Dupixent interactions: Alcohol, medications, and other factors

In some cases, factors or conditions could prevent your doctor from prescribing Dupixent due to the risk of harm. These are known as contraindications. The contraindications of Dupixent include:

Having had an allergic reaction to Dupixent or any of its ingredients

If you’ve had an allergic reaction to Dupixent or any of its ingredients, your doctor will likely not prescribe Dupixent. Using the medication could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Dupixent, it’s important to tell your doctor whether this contraindication applies to you. They can determine whether to prescribe Dupixent.

You may wonder whether you can drink alcohol while using Dupixent. There aren’t any known interactions between alcohol and Dupixent. If you’d like to consume alcohol during Dupixent treatment, talk with your doctor. They can recommend how much alcohol, if any, is safe for you.

Before you start treatment with Dupixent, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Dupixent interacts with supplements, herbs, or vitamins, see “Dupixent and other interactions” below.)

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

Here’s a table of drugs that can interact with Dupixent. Keep in mind that this table doesn’t include all drugs that may interact with Dupixent. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Here’s a closer look at certain drug interactions of Dupixent.

Warfarin

The drug warfarin (Jantoven) is used to decrease the risk of blood clots. Your doctor may prescribe this medication if you have a clotting disorder or an irregular heart rhythm, such as atrial fibrillation.

Interaction result. The exact effect of Dupixent on warfarin may vary from person to person. If you take warfarin and Dupixent, you may have an increased risk of side effects from warfarin. Or taking these medications together could make warfarin less effective than usual.

Interaction explained. A group of enzymes called cytochrome P450 (CYP450) breaks down warfarin in the body. (An enzyme is a type of protein.) Conditions that cause inflammation in the body, such as those Dupixent is used to treat, may affect how well CYP450 works. These conditions may either slow down or speed up the activity of CYP450.

The use of Dupixent can help reduce inflammation related to these conditions. When this inflammation is reduced, the activity of CYP450 may return to a typical level. As a result, one of the following situations may occur:

• The activity of CYP450 may slow down to a typical level. If this happens, the combination of warfarin and Dupixent may increase the level of warfarin in your body. Having more of the drug in your system than usual can increase your risk of side effects from warfarin. These can include bleeding, abdominal pain, and bloating.
• The activity of CYP450 may speed up to a typical level. If this happens, the combination of warfarin and Dupixent may lower the level of warfarin in your body. Having less of the drug in your system could make warfarin less effective than usual.

Steps you or your doctor may take. If your doctor prescribes warfarin and Dupixent, they may order more frequent blood tests to check your international normalized ratio (INR). This is a measurement of how long it takes for your blood to clot. An INR test shows how well warfarin is working for you. It can also help your doctor know whether your risk of side effects has increased.

In some cases, your doctor may need to increase or decrease your dose of warfarin during Dupixent treatment.

Lithium

Doctors may prescribe the medication lithium (Lithobid) to treat certain mood disorders, such as bipolar disorder.

Interaction result. The exact effect of Dupixent on lithium can differ from person to person. The combination of lithium and Dupixent can increase your risk of side effects of lithium or make lithium less effective than usual.

Interaction explained. Lithium is broken down in your body by a group of enzymes called CYP450. The conditions Dupixent is used to treat can cause inflammation in the body. This inflammation can impact how well CYP450 works. Specifically, these conditions may speed up or slow down the activity of CYP450.

Dupixent can help lessen any inflammation caused by these conditions. Having less inflammation may cause the activity of CYP450 to return to a typical level. When this happens, either of the following may result:

• The activity of CYP450 may speed up to a typical level. In this case, taking lithium and Dupixent may lower the level of lithium in your system. Having a lower level of the drug in your body could make lithium less effective than usual.
• The activity of CYP450 may slow down to a typical level. In this case, taking lithium and Dupixent may increase the level of lithium in your system. Having more of the drug in your body than usual can increase your risk of side effects from lithium. These side effects may include diarrhea, headache, and dry mouth.

