Dupixent (dupilumab)

What is Dupixent?

Dupixent (dupilumab) is a brand-name prescription medication. It’s used to treat the following conditions:

• Moderate to severe eczema (atopic dermatitis). It’s prescribed for adults and for children ages 6 years and older when symptoms can’t be controlled with topical prescription drugs, or when those drugs should not be used.
• Moderate to severe asthma. It’s prescribed for adults and for children ages 6 years and older with eosinophilic asthma or oral corticosteroid-dependent asthma. It’s used as an add-on maintenance treatment. Rescue inhalers should still be used as needed for asthma attacks or symptoms such as trouble breathing. Dupixent should never be used to treat a sudden asthma attack.
• Chronic rhinosinusitis with nasal polyps. It’s prescribed for adults whose symptoms are not well controlled. It’s used as an add-on to maintenance treatment.

Dupixent belongs to a class of medications called monoclonal antibodies. These drugs work on a very specific part of your immune system.

Dupixent comes in single-dose prefilled syringes and pens. It’s given as a subcutaneous injection (under your skin). Dupixent comes in two doses: a 200-mg/1.14-mL solution and a 300-mg/2-mL solution.

You can receive Dupixent at your doctor’s office or give yourself injections at home after you learn how. You and your doctor can talk about the best option for you.

How often you’ll receive doses of Dupixent varies with your age and the condition you’re treating.

Effectiveness

Clinical trials have shown Dupixent to be effective in treating eczema, asthma, and chronic rhinosinusitis with nasal polyps.

• For eczema: In a clinical trial for teenagers with moderate to severe eczema, 24% of people saw clearer skin and 37% of people had less itching within a 16-week period. In adults with eczema, clinical trials showed that almost half of people had a 75% improvement in their skin. Between 36% to 39% of people had clear or almost-clear skin at the end of a 16-week period.
• For asthma: In people ages 6 years and older with asthma, clinical trials showed that Dupixent helped prevent severe asthma attacks. It improved people’s breathing, and they didn’t have to use oral corticosteroids as often to relieve asthma symptoms. Oral corticosteroids are medications such as prednisone that are taken by mouth to treat inflammation.
• For chronic rhinosinusitis with nasal polyps: In a 24-week clinical trial, people taking Dupixent saw about a 51% to 59% improvement in nasal congestion. This is compared to a 16% to 18% improvement in people taking a placebo (a treatment without an active drug). Also, 52% of people saw improvement in their sense of smell. Reduced ability to smell is a common side effect of nasal polyps.

FDA approval

Dupixent was first approved by the Food and Drug Administration (FDA) in 2017 to treat eczema in adults.

In 2018, it was approved as an add-on maintenance therapy to treat moderate to severe asthma that’s classified as eosinophilic or corticosteroid-dependent. At this time, Dupixent was approved to treat asthma in adults and in children ages 12 years and older. In 2021, this use was expanded to include children ages 6 to 11 years.

In 2019, Dupixent was approved to treat moderate to severe eczema in children ages 12 years and older:

• with symptoms that can’t be controlled with topical prescriptions, or
• when topical treatments should not be used

In 2020, this use was expanded to include children ages 6 to 11 years.

Also in 2019, Dupixent was approved as add-on maintenance therapy to treat chronic rhinosinusitis with nasal polyps in adults.

Dupixent uses

The Food and Drug Administration (FDA) approves prescription drugs, such as Dupixent, to treat certain conditions. Dupixent may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Dupixent for eczema (atopic dermatitis)

Dupixent is FDA-approved to treat moderate to severe eczema that’s not responding well to topical medications that you apply to your skin, such as creams or ointments, or when topical medications should not be used. Adults and children ages 6 years and older with eczema can take Dupixent.

Eczema is a chronic skin condition that can make your skin red, swollen, dry, and itchy. It affects more than 30 million people in the United States, according to the National Eczema Association.

Atopic dermatitis is a type of eczema.

Eczema is not contagious. It’s typically caused by genetics or an overactive immune system.

Usually, treatment for eczema starts with topical creams or ointments to help relieve itching and redness. However, Dupixent is an option for people with moderate to severe eczema that’s not responding to topical treatments.

Mild eczema typically doesn’t affect your everyday life. However, moderate or severe eczema may interfere with your daily activities. Also, you may feel like you can’t control the itching that comes with moderate to severe eczema. You can find more information about eczema in the Medical News Today dermatology hub.

In 16-week clinical trials for eczema, 44% to 51% of the people taking Dupixent had a 75% decrease in their symptoms. In comparison, about 12% to 15% of people taking a placebo (a treatment without an active drug) experienced a 75% decrease in symptoms.

Of the adults with eczema, 36% to 41% had a significant decrease in itching after 16 weeks. In comparison, 10% to 12% of people taking a placebo had a significant decrease in itching.

Dupixent for asthma

Dupixent is approved for use in adults and children ages 6 years and older with moderate to severe asthma that is either:

• eosinophilic
• oral corticosteroid-dependent

People with eosinophilic asthma have an increased number of eosinophils in their blood. Eosinophils are a type of white blood cell that are part of your immune system. Too many eosinophils can lead to swelling and inflammation in your lungs, which causes eosinophilic asthma. You can learn more about asthma in our asthma and allergies hub.

