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Dupilumab (Subcutaneous)

Generic Name: dupilumab (doo-PIL-ue-mab)

Medically reviewed by Drugs.com. Last updated on Aug 27, 2020.

Commonly used brand name(s)

In the U.S.

  • Dupixent

Available Dosage Forms:

  • Solution

Therapeutic Class: Dermatological Agent

Pharmacologic Class: Monoclonal Antibody

Uses for dupilumab

Dupilumab injection is used alone or in combination with other medicines (eg, topical corticosteroids) to treat moderate to severe atopic dermatitis in patients who have been treated with topical medicines that did not work well or who cannot use topical treatment.

Dupilumab injection is also used together with other medicines to treat moderate to severe asthma in patients whose asthma is hard to control or who are dependent on steroid medicines. Dupilumab helps prevent severe asthma attacks (exacerbations) and can improve your breathing. Dupilumab will not relieve an asthma attack that has already started.

Dupilumab injection is also used as additional treatment for poorly controlled chronic rhinosinusitis with nasal polyposis (CRSwNP).

Dupilumab is available only with your doctor's prescription.

Before using dupilumab

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dupilumab, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to dupilumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of dupilumab injection to treat asthma in children younger than 12 years of age, to treat atopic dermatitis in children younger than 6 years of age, or to treat chronic rhinosinusitis with nasal polyposis in children. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dupilumab injection in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dupilumab, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using dupilumab with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cholera Vaccine, Live
  • Dengue Tetravalent Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Poliovirus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Typhoid Vaccine
  • Varicella Virus Vaccine, Live
  • Yellow Fever Vaccine
  • Zoster Vaccine, Live

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of dupilumab. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma attack or
  • Bronchospasm (breathing problem) or
  • Status asthmaticus (severe asthma attack)—Should not be used in patients with these conditions.
  • Conjunctivitis (pink eye) or
  • Heart problems or
  • Keratitis (inflammation of the cornea of the eye)—Use with caution. May make these conditions worse.
  • Parasitic infection—Use with caution. It is not known if dupilumab may affect patients with this condition. Treat the infection first before using dupilumab.

Proper use of dupilumab

A nurse or other trained health professional will give you dupilumab. It is given as a shot under your skin, usually in the thigh, abdomen (stomach) area, or upper arm. Dupilumab may also be given at home to patients who do not need to be in a hospital or clinic. You or your caregiver may be trained to prepare and inject the medicine at home. Be sure that you understand how to use the medicine.

Dupilumab should come with a patient information leaflet and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

If you use Dupixent® at home, you will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems. Do not inject into skin areas that are tender, damaged, bruised, or scarred.

Dupilumab is available as a prefilled pen or syringe. Use the prefilled pen only for adults and children 12 years of age and older.

Allow the medicine to warm to room temperature for 30 or 45 minutes before using it.

Check the liquid in the prefilled syringe. It should be clear or colorless to slightly yellow. Do not use it if it is cloudy, discolored, or has particles in it.

Dosing

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

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

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

Missed dose

If you miss a dose of dupilumab, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose and it is within 7 days from the missed dose, use a dose as soon as possible and go back to your regular dosing schedule. If you miss a dose and it is more than 7 days, skip the missed dose and go back to your regular schedule (for the every other week dose schedule) or start a new schedule based on this date (for the every 4 week dose schedule).

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

Protect the medicine from direct light. Keep the medicine in the original package until you are ready to use it. You may also store the prefilled syringe or pen at room temperature for up to 14 days. Use the medicine within 14 days after removing it from the refrigerator.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions while using dupilumab

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

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

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

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

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

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

Dupilumab side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Burning or dry eyes
  • excessive tearing
  • pain, redness, irritation, itching, or swelling of the eye, eyelid, or inner lining of the eyelid

Less common

  • Black, tarry stools
  • blistering or crusting of the skin
  • burning, tingling, or numbness in the hands and feet
  • chest pain
  • chills
  • cough
  • fever
  • painful cold sores or blisters on the lips, nose, eyes, or genitals
  • painful or difficult urination
  • reddening of the skin
  • scaly patches on the skin
  • skin rash
  • sore throat
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Rare

  • Feeling of discomfort
  • hives, itching
  • lightheadedness, dizziness, fainting
  • muscle aches
  • pain in the groin or legs, especially the calves
  • pain or swelling in the joints
  • severe, sudden headache
  • slurred speech
  • sudden loss of coordination
  • sudden, severe weakness or numbness in the arm or leg
  • swelling of the hands, face, or mouth
  • trouble breathing
  • trouble swallowing
  • vision changes

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

Less common

  • Burning feeling in the chest or stomach
  • difficulty in moving
  • indigestion
  • mouth or throat pain
  • muscle stiffness
  • stomach upset
  • tenderness in the stomach area
  • toothache
  • trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.