Dupixent Injection Overview

What is Dupixent used for?

Doctors may prescribe Dupixent for certain inflammatory conditions in adults and some children.

Dupixent treats these conditions by targeting a very specific part of your immune system. The immune system is the body’s defense against infection. Sometimes, a person’s immune system is overactive and attacks cells in their body by mistake. This can lead to the conditions described here.

Read on to learn about the specific conditions Dupixent is used to treat.

Moderate to severe atopic dermatitis

Dupixent is used for atopic dermatitis (a type of eczema) in adults and children ages 6 months and older. It’s prescribed when topical medications (which are applied on the skin) are not working well to manage atopic dermatitis symptoms. Dupixent is also an option to try for people who cannot use such medications.

With atopic dermatitis, you have dry, itchy skin patches that can flare up into rashes. Certain triggers, such as scented soaps or detergents, can cause flare-ups of this condition. Atopic dermatitis is a skin condition that’s most common in children, but it can also continue into adulthood.

To treat atopic dermatitis, Dupixent can be used alone or with corticosteroids applied to the skin.

Moderate to severe asthma

Dupixent is used as an add-on treatment for certain types of asthma in adults and children ages 6 years and older. (“Add-on” means a treatment is used together with one or more other medications.) These types of asthma include:

• eosinophilic asthma, which is asthma associated with a high level of eosinophils (a type of white blood cell) in your body
• asthma that must be treated with corticosteroids that are swallowed, such as prednisone

Asthma is a long-term condition that causes inflammation and narrowing of your airways. Symptoms of asthma can include:

• wheezing
• shortness of breath
• feeling of tightness in your chest
• coughing
• increased mucus

Certain triggers, such as exercise or cold weather, can cause asthma symptoms to suddenly become severe. This is called an asthma attack.

It’s important to note that Dupixent should not be used to treat an asthma attack. Instead, you should use a rescue inhaler to ease asthma attack symptoms. Albuterol (ProAir HFA, Ventolin HFA) is an example of a rescue inhaler.

Chronic rhinosinusitis with nasal polyps

Dupixent is used to treat chronic rhinosinusitis with nasal polyps in adults and children ages 12 years and older. Rhinosinusitis is a condition that causes inflammation (damage and swelling) in your sinuses and nasal passages. Polyps are growths on the inside lining of your nose.

For this condition, doctors prescribe Dupixent as an add-on treatment for people who are already using other treatments, but whose symptoms are still not well managed.

Your sinuses are the hollow spaces located behind your nose, forehead, and cheekbones. Rhinosinusitis occurs when your sinuses and nasal passages become inflamed due to allergies, recurrent sinus infections, or other causes. Sinusitis symptoms usually include:

• runny nose
• stuffy nose
• pain or pressure in your face, especially around your eyes and nose
• sore throat due to postnasal drip (drainage of mucus down the back of your throat)
• reduced sense of smell

If you have rhinosinusitis for longer than 3 months, it’s considered chronic rhinosinusitis. Over time, nasal polyps can form in inflamed nasal tissue. These polyps can make it more difficult to breathe through your nose.

Eosinophilic esophagitis

Dupixent is used for eosinophilic esophagitis in adults and children ages 1 year and older who weigh at least 15 kilograms (about 33 pounds).

Eosinophilic esophagitis results from an increase of eosinophils (a type of white blood cell) in the lining of your esophagus. (The esophagus is part of your digestive system. It’s a muscular tube that connects your mouth to your stomach.) This increase in eosinophils causes inflammation, and the condition is usually long term. Symptoms can vary with age and may include:

• difficulty swallowing
• weight loss
• heartburn
• abdominal pain

For treating eosinophilic esophagitis, Dupixent is usually used alone.

Prurigo nodularis

Dupixent is used to treat prurigo nodularis in adults.

Prurigo nodularis is a long-term inflammatory skin condition. It causes itchy, hard bumps called nodules. The itchiness can be so severe that it affects a person’s quality of life. For example, it may cause difficulties with sleep.

It’s not certain what causes this condition, but it’s thought to result from scratching the skin.

For treating prurigo nodularis, Dupixent is usually used alone.

Chronic obstructive pulmonary disease (COPD)

Dupixent is used to treat eosinophilic COPD in adults. When prescribed for this condition, Dupixent is used together with another COPD treatment.