Dupixent can also be used in people with moderate to severe asthma who currently take oral corticosteroids such as prednisone. This type of steroid is used to decrease swelling in your lungs.

If you have an asthma attack, be sure to use your rescue inhaler. Dupixent should never be used to treat an asthma attack.

Dupixent can also help some people with asthma depend less on corticosteroid medications to treat their asthma symptoms. Some might stop needing to use steroids for asthma altogether. However, Dupixent should never be used to treat an asthma attack.

In clinical trials, people taking Dupixent had up to 81% fewer asthma attacks than people taking a placebo. Dupixent use also improved lung function. In clinical trials, lung function in people taking Dupixent improved by 21% to 23%. In comparison, lung function improved by 12% to 14% in people taking a placebo.

Dupixent for chronic rhinosinusitis with nasal polyps

Dupixent is approved to treat chronic rhinosinusitis with nasal polyps (swelling and benign growths in the nasal passages) in adults. It’s used when the condition is not well controlled by other treatments.

Dupixent is used as an add-on treatment in people with chronic rhinosinusitis with nasal polyps who are already taking another medication to treat it. Rhinosinusitis is when your sinus cavities swell and cause pain or pressure in your face, along with congestion. Rhinosinusitis becomes chronic when it lasts for 12 weeks or longer.

Nasal polyps are tissue growths in the nose that are noncancerous. People with chronic rhinosinusitis usually have an increased number of eosinophil cells in their nasal and sinus cavities. Eosinophils are immune system cells that increase swelling in the area.

Dupixent helps by reducing swelling in the area, which relieves symptoms of chronic rhinosinusitis with nasal polyps.

In clinical trials, Dupixent greatly decreased nasal and sinus symptoms caused by chronic rhinosinusitis. It also helped improve people’s sense of smell. Reduced ability to smell is a common side effect of nasal polyps.

After 24 weeks, people taking Dupixent experienced a 51% to 59% decrease in nasal congestion. In comparison, people taking a placebo experienced a 16% to 18% decrease in nasal congestion.

Dupixent for other conditions

You may wonder if Dupixent is used for certain other conditions in addition to those listed above. Here we discuss some conditions that Dupixent may or may not be used to treat.

Dupixent for alopecia (hair loss)

Dupixent is currently in clinical trials to see if it’s effective in treating alopecia. If you have alopecia, your immune system attacks your hair follicles, causing hair loss. Alopecia ranges from patches of hair loss to total hair loss.

Some people with alopecia taking Dupixent for eczema (atopic dermatitis) have had their hair start to regrow while taking the drug.

Dupixent for cancer (not an appropriate use)

Dupixent hasn’t been shown to be effective in treating cancer. Other medications used to treat asthma that are similar to Dupixent, such as Xolair, may increase the risk of developing cancer.

Dupixent can help treat nasal polyps in people with chronic rhinosinusitis with nasal polyps. However, these nasal growths are not cancerous.

Dupixent for psoriasis (not an appropriate use)

Dupixent is not approved to treat psoriasis, a condition that causes thick, red patches to appear on the skin. Eczema may appear to be similar to psoriasis. However, eczema is usually much itchier than psoriasis.

Your doctor can determine if you have eczema or psoriasis and if Dupixent is the right treatment for you.

Dupixent for dyshidrotic eczema (not an appropriate use)

Dupixent is not currently approved for the treatment of dyshidrotic eczema. Although dyshidrotic eczema is a type of eczema, it’s not the same as atopic dermatitis. Dyshidrotic eczema often appears as blisters on your feet and hands. The blisters may flare up if you are stressed or have sensitive skin that’s exposed to certain allergens.

Dupixent and children

For moderate to severe eczema or asthma, Dupixent is approved for use in children ages 6 years and older.

How to inject Dupixent

Dupixent is given as a subcutaneous injection (under the skin). You should take Dupixent according to your doctor or pharmacist’s instructions.

For your first dose of Dupixent for treating eczema or asthma, you will typically get two injections in two different areas of your body. Usually, the first dose is given at your doctor’s office. After the first dose, most people only need one dose every other week.

For treating chronic rhinosinusitis with nasal polyps, treatment starts and continues with one dose every other week.

Your doctor can teach you how to give yourself injections, or you can go to their office for injections. For children, it’s recommended that the doctor gives the injections in their office.

Dupixent syringes and pens should be stored in the refrigerator at 36 to 46°F (2 to 8°C).

Before using Dupixent, remove it from the refrigerator and let it reach room temperature. Depending on the form of Dupixent you’re using, you’ll need to leave it out of the fridge for either 30 minutes or 45 minutes.

Never heat Dupixent syringes or pens, or put them in the sunlight.

Dupixent can be injected into your thigh, upper arm, or stomach. Dupixent shouldn’t be injected within 2 inches of your belly button. Use a different area each time you inject, and don’t inject into skin that’s bruised, damaged, tender, or scarred.

Be sure to dispose of the used syringe properly in a sharps container.

There are detailed instructions for Dupixent injections on the drug’s website.

When to take

After your first dose, Dupixent should be taken once every other week. Some children will take a dose every 4 weeks.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Dupixent generic or biosimilar

Dupixent contains the active ingredient dupilumab, which is a biologic drug. Dupixent is available only as a brand-name medication. It’s not currently available in biosimilar form.