Steps you or your doctor may take. If your doctor has you take lithium during your treatment with Dupixent, they may check the level of lithium in your blood. This can help determine whether the lithium level is too low or too high.

If the lithium level is too low, your doctor may increase your lithium dose while you use Dupixent. If the level of lithium becomes too high, your doctor may decrease your dose while you use Dupixent.

Dupixent may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Dupixent.

Dupixent and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Dupixent and herbs

There have been no specific reports of herbs interacting with Dupixent. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Dupixent treatment.

Dupixent and vitamins

Vitamins have not been reported to interact with Dupixent. Keep in mind that doesn’t mean vitamin interactions won’t occur or be recognized in the future. So to be safe, talk with your doctor or pharmacist before taking any vitamin product with Dupixent.

Dupixent and food

There haven’t been any reports of food interactions with Dupixent. If you’d like to learn more about eating certain foods during treatment with Dupixent, talk with your doctor.

Dupixent interactions with vaccines

Dupixent can interact with certain vaccines. Specifically, this drug can interact with live vaccines.

Live vaccines contain a weakened version of the virus or bacterium they’re meant to fend off. Live vaccines typically won’t cause infection if your immune system is healthy.

Dupixent may weaken your immune system. So, if you receive a live vaccine during Dupixent treatment, your immune system may not be strong enough to fight the virus or bacterium. This could cause you to develop an infection.

Due to this risk, doctors usually recommend getting any live vaccines you may need before starting Dupixent treatment. Your pharmacist or doctor can help make sure that you’re up to date on your vaccines before you begin using Dupixent.

Examples of live vaccines that you should not receive during Dupixent treatment include:

• measles, mumps, rubella (MMR)
• the nasal spray version of the flu vaccine (FluMist)
• cholera
• chickenpox
• yellow fever
• rotavirus
• typhoid
• smallpox

Dupixent isn’t known to interact with inactive vaccines, such as the injectable flu vaccine. Inactive vaccines are also called non-live vaccines. They don’t contain a live version of the virus or bacterium they’re meant to fend off. If you have questions about getting inactive vaccines while using Dupixent, talk with your doctor or pharmacist.

Dupixent and lab tests

Dupixent isn’t known to interact with any lab tests. If you have questions about what lab tests you need during your treatment, talk with your doctor.

DUPIXENT AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Dupixent. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Dupixent. The impact of cannabis may affect how well you stick to your Dupixent treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Dupixent. Before you start treatment with this drug, be sure to talk with your doctor about your health history. Dupixent may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Dupixent include the following.

Eye conditions. Dupixent may cause new or worsening eye problems, such as keratitis or pink eye. If you have an eye condition, tell your doctor before starting treatment with the drug. They may recommend that an eye doctor monitor your eyes more frequently while you use Dupixent.

Joint pain. If you have joint pain or a condition that causes joint pain, such as arthritis, tell your doctor before starting Dupixent treatment. The drug may worsen the pain. Also tell them if you have new or worsening joint pain while you use Dupixent. If your pain is severe, they may recommend stopping treatment.

Parasitic infections. People with parasitic infections weren’t included in clinical trials of Dupixent. So it’s unknown whether the drug could make treatment of the infection less effective.

Before using Dupixent, tell your doctor if you have a parasitic infection. They’ll treat it before you start using the medication.

If you develop a parasitic infection while using Dupixent, your doctor will treat the infection. They may have you stop using Dupixent while the infection is being treated.

Asthma attack. You should not use Dupixent to treat an asthma attack. The medication is meant to help ease symptoms of asthma. Dupixent will not treat an asthma attack that’s occurring.

Your doctor will likely prescribe a rescue inhaler for you to have on hand to treat asthma attacks.

Upcoming vaccination. If you plan to have any vaccines, talk with your doctor first. Some vaccines may interact with Dupixent. For more information, see “Dupixent and other interactions” above.