With COPD, your airways become inflamed and coated in mucus, making breathing difficult. In some cases, COPD can produce an increased level of white blood cells called eosinophils. Symptoms of COPD include:

• breathlessness
• persistent cough
• wheezing
• difficulty breathing that worsens over time

It’s important to note that Dupixent is not intended to treat an active COPD flare-up (also known as a COPD exacerbation). If you’re having a COPD flare-up, you should use a rescue inhaler, such as albuterol.

Bullous pemphigoid

Dupixent is used to treat bullous pemphigoid in adults. Bullous pemphigoid is a serious skin condition that can cause blistering under the outer layer of a person’s skin. Another symptom of this condition is extreme itchiness.

At the start of Dupixent treatment for this condition, you may take the drug together with a corticosteroid. Your doctor will decrease the dosage of the corticosteroid over time until you’re only using Dupixent.

Chronic spontaneous urticaria

Dupixent is used to treat chronic spontaneous urticaria in adults and children ages 12 years and older. Chronic spontaneous urticaria is the medical term for long-lasting hives with no known cause. (It’s unclear what, if anything, is causing a person to have these hives.)

Symptoms of hives include raised welts on your skin that may be discolored and severe itchiness.

For treating chronic spontaneous urticaria, Dupixent is used when certain antihistamines do not help relieve symptoms.

It’s important to note that Dupixent is not intended to treat other types of hives.

Using Dupixent with other drugs

It’s common for doctors to prescribe Dupixent along with other types of drugs.

Some examples of other kinds of drugs that your doctor may prescribe with Dupixent include:

• topical corticosteroids for atopic dermatitis (a type of eczema) treatment
• inhaled corticosteroids or rescue inhalers for asthma treatment
• nasal corticosteroids or nasal decongestants for the treatment of chronic rhinosinusitis with nasal polyps
• topical corticosteroids for prurigo nodularis treatment
• liquid corticosteroids or proton pump inhibitors for eosinophilic esophagitis treatment

If you have questions about taking other drugs with Dupixent, talk with your doctor or pharmacist.

What are Dupixent’s side effects?

Like most drugs, Dupixent may cause mild or serious side effects. The lists here include some of the more common side effects that Dupixent may cause. These lists do not include all possible side effects.

The common side effects of Dupixent can vary depending on the condition it’s treating. Also, keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you may be taking

Some side effects of Dupixent may continue for as long as you’re receiving the drug. Some people may even experience certain long-term side effects after stopping treatment. If you have concerns about long-term side effects that Dupixent may cause, talk with your doctor.

If you have questions about side effects of Dupixent, talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect during treatment with Dupixent and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Mild side effects

Here’s a list of some of the mild side effects that Dupixent can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Dupixent’s prescribing information.

Mild side effects of Dupixent that have been reported include:

• injection site reactions
• sore throat
• cold sores due to herpes virus
• eye problems, such as conjunctivitis (pink eye)
• difficulty sleeping
• joint pain
• tooth pain
• gastritis (swelling in your stomach)
• eosinophilia (increased level of eosinophils, which are a type of white blood cell)
• rash on your face

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if any side effects you develop become bothersome, talk with your doctor or pharmacist. They may suggest ways to help reduce side effects.

Serious side effects

Serious side effects from Dupixent can occur, but they are not common. If you have serious side effects from Dupixent, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

A serious side effect of Dupixent that has been reported is eye problems, such as corneal ulcers.

After Dupixent became available to prescribe, the following possible side effects were reported:

• vasculitis, a condition that affects blood vessels
• psoriasis, a condition that affects the skin
• psoriatic arthritis, a type of arthritis that may develop from psoriasis

Because these were not reported in clinical trials, it is unclear whether Dupixent was the cause.

What is Dupixent’s dosage?

The Dupixent dosage your doctor prescribes will depend on several factors. These may include:

• the type and severity of the condition you’re prescribed Dupixent to treat
• your age
• your weight
• other medical conditions you may have

The information here describes dosages that are commonly used or recommended. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strengths

Dupixent comes as a liquid solution in prefilled syringes or prefilled pens. Dupixent is given as an injection under your skin.