A biosimilar medication is a drug that’s similar to a brand-name biologic medication (the parent drug).

Biologics are made from living cells. It’s not possible to make an exact copy of these drugs. A generic, on the other hand, refers to medications made from chemicals. A generic is an exact copy of the active drug in a brand-name medication.

Biosimilars are considered to be just as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

Dupixent cost

As with all medications, the cost of Dupixent can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Dupixent at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Dupixent, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

Financial and insurance assistance

If you need financial support to pay for Dupixent, or if you need help understanding your insurance coverage, help is available.

Sanofi and Regeneron Pharmaceuticals Inc., the manufacturer of Dupixent, offers a MyWay Copay Card Program. This may help lower the cost of your medication if you have insurance coverage for prescription drugs.

If you don’t have insurance coverage for this drug, the Dupixent MyWay Patient Assistance Program may be able to help lower the cost of your treatment. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website.

Dupixent side effects

Dupixent can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Dupixent. These lists do not include all possible side effects.

For more information on the possible side effects of Dupixent, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome. You can also see this article for details about side effects that Dupixent can cause.

More common side effects

The more common side effects of Dupixent can include:

• injection site reactions; see “Side effect details” below for more information
• throat pain
• oral herpes causing cold sores, or other herpes infections;* see “Side effect details” below for more information
• dry or itchy eyes
• conjunctivitis (pink eye); see “Side effect details” below for more information
• insomnia (trouble sleeping)†
• toothache†
• joint pain†
• gastritis (swelling in your stomach)†
• eosinophilia (increase in a type of white blood cells)
• eyelid inflammation‡

* Occurs only if you’ve been exposed to the herpes virus. Also, this side effect wasn’t reported by people using Dupixent to treat chronic rhinosinusitis.
† This side effect was most commonly reported by people using Dupixent to treat chronic rhinosinusitis.
‡ This side effect was only reported by people using Dupixent to treat eczema.

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Dupixent aren’t common, but they can occur. Call your doctor 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.

Serious side effects and their symptoms can include:

• Eye problems in people with eczema (atopic dermatitis) or chronic rhinosinusitis. Symptoms can include:
  • changes in vision
  • eye pain
  • new or worsening eye problems
• Eosinophilic conditions, including pneumonia and vasculitis. See “Side effect details” below.
• Severe allergic reaction. See “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on some of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Dupixent. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing
• hives

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Dupixent. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Conjunctivitis

If you take Dupixent for eczema (atopic dermatitis) or chronic rhinosinusitis, you may develop conjunctivitis (pink eye).

During a 16-week clinical trial, conjunctivitis occurred in about 10% of people with eczema taking Dupixent. In comparison, 2% of people taking a placebo (a treatment without an active drug) developed conjunctivitis. For most people with conjunctivitis, it cleared up or was getting better during the clinical trial.

There was no increased risk of conjunctivitis in people with asthma taking Dupixent.

In chronic rhinosinusitis with nasal polyps, conjunctivitis occurred in 2% of people taking Dupixent and 1% of people taking a placebo.

Talk with your doctor or pharmacist if you have any new or worsening eye conditions while taking Dupixent. They may suggest ways to relieve your symptoms.

Eosinophilic conditions

If you take Dupixent for asthma, you may develop eosinophilic conditions, including pneumonia and vasculitis. Eosinophils are blood cells that help fight infection. However, higher-than-normal levels of eosinophils can cause inflammatory issues.

Symptoms of eosinophilic conditions can include:

• vasculitis (swelling of the blood vessels)
• pneumonia
• fever
• swollen lymph nodes
• skin lesions (an abnormal growth or appearance on part of your skin)

Cases of eosinophilic pneumonia and vasculitis were reported in early clinical testing of Dupixent for asthma and chronic rhinosinusitis with nasal polyps. It’s not clear if Dupixent is responsible for these side effects.

Talk with your doctor if you get any of the symptoms associated with eosinophilic conditions. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Long-term side effects

Side effects from long-term use of Dupixent are similar to those from shorter-term use.

For instance, side effects that occurred in a clinical trial lasting 52 weeks were similar to common side effects listed above for eczema, asthma, and chronic rhinosinusitis with nasal polyps.

Herpes

You could develop oral herpes (cold sores) while taking Dupixent. However, to get a cold sore, you must already have the herpes virus in your body. If you’ve never had a cold sore before, it’s very rare that Dupixent would cause one.

In clinical trials, oral herpes or other herpes infections occurred in less than 6% of people taking Dupixent. This side effect wasn’t reported by people using Dupixent to treat chronic rhinosinusitis.

If you do develop cold sores, talk to your doctor about medications that can help treat them. You can also talk to your pharmacist about over-the-counter options for cold sores that may relieve your symptoms or prevent them from occurring.

Injection site reactions

You could have an injection site reaction from taking Dupixent. This is most common with the first injection. In clinical trials of people taking Dupixent, injection site reactions occurred in:

• 10% of people with eczema
• 14% to 18% of people with asthma
• 6% of people with chronic rhinosinusitis with nasal polyps

Injection site reactions include redness, swelling, pain, and itching around the area where Dupixent was injected. These symptoms can last a few days after your injection is given. If you get an injection site reaction and are concerned, talk to your doctor or pharmacist about ways to relieve your symptoms.

