What is Dupixent®:
Uses, Side Effects & Dosage

Dupixent® is a biologic medication. Its generic name is dupilumab. It belongs to a drug class known as monoclonal antibodies.

Dupixent is approved by the U.S. Food and Drug Administration (FDA) to treat the following allergic conditions:

• moderate to severe asthma, and eosinophilic asthma
• chronic obstructive pulmonary disease (COPD)
• moderate to severe eczema
• eosinophilic esophagitis (EoE)
• severe chronic rhinosinusitis with nasal polyps (CRSwNP)

Dupixent is given as an injection into the skin. Patients have the option of taking Dupixent in a doctor’s office or clinic or self-administering it at home using an injectable pen.

Dupixent stops inflammation in the airways and on the skin before it can start. The medication can reduce the risk of asthma attacks, provides symptom relief, and helps improve lung function.

What is Dupixent used for?

Dupixent is indicated for people who have moderate to severe asthma, allergies, and skin conditions.

Dupixent indications

• Adults and children ages 6 years and older who have moderate/severe uncontrolled eosinophilic asthma, or who depend on oral corticosteroids to treat their asthma.
• Adults with inadequately controlled COPD with an eosinophilic phenotype.
• Adults and children ages 6 months and older with moderate-to-severe atopic dermatitis that is not adequately controlled with other medicine.
• Adults and children ages 1 years and up with eosinophilic esophagitis, and weighing at least 33 pounds.
• Adults and children ages 12 years and older with severe chronic rhinosinusitis with nasal polyps that is not adequately controlled.

Dupixent is also indicated for prurigo nodularis, a chronic skin disorder.

The drug is in clinical trials to treat chronic spontaneous urticaria and COPD.

How does Dupixent work?

Dupixent works by targeting proteins called interleukin-4 (IL-4) and interleukin-13 (IL-13), which both promote inflammation. Dupixent blocks IL-4 and IL-13 from binding and interacting with cell surface receptors. The medication prevents IL-4 from activating eosinophils, a type of white blood cell that causes inflammation in the body. It prevents the over-production of IL-13, which also causes inflammation and other symptoms.

Dupixent is an add-on maintenance treatment, meaning that it can be taken alongside other prescribed medications. For example, it can be taken with inhaled corticosteroids that treat asthma or topical corticosteroids that treat eczema. This drug combination can help improve symptom control.

If you’re prescribed Dupixent, work together with your doctor on a treatment plan. Follow it closely, as the specific combination of medications you are prescribed may vary based on the severity of your condition. Regular appointments and communication with your doctor can ensure your treatment plan is effective.

How long does it take for Dupixent to start working?

Dupixent starts working following the first injection. It might take a few weeks for you to notice symptoms are improving. Stay in contact with your doctor during this time so you can monitor symptoms together.

Dupixent dose

The Dupixent dosageand dosing schedule depends on whether you have asthma, COPD, eczema, EoE, or chronic rhinosinusitis with nasal polyps.

Treatment usually begins with a starting dose (also called loading dose) of two injections. It is a high dose that is intended help make the drug work quicker. After the starting dose, the maintenance dose is administered every two weeks to help maintain the drug’s effectiveness.

Dupixent dosage for asthma

The starting dose is two injections. It is either 400 mg (two 200 mg injections) or 600 mg (two 300 mg injections), depending on age and weight of the patient.

The subsequent doses are either one 200 mg injection or one 300 mg injection every two weeks, again depending on the age and weight of the patient.

People who have oral corticosteroid-dependent asthma, or also have moderate to severe eczema or CRSwNP, should receive the higher dose.

Dupixent dosage for COPD

The starting dose is two injections of 600 mg (two 300 mg injections). It is either 400 mg (two 200 mg injections) or 600 mg (two 300 mg injections). The follow-up doses are one 300 mg injection given every other week.

Dupixent dosage for eczema

For adults, the starting dose is 600 mg (two 300 mg injections), followed by 300 mg taken every two weeks thereafter.

For children ages 6 months of age to 17 years, the starting dose and subsequent doses depend on body weight. Check with your doctor or consult the Dupixent prescribing information (inserts) to find out the dosage amount for children.