Dupixent prefilled syringes and prefilled pens are available in the following strengths, expressed in milligrams per milliliter of solution (mg/mL):

• 200 mg/1.14mL
• 300 mg/2 mL

Recommended dosage

For certain uses of Dupixent, doctors will prescribe a loading dose at the beginning of treatment. With a loading dose, a medication is started at a higher dose than the doses that follow. Loading doses get more of the drug into your body to help relieve your symptoms faster.

Dupixent’s loading dose is usually given at a doctor’s office. It includes two injections in two different areas of your body.

Your dosing schedule for Dupixent is usually based on the condition it’s being used to treat and your age. The following describes Dupixent dosages for adults. For recommended dosages of Dupixent for children, see the “Children’s dosages” section.

Dosage for atopic dermatitis

For helping to treat atopic dermatitis (a type of eczema), you’ll first receive a loading dose of Dupixent: two injections of 300 mg for a total dose of 600 mg. Then, you’ll receive one injection of 300 mg every 2 weeks.

Dosage for asthma

For helping to treat asthma, you may receive a 400-mg loading dose (two 200-mg injections) of Dupixent. Then, you’ll receive one injection of 200 mg every 2 weeks.

Your doctor may suggest a higher dosage of Dupixent for your asthma. This is especially likely if either of the following applies to you:

• You’re taking certain corticosteroids for your asthma.
• You also have moderate to severe chronic rhinosinusitis with nasal polyps or atopic dermatitis.

With the higher dosage, you’ll receive a 600-mg loading dose (two 300-mg injections) of Dupixent. Then, you’ll receive one injection of 300 mg every 2 weeks.

Dosage for chronic rhinosinusitis with nasal polyps

For helping to treat chronic rhinosinusitis with nasal polyps, you’ll receive one Dupixent injection of 300 mg every 2 weeks.

Dosage for eosinophilic esophagitis

For helping to treat eosinophilic esophagitis, the manufacturer recommends the following dosages based on kilograms (kg), with 1 kg being about 2.2 pounds (lb).

Dosage for prurigo nodularis

For helping to treat prurigo nodularis, you’ll first receive a loading dose of Dupixent: two injections of 300 mg for a total dose of 600 mg. Then, you’ll receive one injection of 300 mg every 2 weeks.

Dosage for eosinophilic chronic obstructive pulmonary disease

For helping to treat eosinophilic chronic obstructive pulmonary disease (COPD), you’ll receive one Dupixent injection of 300 mg every 2 weeks.

Dosage for bullous pemphigoid

For helping to treat bullous pemphigoid, you’ll first receive a loading dose of Dupixent: two injections of 300 mg for a total dose of 600 mg. Then, you’ll receive one injection of 300 mg every 2 weeks.

You may take a corticosteroid with Dupixent at the start of treatment. Your doctor will lower the dosage of this corticosteroid as treatment continues until you’re only receiving Dupixent for bullous pemphigoid. Your doctor will let you know what dosage to follow for the corticosteroid.

Dosage for chronic spontaneous urticaria

For helping to treat chronic spontaneous urticaria, you’ll first receive a loading dose of Dupixent: two injections of 300 mg for a total dose of 600 mg. Then, you’ll receive one injection of 300 mg every 2 weeks.

Children’s dosages

The dosage of Dupixent may vary for children based on their age and the condition being treated. It may also vary depending on a child’s body weight in kg. This means the child’s dosage may change as they grow.

Children’s dosage for atopic dermatitis

The following table gives recommended dosages for children receiving Dupixent for atopic dermatitis. Whether a child receives a loading dose at the start of Dupixent treatment depends on their age.

Children’s dosage for asthma

The following table gives recommended dosages for children ages 6 to 11 years who are receiving Dupixent for asthma. Children in this age group generally do not receive a loading dose for treating asthma. But a doctor may recommend a loading dose for this condition if the child also has atopic dermatitis.

Children ages 12 years and older will receive the same dosage for treating asthma as adults. Note that a child’s doctor may recommend a higher loading dose and ongoing dosage. This is especially likely if the child is taking certain corticosteroids for asthma or also has atopic dermatitis.

Children’s dosage for chronic rhinosinusitis with nasal polyps

For helping to treat chronic rhinosinusitis with nasal polyps in children ages 12 years and older, the dosage is the same as it is for adults: one Dupixent injection of 300 mg every 2 weeks.