Weight gain (not a side effect)

It’s unlikely that you will gain weight from taking Dupixent. Weight gain was not a side effect in clinical trials of Dupixent. Sometimes, steroids such as prednisone can be used to treat severe eczema or asthma. Ongoing use of these steroids may cause weight gain.

Talk to your doctor if you’re concerned about gaining weight from your eczema or asthma treatments.

Depression (not a side effect)

It’s unlikely that taking Dupixent will make you feel depressed. Depression was not a side effect in clinical trials of Dupixent.

However, eczema can sometimes cause depression because people feel upset, sad or hopeless about their skin condition. Dupixent can help improve your skin, so it may help with eczema-related depression.

It’s also possible that asthma or chronic rhinosinusitis with nasal polyps could lead to depression. Any long-term condition can make you feel anxious or depressed.

Talk with your doctor if you have concerns about your mental health.

Dupixent dosage

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

• the type and severity of the condition you’re using Dupixent to treat
• your age
• body weight, in children
• other medical conditions you may have

Your doctor may adjust your dose over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

For treating eczema or asthma, the first dose of Dupixent is usually given as a loading dose. A loading dose is when a higher dose of medication is given as the first dose of treatment. This way, you get more medication at the beginning of treatment, which can help get the best results.

After a loading dose of Dupixent, you take one maintenance dose every other week for eczema or asthma. Maintenance doses help maintain the same level of medication in your body so it can be effective.

For chronic rhinosinusitis with nasal polyps, you don’t take a loading dose. You start with a normal dose and continue taking that dose every other week.

The following information describes dosages that are commonly used or recommended. You can also see this article for details about Dupixent’s typical dosages. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Dupixent comes in single-dose prefilled syringes and pens. There are two syringes in each box of Dupixent.

Dupixent comes in the following doses:

• 200 milligrams (mg)/1.14 milliliters (mL)
• 300 mg/2 mL
• 100 mg/0.67 mL

Dosage for eczema (atopic dermatitis)

In adults with eczema, the first dose of Dupixent consists of two injections of 300 mg each. This gives a total dose of 600 mg.

After the first dose, you’ll get one injection of 300 mg every other week.

Dosage for asthma

When Dupixent is used to treat asthma, there are two possible starting dosages for adults and children ages 12 years and older. (See “Pediatric dosage” just below for information about the dosage for asthma in children 6 to 11 years old.)

One option is to give a first dose of two 200-mg injections. This gives a total dose of 400 mg. This dose is followed by one 200-mg injection every other week.

The other option is to give a starting dose of two 300-mg injections. This gives a total dose of 600 mg. This dose is followed by one 300-mg injection every other week.

Doctors may recommend that some people with asthma start at the higher dose. This includes people who:

• are currently taking steroids for their asthma
• also have moderate to severe eczema in addition to asthma

Dosage for chronic rhinosinusitis with nasal polyps

To treat chronic rhinosinusitis with nasal polyps in adults, the typical Dupixent dose is one 300-mg injection every other week. (With nasal polyps, you have swelling and benign growths in the nasal passages.)

Pediatric dosage

The Dupixent dosage for children varies depending on the condition it’s used to treat.

Children’s dosage for eczema

In children ages 6 to 17 years and older with eczema, the Dupixent dosage is based on body weight.

In children weighing 15 kilograms (kg), or 33 pounds (lb), to less than 30 kg, or 66 lb, the first dose is two 300-mg injections given at one time. Then, they would receive one 300-mg injection once every 4 weeks.

In children weighing 30 kg (66 lb) to less than 60 kg (132 lb), the first dose is two 200-mg injections given at one time. Then, they would receive one 200-mg injection once every other week.

Children weighing 60 kg (132 lb) or more would get two 300-mg injections for the first dose. Then they would only get one 300-mg injection every other week.

Children’s dosage for asthma

For children ages 6 to 11 years old with asthma, Dupixent’s dosage is based on body weight.

In children weighing 15 kilograms (kg), or 33 pounds (lb), to less than 30 kg, or 66 lb, the recommended dosage is either:

• a 100-mg injection every other week, or
• a 300-mg injection once every 4 weeks

In children weighing 30 kg (66 lb) or more, the recommended dosage is a 200-mg injection given every other week.

Children’s dosage for chronic rhinosinusitis with nasal polyps

Dupixent is not approved for use in children with chronic rhinosinusitis with nasal polyps.

What if I miss a dose?

What to do if you miss a dose of Dupixent depends on how often you take the drug.

For instance, if you take Dupixent every other week and miss a dose, take the dose within 7 days of missing it. If you forget to take it within 7 days, skip that dose and wait until you’re supposed to take the next dose.

For children taking Dupixent once every 4 weeks, give the missed dose within 7 days of when it was missed. Then, go back to their original dosing schedule. If the missed dose isn’t given within 7 days, give one dose, then start a new dosing schedule based on the date it’s given.

For example, let’s say your child usually takes a dose of Dupixent on the first of the month. But this dose is missed, and it’s not taken until the eighth of the month. In that case, your child will start taking a dose on the eighth of every month.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Dupixent is meant to be used as a long-term treatment. If you and your doctor determine that Dupixent is safe and effective for you, you’ll likely take it long term.

