to inject with an alcohol swab. Allow your skin to dry without blowing on it or touching it again.
  4. Once you’re ready to inject, remove the pen cap by pulling it straight off. Do not try to put the cap back on.
  5. Hold the pen against your skin at a 90-degree angle. Then press down firmly and hold the pen against your skin until you can no longer see the yellow (300 milligrams) or orange (200 milligrams) needle cover. You will hear a click then see the injector window slowly start to turn yellow. Once it is fully yellow, you will hear another click.
  6. Continue to hold the pen against your skin for five more seconds to make sure all of the medicine gets injected.
  7. Lift the pen off of your skin and place the entire pen into your sharps container.
  8. If you see any blood, you can lightly press a cotton ball over the injection site, but do not rub your skin.
  9. Keep track of where you inject each dose of Dupixent, as you’ll want to rotate sites each time you administer the drug.

You may want to visit the Dupixent website, where you can watch helpful videos that show exactly how to use each type of injector device with step-by-step instructions.

Storage

Store your Dupixent syringes or pens in the refrigerator (36 degrees to 46 degrees F) in the original carton to protect the medicine from light.

Once you remove them from the fridge, they need to be used within 14 days. Only leave the syringe or pen out for 45 minutes while waiting for it to naturally warm to room temperature. If you are traveling or, for some reason, are unable to refrigerate your Dupixent, it can be kept at room temperature (up to 77 degrees F) for a maximum of 14 days. Do not leave Dupixent out in heat or direct sunlight. Do not freeze or shake this medication.

A sharps container will most likely be provided to you by your specialty pharmacy when Dupixent is sent to you. If not, call the specialty pharmacy or ask your local pharmacist about getting a sharps container so that you don’t have loose needles or medicine in your household garbage.

If you’re traveling by plane, keep Dupixent in your carry-on luggage in case your checked luggage happens to go missing.

How Long Does Dupixent Take to Work?

You may start to experience some improvement in itching as soon as two to four weeks after starting Dupixent. Seeing visible improvement in your skin’s clarity may take a bit longer. During clinical trials, results were measured at 16 weeks of use, by which a majority of the people who used Dupixent saw improved skin clarity.

What Are the Side Effects of Dupixent?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

These are the most common side effects of Dupixent. Notify your healthcare provider if these side effects become severe or do not go away:

  • Injection site reaction: Pain, itching, or redness in the area where you inject Dupixent
  • Conjunctivitis, also known as pink eye: An irritation or infection of the outer lining of your eye that may be very contagious but usually resolves on its own

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

  • Hypersensitivity reactions: This type of reaction may present as widespread redness or a rash and may also include serum sickness-like reactions, which can cause fever and pain in the joints. These reactions are brought about by your immune system, and they were reported in less than 1% of people in Dupixent clinical trials.
  • Eosinophilia: This occurs when there is a higher-than-normal level of eosinophils, a type of white blood cell that’s part of your immune system. People using Dupixent to treat asthma may rarely experience this side effect which can present as a rash, runny nose, shortness of breath, or chest pain.

Long-Term Side Effects

In one clinical trial, individuals were evaluated for side effects after using Dupixent for 148 weeks (almost three years). Their side effects were generally consistent with the ones listed above during shorter-term trials, indicating that long-term use does not add extra safety risk.

Report Side Effects

Dupixent may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Dupixent Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form (prefilled syringe):
    • For asthma dependent on steroids or asthma with atopic dermatitis:
      • Adults and children 12 years of age and older—At first, 600 milligrams (mg) (two 300 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 300 mg every other week.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    • For chronic rhinosinusitis with nasal polyposis:
      • Adults—300 milligrams (mg) injected under the skin every other week.
      • Children—Use and dose must be determined by your doctor.
    • For moderate to severe asthma:
      • Adults and children 12 years of age and older—At first, 400 or 600 milligrams (mg) (two 200 or 300 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 200 or 300 mg every other week.
      • Children 6 to 11 years of age—Dose is based on body weight and must be determined by your doctor.
        • Weighing 30 kilograms (kg) or more—200 mg injected under the skin every other week.
        • Weighing 15 kg to less than 30 kg—100 mg injected under the skin every other week or 300 mg injected under the skin every 4 weeks.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
    • For moderate to severe atopic dermatitis:
      • Adults—At first, 600 milligrams (mg) (two 300 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 300 mg every other week.
      • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor.
        • Weighing 60 kilograms (kg) or more—At first, 600 mg (two 300 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 300 mg every other week.
        • Weighing 30 kg to less than 60 kg—At first, 400 mg (two 200 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 200 mg every other week.
        • Weighing 15 kg to less than 30 kg—At first, 600 mg (two 300 mg injections) injected under the skin at different injection sites. Then, your dose will be reduced to 300 mg every 4 weeks.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Modifications

In certain cases, you may need to take precautions while taking or administering this medication.

Pregnancy

Available data from case reports of pregnant women taking Dupixent have not identified risks of birth defects, miscarriage, or adverse outcomes. The medicine may be transferred from the person to the fetus. If you are pregnant or plan to become pregnant and have uncontrolled asthma, you and your healthcare provider should discuss whether the benefit of using this medication outweighs the risk to the developing fetus.

Breastfeeding

How much Dupixent may get into a person's breast milk or the effect it may have on a nursing baby are not well understood. The person's need for Dupixent should be considered and weighed against any potential risk to the baby.

Children

For children ages 6 to 11 years old, the prefilled syringe should be given by a caregiver. Adolescents aged 12 years and older who are prescribed the prefilled pen should receive the injection by or under the supervision of an adult.