Children’s dosage for eosinophilic esophagitis

For helping to treat eosinophilic esophagitis in children ages 1 year and older, the dosage is the same as it is for adults. It varies based on body weight in kg. See “Dosage for eosinophilic esophagitis” earlier for details.

Children’s dosage for chronic spontaneous urticaria

The following table gives recommended dosages for children ages 12 to 17 years receiving Dupixent for chronic spontaneous urticaria, including loading doses.

How to use

Your doctor will explain how you should inject Dupixent. They’ll also explain how much to inject and how often. Be sure to follow their instructions exactly.

Dupixent is available as a liquid solution that’s given as an injection under your skin. You’ll receive your first dose at your doctor’s office. After that, your doctor may teach you or a caregiver how to give the injections at home.

If your child is prescribed Dupixent and they are younger than age 12 years, you should give your child their injections. If your child is age 12 years or older, they may inject Dupixent themselves if you or another adult is present to supervise.

Injecting Dupixent

For each Dupixent injection, you can choose one of the following injection sites:

• thigh
• abdomen, but not within 2 inches of your belly button
• outer upper arm, but only if a caregiver gives the injection

When you choose your injection site, avoid areas of skin that are painful, bruised, or scarred. Also, it’s best to choose a different site each time you inject Dupixent.

You can view step-by-step injection instructions for Dupixent injections on the manufacturer’s website.

Questions about using Dupixent

Here are answers to some frequently asked questions about using Dupixent.

• Should I inject my dose of Dupixent with a meal? Since you receive Dupixent as an injection under your skin, when you eat does not affect how the drug works in your body.
• What should I know about storing Dupixent? You should keep Dupixent in a refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). After you take Dupixent out of the refrigerator, you should let the drug come to room temperature before injecting it. Depending on which form you use, you may have to leave it out of the refrigerator for 30 or 45 minutes.
• How long can Dupixent stay out of the refrigerator? Dupixent can be kept at room temperature (up to 77°F or 25°C) for 14 days at most. After that, it must be discarded. Be sure to keep Dupixent in its original carton to protect the drug from light.
• How do you stop treatment with Dupixent? If you and your doctor decide that you’ll end Dupixent treatment, you simply will not receive any more doses. There are no special instructions for stopping Dupixent.
• What if I miss a dose of Dupixent? What to do about a missed dose of Dupixent depends on whether you receive injections at a doctor’s office or at home. It also depends on your dosing schedule. For details about what to do if you miss a dose of Dupixent, talk with your doctor or pharmacist.
• Will I need treatment with Dupixent long term? Dupixent is meant to be a long-term treatment. If you and your doctor decide that Dupixent is safe and effective for you, you’ll likely receive it long term.
• How long does Dupixent take to work? Dupixent begins to work in your body after the first injection. But it may be a few weeks to months before you experience symptom relief.

Overdose

Do not inject more Dupixent than your doctor prescribes. Doing so may lead to serious side effects.

What to do in case you receive too much Dupixent

Call your doctor if you think you’ve injected too much Dupixent. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Questions for your doctor

You may have questions about Dupixent and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions such as:
  • How will Dupixent affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you do not understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So do not be afraid to ask questions or offer feedback on your treatment.

What are some frequently asked questions about Dupixent?

Find answers to some commonly asked questions about Dupixent.

What does Dupixent do to your immune system?

Dupixent is a monoclonal antibody drug, which works on very specific targets within your immune system. It‘s not considered an immunosuppressant, which is a type of drug that suppresses the immune system more generally. Corticosteroids are an example of a group of drugs that are immunosuppressants.

Dupixent is not known to weaken your immune system in a way that makes it easier for you to get infections. Instead, the drug reduces inflammation signals in your immune system that can cause the conditions Dupixent is used to treat, such as atopic dermatitis.

Keep in mind that your immune system relies on inflammation signals to respond to certain vaccines. For information about receiving vaccines during Dupixent treatment, see “Dupixent and vaccines” later in this article.

If you have questions about Dupixent’s effects on your immune system, talk with your doctor.

How does Dupixent work, and how long does it last?

The conditions that Dupixent is prescribed to treat are all worsened by inflammation (damage and swelling in your body). Dupixent helps to ease symptoms of these conditions by reducing inflammation.