Dupixent use with other drugs

Dupixent can be used along with topical corticosteroids you apply to your skin, such as triamcinolone, to help relieve symptoms of eczema (atopic dermatitis). These topical corticosteroids usually come in the form of creams or ointments.

Calcineurin inhibitors, such as tacrolimus (Protopic), are another type of cream or ointment that can be used along with Dupixent. Topical calcineurin inhibitors should only be used on irritated skin including your face, neck, and genital areas.

Calcineurin inhibitors do not prevent eczema. However, they can be helpful in treating currently inflamed skin. Therefore, calcineurin inhibitors should only be used where you have eczema.

When Dupixent is used for asthma, it can be used along with steroids and a rescue inhaler. Dupixent will not treat an asthma attack, so you should continue to use your rescue inhaler as needed.

Don’t stop taking steroids abruptly. Talk to your doctor about whether you need to continue taking your steroid medication while using Dupixent. Sometimes, steroid doses can be reduced or stopped altogether.

Dupixent and alcohol

There are no known interactions with Dupixent and alcohol. However, if you drink alcohol and are concerned about drinking while taking Dupixent, talk with your doctor.

Dupixent vs. Fasenra

You might wonder how Dupixent compares with Fasenra. Dupixent contains dupilumab, and Fasenra contains a different active drug called benralizumab. Both drugs are biologics.

Dupixent is used to treat eczema (atopic dermatitis) and asthma in adults and children 6 years and older. It’s also used for chronic rhinosinusitis with nasal polyps in adults.

Fasenra is used for eosinophilic asthma in adults as well as children 12 years and older.

Both Dupixent and Fasenra can be self-injected or given by a healthcare professional. You’ll still need to use a rescue inhaler as needed for asthma if you’re taking either drug.

Talk with your doctor or a pharmacist if you’d like to learn more about how these drugs compare.

Alternatives to Dupixent

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Dupixent, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for eczema (atopic dermatitis)

Examples of other treatments that may be used for eczema include:

• Oral medications such as:
  • Imuran (azathioprine)
  • Trexall (methotrexate)
  • CellCept (mycophenolate)
  • Rayos (prednisone)
  • Sandimmune (cyclosporine)
• Topical medications that you apply to your skin, such as:
  • Eucrisa (crisaborole)
  • Elidel (pimecrolimus)
  • Protopic (tacrolimus)
  • Lidex (fluocinonide)
  • Elocon (mometasone)
  • Ala-Cort (hydrocortisone)
• phototherapy (UV light therapy)

Alternatives for asthma

Examples of other drugs that may be used to treat asthma include:

• Xolair (omalizumab)
• Fasenra (benralizumab)
• Uniphyl (theophylline)
• Cinqair (reslizumab)
• Nucala (mepolizumab)
• inhaled medications such as Spiriva (tiotropium)
• Singulair (montelukast)

Alternatives for chronic rhinosinusitis with nasal polyps

Examples of other treatments that may be used for chronic rhinosinusitis with nasal polyps (swelling and benign growths in the nasal passages) include:

• saline nasal rinses such as NeilMed
• nasal steroid sprays such as Flonase (fluticasone)
• Singulair (montelukast)
• oral corticosteroids such as Rayos (prednisone)

These medications are used off-label to treat chronic rhinosinusitis with nasal polyps. Dupixent is the first and only medication approved to treat this condition.

Dupixent vs. Xolair

You may wonder how Dupixent compares to other medications that are prescribed for similar uses. Here we look at how Dupixent and Xolair are alike and different.

Uses

Dupixent is approved for use in adults and children ages 6 years and older with moderate to severe eosinophilic asthma or moderate to severe oral corticosteroid-dependent asthma.

Dupixent can be used along with other medications such as oral or inhaled corticosteroids in people whose asthma wasn’t well controlled with other medications they’ve tried.

Adults and children ages 6 years and older can take Dupixent to treat moderate to severe eczema (atopic dermatitis) that’s not well controlled with topical medications applied to the skin. Dupixent can also be used when topical treatments shouldn’t be used to treat someone’s eczema.

Dupixent is also approved for use in adults with chronic rhinosinusitis with nasal polyps (swelling and benign growths in the nasal passages) whose symptoms are not well controlled.

Dupixent is an injected medication.

Xolair is approved to treat moderate to severe asthma that’s not well controlled with inhaled corticosteroids. Adults and children ages 6 years and older can use Xolair for asthma.

Xolair is also approved for use in adults and children ages 12 and older who have chronic hives without a known cause that continues to be symptomatic after treatment with an antihistamine.

Additionally, Xolair is approved to treat nasal polyps in adults. It’s used when nasal corticosteroids haven’t improved the condition enough.

Xolair is an injected medication.

Drug forms and administration

Dupixent comes in single-dose prefilled syringes and pens, which are each available in the following strengths:

• 200 mg/1.14 milliliters (mL)
• 300 mg/2 mL

Dupixent syringes also come in a strength of 100 mg/0.67 mL.

When used to treat asthma in adults and children ages 6 years and older, Dupixent is injected every other week or every 4 weeks.

Usually, the first dose of Dupixent is two 200-mg injections. Then, you get one 200-mg injection every other week.