Older Adults

No differences in side effects were seen between younger and older people (over age 65). However, not enough older adults were included in trials to know for sure if they may be affected differently.

Missed Dose

You will give yourself an injection of Dupixent either every other week, or every four weeks.

For an every-other-week schedule, if you miss a dose on the day it’s due, give it within seven days of the missed date and continue your normal schedule. If you don’t give it within seven days, just skip that dose and wait until your next scheduled dose.

For an every-four-week schedule, if you miss a dose on the day it’s due, give it within seven days of the missed date and continue your normal schedule. If you don’t give it within seven days, give the dose as soon as you can and then start a new schedule based on that date, meaning you’ll give your next dose four weeks later.

Overdose: What Happens If I Take Too Much Dupixent?

If you only take Dupixent as directed, you shouldn’t be concerned about using too much or overdosing. Keep a schedule written down or set reminders in your phone for when doses are due and where you inject them.

What Happens If I Overdose on Dupixent?

If you think you or someone else may have overdosed on Dupixent, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Dupixent, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, generalized urticaria, or serum sickness, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a feeling of discomfort, fever, pain or swelling of the joints, hives, itching, lightheadedness, dizziness, fainting, muscle aches, rash, swollen lymph glands, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Check with your doctor right away if you have redness, irritation, or itching the of eye, eyelid, or inner lining of the eyelid. These could be symptoms of eye problems, including conjunctivitis or keratitis.

A rare but serious condition called eosinophilia (increased white blood cells in the body) may occur while you are using this medicine. Pneumonia or a condition called vasculitis (inflammation of the blood vessels) may also be present. Eosinophilia can be serious and requires immediate medical attention. Tell your doctor right away if you or your child have worsening lung symptoms, rash or bruising of the skin, fever, chest pain, or burning, tingling, or numbness in the hands and feet after using this medicine.

If you are using a steroid medicine for your asthma, do not suddenly stop taking it without first checking with your doctor. You may need to slowly decrease your dose before stopping it completely.

Do not have any live vaccines (immunizations) while you are being treated with dupilumab. Check with your doctor before having any vaccines.

What Are Reasons I Shouldn't Take Dupixent?

You shouldn’t use Dupixent if you have a known hypersensitivity or allergy to it or any of its ingredients.

Dupixent should also not be used to treat acute asthma symptoms or acute exacerbations. You should let your healthcare provider know if your asthma remains out of control or gets worse after you start using Dupixent.

What Other Medications Interact With Dupixent?

You should avoid live vaccinations while you’re taking Dupixent. Live vaccines include:

  • Chickenpox (varicella) vaccines
  • FluMist (the flu vaccine given as a nasal spray)
  • MMR vaccines (measles, mumps, and rubella)
  • Japanese encephalitis vaccine
  • Rotavirus vaccines
  • Smallpox vaccine (no longer given due to the fact smallpox no longer exists)
  • Yellow fever vaccine

Non-live or inactivated vaccinations are fine for individuals using Dupixent.

What Medications Are Similar?

There are many other medications that are known as monoclonal antibodies like Dupixent. They all have slightly different mechanisms but work similarly in that they mimic or improve a certain part of the function of your immune system. A few examples are:

  • Aerovant (pitrakinra)
  • Cinqair (reslizumab)
  • Fasenra (benralizumab)
  • Rinvoq (upadacitinib)
  • Xolair (omalizumab)

This is a list of drugs also prescribed for immune-mediated conditions such as arthritis, skin conditions or asthma. It is NOT a list of drugs recommended to take with Dupixent. In fact, you should not take these drugs together. Ask your pharmacist or a healthcare practitioner if you have questions.

Frequently Asked Questions

  • What is Dupixent used for?

    Dupixent is an injectable medicine that treats atopic dermatitis (eczema) and asthma in certain individuals.

  • How does Dupixent work?

    Dupixent is a monoclonal antibody, which means it interacts with your immune system to block certain proteins called interleukins that can cause inflammation. Many monoclonal antibodies (sometimes abbreviated as mAbs) exist that mimic or enhance certain parts of your immune system to treat different conditions.

  • What drugs should not be taken with Dupixent?

    Avoid live vaccinations while taking Dupixent, such as the chickenpox vaccine, FluMist (nasal spray flu vaccine), and MMR (measles, mumps, rubella) vaccines. Non-live vaccines are OK, such as the injectable flu vaccine, hepatitis A vaccine, and typhoid vaccine.

How Can I Stay Healthy While Taking Dupixent?

Conditions caused by an overactive immune system (or autoimmune diseases) can be difficult to understand because our immune systems are so complicated. Atopic dermatitis, or eczema, can be very frustrating to deal with when it seems like no amount of moisturizers or topical steroids is improving your skin.

Sometimes topical and even oral medicines are simply not enough to combat the condition. Fortunately, in the last decade or so, the advancement of drugs called monoclonal antibodies has made enormous differences in treating many conditions such as arthritis, asthma, and skin conditions like psoriasis and eczema. 

While receiving an injectable medication may seem scary at first, the prefilled syringes or pen injectors can help make the process easier for you. To clear your skin, be patient, stick to your dosing schedule, and continue using other prescribed medicines. Skincare strategies, such as moisturizing, can help in addition to your prescribed therapy.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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  2. Pyun BY. Natural history and risk factors of atopic dermatitis in children. Allergy Asthma Immunol Res. 2015;7(2):101-105. doi:10.4168/aair.2015.7.2.101

  3. Castelli MS, McGonigle P, Hornby PJ. The pharmacology and therapeutic applications of monoclonal antibodies. Pharmacol Res Perspect. 2019;7(6):e00535. doi:10.1002/prp2.535