Pregnancy. It’s not known whether it’s safe to use Dupixent during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before using the medication.

Breastfeeding. At this time, it’s not known whether it’s safe to breastfeed while using Dupixent. If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can advise you on whether Dupixent is right for you.

Allergic reaction. If you’ve had an allergic reaction to Dupixent or any of its ingredients, your doctor will likely not prescribe Dupixent. To learn more, see “When to avoid Dupixent” above.

Here are some frequently asked questions about Dupixent and possible interactions.

Does Dupixent cause sun sensitivity?

No, Dupixent isn’t known to cause sun sensitivity.

It’s important to note that atopic dermatitis (a type of eczema) may be improved or worsened by exposure to the sun. (Dupixent can be used to treat atopic dermatitis.) Some people may notice that their atopic dermatitis clears up in the sun. Others who go out in the sun may notice that their condition worsens.

If you notice that your skin is more sensitive to the sun than usual while using Dupixent, talk with your doctor. They can try to determine the cause. They’ll likely recommend using sunscreen and covering your skin when you’re out in the sun to help prevent burning.

Who should not take Dupixent?

Doctors typically won’t prescribe Dupixent if you’re allergic to its active ingredient, dupilumab. They also usually won’t recommend this medication if you have had an allergic reaction to any other ingredients in Dupixent.

Also, it’s unknown whether Dupixent is safe to use while pregnant or breastfeeding.

In addition, if you have certain medical conditions, they may worsen during your treatment with Dupixent. These can include eye problems, such as keratitis and pink eye.

For more information, see “Dupixent precautions” above. And if you have any concerns about whether Dupixent is safe for you, talk with your doctor.

Would my doctor prescribe Dupixent with a corticosteroid?

They might. Corticosteroids are drugs used to help ease inflammation. Your doctor may prescribe Dupixent for a condition that’s already being treated with a corticosteroid, such as asthma. They may do this if the corticosteroid is no longer working or you’re having bothersome side effects from it.

In some cases, using Dupixent can reduce your need for a corticosteroid to treat the condition. As a result, your doctor may lower your corticosteroid dosage or have you stop taking the corticosteroid after starting Dupixent treatment.

However, suddenly stopping corticosteroid treatment or lowering its dosage too quickly may lead to withdrawal symptoms. These are side effects that can occur when you stop taking a drug that your body has become dependent on. (With drug dependence, your body needs the drug to feel as it typically does.) Examples of corticosteroid withdrawal symptoms can include nausea, vomiting, and fatigue.

Here are some corticosteroid drugs that may interact with Dupixent:

• dexamethasone (Hemady)
• prednisone (Rayos)
• methylprednisolone (Medrol)

If your doctor prescribes Dupixent and a corticosteroid, be sure to follow their directions for both drugs. You should not suddenly stop taking a corticosteroid during Dupixent treatment.

If you’d like to stop taking a corticosteroid during Dupixent treatment, talk with your doctor. They’ll likely decrease your dose of the corticosteroid slowly. This gives your body time to adjust to a lower level of the drug, helping prevent withdrawal symptoms.

You can take certain steps to help prevent interactions with Dupixent. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Dupixent label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Dupixent doesn’t come with paperwork, you can ask your pharmacist to print a copy.)

If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Dupixent by using it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Dupixent. These resources might help:

• Overview of Dupixent. For a general overview of Dupixent, you can see this article.
• Side effects. If you’re interested in the side effects of Dupixent, refer to this article. Another option is to look at the Dupixent prescribing information.
• Dosage specifics. To learn about the dosage of Dupixent, view this article.
• Drug costs. If you’d like information about cost and Dupixent, refer to this article.
• Facts about your condition. To learn more about some of the conditions Dupixent is used to treat, see the following resources:
  • asthma and allergies hub
  • dermatology hub
  • this list of related articles for details about atopic dermatitis (a type of eczema)
  • this list of ear, nose, and throat articles for information about rhinosinusitis and nasal polyps

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.