However, the doses may be higher for people who also take corticosteroids (such as prednisone) or who have both asthma and eczema. In these people, two 300-mg injections are given the first week. After that, they get one 300-mg injection every other week.

Xolair comes in the following forms:

• 75-mg/0.5-mL prefilled syringe
• 150-mg/1-mL prefilled syringe
• 150-mg powder that’s mixed into an injectable solution by a healthcare professional

Dosages of Xolair range from 75 mg to 375 mg and are injected every 2 or 4 weeks. Xolair dosages are based on body weight and the results of a blood test called the immunoglobulin E (IgE) test. This test shows whether your immune system is overactive (often due to allergens).

Side effects and risks

Dupixent and Xolair have some similar side effects and others that differ. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Dupixent, with Xolair, or with both drugs (when taken individually).

• Can occur with Dupixent:
  • throat pain
  • conjunctivitis (pink eye)
  • eosinophilia (increase in a type of white blood cells)
  • oral herpes causing cold sores, or other herpes infections*
  • toothache
  • dry or itchy eyes
  • gastritis (swelling in your stomach)
  • insomnia (trouble sleeping)
• Can occur with Xolair:
  • general body aches and pains
  • leg or arm pain
  • bone fractures
  • feeling tired
  • dizziness
  • earache
  • inflammation of the skin
  • itchy skin
• Can occur with both Dupixent and Xolair:
  • joint pain
  • injection site reactions

* This can occur only if you’ve been exposed to the herpes virus

Serious side effects

These lists contain examples of serious side effects that can occur with Dupixent, with Xolair, or with both drugs (when taken individually).

• Can occur with Dupixent:
  • eosinophilic conditions, including pneumonia and vasculitis
  • eye problems
• Can occur with Xolair:
  • certain types of cancer, such as breast or skin cancer
  • an immune response called serum sickness, which can cause fever, severe joint pain, and rash
• Can occur with both Dupixent and Xolair:
  • severe joint pain
  • severe allergic reaction

Effectiveness

Dupixent and Xolair have different FDA-approved uses, but they’re both used to treat moderate to severe asthma that’s not well controlled with other medications.

These drugs haven’t been directly compared in clinical studies, but studies have found both Dupixent and Xolair to be effective for treating asthma.

Costs

Dupixent and Xolair are both brand-name drugs and also biologics. There are currently no biosimilar forms of either drug. Brand-name medications usually cost more than generics or biosimilars.

Dupixent generally costs more than Xolair. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Dupixent vs. Eucrisa

Dupixent and Eucrisa are prescribed for similar uses. Below are details of how these medications are alike and different.

Uses

Adults and children ages 6 years and older can take Dupixent to treat moderate to severe eczema (atopic dermatitis) that’s not well controlled with topical medications applied to the skin. Dupixent can also be used when topical treatments shouldn’t be used to treat someone’s eczema.

Dupixent is approved for use in adults and children ages 6 years and older with moderate to severe eosinophilic asthma or moderate to severe oral corticosteroid-dependent asthma.

Dupixent can be used along with other medications such as oral or inhaled corticosteroids in people whose asthma wasn’t well controlled with other medications they’ve tried.

Dupixent is also approved for use in adults with chronic rhinosinusitis with nasal polyps (swelling and benign growths in the nasal passages) whose symptoms are not well controlled.

Dupixent is an injected medication.

Eucrisa is used to treat mild to moderate eczema in adults and children ages 3 months and older. Eucrisa is a topical ointment, so you apply it to your skin.

Drug forms and administration

Eucrisa is available in an ointment tube, with 20 milligrams (mg) of Eucrisa in each gram of ointment. Eucrisa should be used twice a day. Apply it as a thin layer to affected areas only. Eucrisa should never be used in the eyes, mouth, or vagina.

Dupixent is available as an injectable medication that goes under the skin. It comes in single-dose prefilled syringes and pens, which are each available in the following strengths:

• 200 mg/1.14 milliliters (mL)
• 300 mg/2 mL

Dupixent syringes also come in a strength of 100 mg/0.67 mL.

In adults with eczema, the first dose of Dupixent consists of two injections of 300 mg each. This gives a total dose of 600 mg. After the first dose, one injection of 300 mg is given every other week.

In children ages 6 to 17 years and older with eczema, the Dupixent dosage is based on body weight. For more information, see “Children’s dosage for eczema” in the “Dupixent dosage” section above.

Side effects and risks

Dupixent and Eucrisa both contain medications to treat eczema. Eucrisa is an ointment you apply directly onto your skin, and Dupixent is an injected medication. Therefore, these medications can cause side effects that may be very different. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Dupixent, with Eucrisa, or with both drugs (when taken individually).

• Can occur with Dupixent:
  • throat pain
  • conjunctivitis (pink eye)
  • eosinophilia (increase in a type of white blood cells)
  • oral herpes causing cold sores, or other herpes infections*
  • toothache
  • itchy eyes
  • gastritis (swelling in your stomach)
  • insomnia (trouble sleeping)
• Can occur with Eucrisa:
  • red welts or rash
• Can occur with both Dupixent and Eucrisa:
  • pain at the site of application or injection

* This can occur only if you’ve been exposed to the herpes virus

Serious side effects

These lists contain examples of serious side effects that can occur with Dupixent or with both drugs (when taken individually).