Specifically, Dupixent’s mechanism of action (how it works) is to block certain proteins from binding to their receptors in your immune system. These proteins are called interleukin-4 (IL-4) and interleukin-13 (IL-13).

Usually, when IL-4 and IL-13 bind to their receptors, your immune system releases proteins called cytokines. This release of cytokines leads to inflammation.

The exact half-life of Dupixent is not known. (A drug’s half-life is the time it takes for your body to clear half of a dose of the drug.) But it takes about 3 months for Dupixent to be fully cleared from your body.

Can Dupixent cause weight gain or hair loss?

It’s unclear whether Dupixent causes weight gain or hair loss. These were not reported as side effects in studies of the drug.

Some research on dupilumab, the active ingredient in Dupixent, suggests the drug may be associated with hair loss. A small study on dupilumab for atopic dermatitis found that some people experienced weight gain during treatment with the drug. But more research is needed to determine whether Dupixent causes weight gain or hair loss.

Keep in mind that other drugs may be used together with Dupixent. These drugs, such as corticosteroids, often cause multiple side effects.

If you have concerns about any side effects from Dupixent, talk with your doctor.

Where can I find before and after pictures of Dupixent treatment?

You can view photos of results from Dupixent treatment of adults and children with eczema on the Dupixent manufacturer’s website. (You’ll need to select an age range under the “Dupixent results” tab to see pictures for different age groups.)

What should be considered before using Dupixent?

Here is important information you should consider before starting Dupixent treatment.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Dupixent is not known to interact with other medications, herbs, supplements, foods, or alcohol. The manufacturer did not list any interactions in the drug’s prescribing information. However, certain interactions may still be possible even if they have not been reported with Dupixent.

Before starting Dupixent treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

Dupixent and alcohol

Alcohol is not known to interact with Dupixent.

It’s likely safe to consume alcohol while receiving Dupixent injections. If you have questions about drinking alcohol during treatment with Dupixent, talk with your doctor or pharmacist. They can tell you how much alcohol, if any, is safe to drink during Dupixent treatment.

Dupixent and vaccines

You should not receive live vaccines during your Dupixent treatment. This is because live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.

Getting a live vaccine during treatment with Dupixent can increase your risk of infection. Examples of live vaccines include measles, mumps, rubella (MMR), rotavirus, and chickenpox.

If you need to receive a vaccine, talk with your doctor first to make sure it’s safe.

Pregnancy and breastfeeding

If you can become pregnant or are breastfeeding, it’s important to consider whether Dupixent is a safe choice for you. It’s unclear whether Dupixent is safe for use during pregnancy or while breastfeeding.

For more information, you can refer to this article on Dupixent and reproductive health. If you have other questions, talk with your doctor.

Warnings

Dupixent can sometimes cause harmful effects in people who have certain conditions. These are known as drug-condition interactions. Other factors may also affect whether Dupixent is a good treatment option for you.

Talk with your doctor about your health history before you inject Dupixent. Be sure to tell them if any of the following factors apply to you:

• history of joint pain
• history of eye problems, such as pink eye or keratitis (inflammation of the cornea)
• risk factors for psoriasis, such as a family history of the condition, certain injuries, or smoking
• risk factors for psoriatic arthritis, such as having psoriasis, a family history of the condition, or smoking
• taking or stopping a steroid medication
• active parasitic infection
• previous allergic reaction to Dupixent or a similar drug
• pregnancy or breastfeeding

What should I know about Dupixent vs. Xolair?

Dupixent (dupilumab) and Xolair (omalizumab) are both biologic drugs, which are made from living cells rather than chemicals. Both drugs are types of monoclonal antibodies. They work by targeting very specific parts of your immune system, but what each drug targets is different.

Dupixent works by blocking inflammation signals. Xolair works by blocking a protein that’s involved in allergic reactions.

Dupixent and Xolair are both used to treat certain forms of asthma, chronic rhinosinusitis with nasal polyps, and chronic spontaneous urticaria. They each have other uses, too.

For more information about either drug, talk with your doctor or pharmacist.

Dupixent cost and coupons

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. For more information, including ways to save on your prescription, see this article about Dupixent and cost.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Dupixent manufacturer’s website to see support options, such as the Dupixent MyWay Copay Card.