• Can occur with Dupixent:
  • eosinophilic conditions, including pneumonia and vasculitis
  • eye problems
• Can occur with both Dupixent and Eucrisa:
  • severe allergic reaction

Effectiveness

The Food and Drug Administration (FDA) has approved Dupixent and Eucrisa for some different uses, but they’re both used to treat eczema.

These drugs haven’t been directly compared in clinical studies. But different studies have found both Dupixent and Eucrisa to be effective in treating eczema.

Costs

Dupixent and Eucrisa are both brand-name drugs. There are currently no generic or biosimilar forms of Dupixent or generic forms of Eucrisa. Brand-name medications usually cost more than generics or biosimilars.

Eucrisa is typically much less expensive than Dupixent. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Dupixent and pregnancy

It’s not known if Dupixent may harm a fetus or affect a pregnancy. Talk with your doctor if you’re pregnant or plan to become pregnant. They can discuss the possible risks and benefits of using Dupixent.

If you use Dupixent while pregnant, you could consider joining the drug’s pregnancy registry. The purpose of a pregnancy registry is to monitor how a drug affects pregnancy. If any side effects occur, they should be reported so that Dupixent use in pregnancy can be more thoroughly studied. To sign up for the pregnancy registry or learn more, call 877-311-8972 or visit the registry website.

Dupixent and breastfeeding

It’s not currently known if Dupixent can pass into breast milk. If Dupixent does get into breast milk, the medication may have a harmful effect on the child who’s being breastfed.

If you are breastfeeding or plan to breastfeed, talk with your doctor about the possible risks and benefits of using Dupixent.

How Dupixent works

Dupixent blocks two proteins that can cause inflammation in your body. By blocking these proteins, Dupixent reduces inflammation. This can make symptoms of asthma, dermatitis, or chronic rhinosinusitis with nasal polyps (swelling and benign growths in the nasal passages) more manageable.

For eczema (atopic dermatitis)

If you have eczema, your immune system causes inflammation under your skin. When this inflammation flares up, it can cause a red, itchy rash on your skin. Dupixent works by reducing the inflammation. This helps relieve your symptoms and makes your skin clearer.

For asthma

If you have moderate to severe asthma, your lungs may have more inflammation than someone without asthma. This can lead to coughing, wheezing, or difficulty breathing.

Dupixent works by reducing the inflammation in your lungs. When taking Dupixent, you might not need to use oral steroid pills as often to control your asthma. Also, Dupixent may help prevent asthma attacks and improve your breathing.

For chronic rhinosinusitis with nasal polyps

If you have chronic rhinosinusitis with nasal polyps, you usually have long-term inflammation in your nose and sinuses. This swelling often causes congestion and difficulty breathing. Dupixent works by reducing the swelling in your nose and sinuses.

How long does it take to work?

Dupixent begins to work after the first injection. However, it may take a few weeks before you notice an improvement in symptoms.

In a clinical study, more than 36% of adults with eczema had relief from itching in 16 weeks or less while taking Dupixent. In children ages 12 to 17 years old, 37% had itching relief in 16 weeks.

You should continue treatment for at least 16 weeks to determine if Dupixent works for you. If your eczema, asthma, or chronic rhinosinusitis with nasal polyps isn’t responding or improving after 16 weeks, talk with your doctor. You can discuss whether you should keep taking Dupixent or switch to another treatment.

Common questions about Dupixent

Here are answers to some frequently asked questions about Dupixent.

Will I have withdrawal symptoms if I stop using Dupixent?

It’s not likely that you’ll experience withdrawal symptoms when you stop taking Dupixent. Withdrawal refers to symptoms that occur when you stop taking a drug that your body is dependent on.

However, if you take steroid pills such as prednisone to control your symptoms, you may have withdrawal symptoms if you stop taking those. Symptoms of withdrawal from suddenly stopping a steroid includes weakness, nausea, vomiting, and feeling tired.

You shouldn’t stop taking steroid medications abruptly or without talking to your doctor. It’s best to slowly lower your dose of steroids before stopping entirely.

If I’m taking Dupixent for asthma, do I still need to use my rescue inhaler?

Yes, you should still have a rescue inhaler even if you’re treating your asthma with Dupixent. Dupixent is used to prevent asthma attacks from happening. However, if you have an asthma attack, you need a rescue inhaler to help open up your lungs quickly so you can breathe. Never use Dupixent to treat an asthma attack.

Talk with your doctor if while taking Dupixent your breathing worsens, your rescue inhaler isn’t working, or you need to use your rescue inhaler more often than usual.

Will I be able to get vaccines while I’m using Dupixent?

You shouldn’t get any live vaccines while taking Dupixent. For live vaccines, you’re injected with a small amount of a virus so your body can learn to fight it. You shouldn’t get these vaccines while using Dupixent because the drug may weaken your immune system. If this happens, your body won’t be able to properly fight the vaccine, and it may make you sick.

Talk to your doctor or pharmacist about what vaccines you may need. It’s best to get any needed vaccines before starting Dupixent.

Live vaccines you should avoid while taking Dupixent include:

• measles, mumps, rubella (MMR)
• intranasal flu
• smallpox
• chickenpox
• rotavirus
• yellow fever
• typhoid

Does Dupixent treat food allergies?

No, Dupixent is not used to treat food allergies at this time. Dupixent was being tested as a treatment for children with peanut allergies, but it’s not approved for this use.

Dupixent was tested along with another medication, Palforzia, that was recently approved for peanut allergies. The idea is that using the combination of Palforzia and Dupixent could allow children’s immune systems to learn not to react to peanuts. This would mean that children with severe peanut allergies who were exposed to peanuts wouldn’t have a life-threatening allergic reaction. While the trial testing Dupixent’s use with Palforzia is complete, the results have not yet been made public.

Your doctor or pharmacist can provide more information about Dupixent and food allergies.

Will I still need to use topical treatments for my skin condition if I’m using Dupixent?

You might. Often, Dupixent is used along with topical corticosteroids that you apply to your skin to treat eczema (atopic dermatitis). Topical corticosteroids can help treat problem areas that already exist. Dupixent works inside your body by reducing the inflammation that causes eczema.

Some examples of topical corticosteroids include:

• Lidex (fluocinonide)
• Kenalog (triamcinolone)
• Topicort (desoximetasone)
• Elocon (mometasone)
• Cortisone (hydrocortisone)

Dupixent interactions

Dupixent can interact with some other medications. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

However, Dupixent doesn’t interact with many other medications. This is because it’s a monoclonal antibody, which is metabolized (broken down) inside your cells instead of in your liver. Many other drugs are broken down in your liver, which is where they can interact with each other.

Dupixent and other medications

Below is a list of medications that can interact with Dupixent. This list does not contain all drugs that may interact with Dupixent.

Before taking Dupixent, 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 use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Live vaccines

It’s important not to get any live vaccines while taking Dupixent. For live vaccines, you’re injected with a small amount of a virus so your body can learn to fight it. Dupixent may weaken your immune system, so a live vaccine could make you sick.

Before starting Dupixent, talk to your doctor or pharmacist about any vaccines you may need. You should get any live vaccines you need before you start taking Dupixent.

Live vaccines you should avoid when taking Dupixent include:

• measles, mumps, rubella (MMR)
• intranasal flu
• smallpox
• chickenpox
• rotavirus
• yellow fever
• typhoid

In clinical trials, non-live vaccines such as Tdap (Adacel) and the meningitis vaccine (Menomune) were not affected by Dupixent.

Corticosteroid medications

Swelling of the blood vessels can very rarely occur in patients with asthma who also take a steroid medication. Symptoms can include:

• rash
• shortness of breath
• chest pain
• prickling or tingling feeling like pins and needles in your arms or legs
• fever

If you’re taking any corticosteroids such as prednisone, it’s important not to stop using them suddenly. Stopping any steroids abruptly may cause withdrawal symptoms such as nausea, vomiting, and feeling tired. You may need to slowly decrease your steroid dose before stopping altogether. If you want to decrease or stop your treatment with steroids while you’re taking Dupixent, talk with your doctor about the best way to do this.

Dupixent and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Dupixent. However, you should still check with your doctor or pharmacist before using any of these products while taking Dupixent.

Dupixent precautions

Before taking Dupixent, talk with your doctor about your health history. Dupixent may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Allergic reaction: Do not use Dupixent if you have had an allergic reaction to it. Allergic reactions include rash, hives, and trouble breathing.
• New or worsening eye conditions: Dupixent can cause new or worsening symptoms of eye conditions. Talk to your doctor about eye symptoms that occur while taking Dupixent.
• Parasitic infections: if you have any parasitic infections such as tapeworm, it needs to be treated before starting Dupixent. If you develop a parasitic infection while taking Dupixent, you can be treated with medication while taking it. However, if the infection doesn’t clear up, you may need to stop using Dupixent until the parasitic infection goes away.
• Vaccines. Talk with your doctor to make sure you have all of your vaccines before starting Dupixent treatment. Some vaccines aren’t safe while you’re receiving Dupixent. See “Live vaccines” under “Dupixent interactions” just above for details.
• Asthma attacks: Dupixent should never be used to treat an asthma attack or if you’re having trouble breathing. Dupixent works to reduce asthma symptoms but will not stop an asthma attack from happening after its already started.

Note: For more information about the potential negative effects of Dupixent, see the “Dupixent side effects” section above.

Dupixent overdose

Using more than the recommended dosage of Dupixent can lead to serious side effects.

What to do in case of overdose

If you think you’ve taken or received too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Dupixent expiration, storage, and disposal

When you get Dupixent from the pharmacy, the pharmacist will add an expiration date to the label on the box of syringes. This date is typically one year from the date they dispensed the medication.

The expiration date helps guarantee the medication will be effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Dupixent syringes and pens should be stored in the refrigerator at 36 to 46°F (2 to 8°C). They should be stored in the original box to protect the medication from light.

Dupixent syringes and pens can be stored at room temperature up to a maximum of 77°F (25°C) for up to 14 days. After 14 days at room temperature, Dupixent must be used or discarded. Never heat Dupixent syringes or pens, or put them in the sunlight.

Disposal

If you no longer need to take Dupixent and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Always get rid of your syringes and needles using a sharps container. Never put needles or syringes into your regular household trash. When not disposed of correctly, needles or syringes could injure someone or possibly spread infections. For information about the best ways to get rid of your needles or syringes, see the FDA guidelines.