Dupixent dosage for eosinophilic esophagitis

The dosage amount for adults and children is based on body weight, starting at 33 pounds:

• People weighing 33-66 pounds: 200 mg every two weeks
• People weighing 66-88 pounds: 300 mg every two weeks
• People weighing 88+ pounds: 300 mg every week

Dupixent dosage for chronic rhinosinusitis with nasal polyps

The dosage amount is 300 mg every two weeks.

Dupixent injection

The Dupixent injection is typically administered beneath the skin, either in the upper arm, thigh, or stomach. This helps ensure the medication is delivered to the tissue layer between the skin and the muscle.

Avoid injecting the biologic into the same site each time. This can cause sensitivity, pain and scarring.

You can choose to receive the medication at your doctor’s office or self-administer at home with the Dupixent pen. Your doctor can provide training on how to administer the Dupixent pen.

Dupixent pen

The Dupixent pen is a pre-filled auto-injector device that you can self-administer at home. Many people taking Dupixent at home feel this option offers greater convenience and a sense of empowerment. They can take the injection when they want, on their own schedule.

If you choose to self-administer with the Dupixent pen, it’s important to follow the specific instructions for taking the medication. Ask your doctor for training on how to correctly administer the Dupixent pen. Make sure you know the injection site and proper technique. Talk with your doctor regularly to ensure you are injecting it safely and effectively.

Dupixent ingredients

Active ingredient: dupilumab

Non-medicinal ingredients: L-arginine hydrochloride, L-histidine, polysorbate 80, sodium acetate, sucrose, and water for injection.

Dupixent side effects

Dupixent can cause mild or severe side effects. The most common side effects include:

• fever
• injection site irritation
• cold sores
• dry, itchy, or red eyes
• hives
• facial rash or redness
• headache
• sore throat
• joint pain
• swollen or itchy eyelids
• difficulty sleeping
• upset stomach

In addition, Dupixent may cause conjunctivitis and keratitis. Check with your doctor if you start experiencing the following:

• eye pain or vision changes
• symptoms of an eye infection (swollen red eyes, eye pain when exposed to light, discharge from the eye)

Some people may experience an allergic reaction soon after the Dupixent injection. Tell your healthcare provider or get emergency medical help right away if the allergic reaction is severe. This is anaphylaxis, a potentially life-threatening condition. Symptoms of anaphylaxis may include:

• hives on the skin
• swelling of your face, mouth and/or tongue
• breathing problems
• nausea, abdominal cramps or vomiting
• low blood pressure
• fainting, dizziness, feeling lightheaded

If you take Dupixent at home, your doctor will prescribe you epinephrine to take as treatment for a severe allergic reaction. Epinephrine is the first line of treatment for anaphylaxis. Take it at the first sign of symptoms.

Before using Dupixent, tell your healthcare provider about all of your medical conditions. Provide a list of any other medications you’re taking that could cause drug interactions. Do not stop taking other medications unless instructed to do so by your healthcare provider.

How much does Dupixent cost?

Biologics are expensive medications due to their complex production process. The list price for Dupixent is $3,803.20 per carton for people without insurance. Most patients do not pay the list price. The actual cost will vary based on your insurance coverage. Many options are available to help eligible patients pay for Dupixent. Most insurance plans cover Dupixent but they may require prior authorization.

Check your health insurance plan to find out if you’re covered for Dupixent. Eligible people who are commercially insured may pay as little as $0 copay using the Dupixent MyWay® Copay Card as part of Dupixent’s patient support program. The maximum amount of coverage is $13,000 per calendar year. Commercial insurance includes health insurance exchanges and federal and state employee plans.

You can also request copay reimbursement through Dupixent MyWay if your health plan does not accept your copay card or you paid before enrolling in Dupixent MyWay.

The Dupixent MyWay Patient Assistance Program allows eligible patients who are uninsured or whose insurance does not cover Dupixent to receive the medication at no cost. Eligibility criteria may include household income and a demonstrated financial need. The Dupixent MyWay team will research each patient’s situation and determine eligibility.

Check out Dupixent’s Cost and Coverage Tool to determine what you’ll pay for the medication.

Charitable organizations such as The Assistance Fund, Inc., Patient Advocate Foundation and The HealthWell Foundation are dedicated to offering financial support to patients with specific medical conditions, irrespective of their chosen treatment. People with commercial or public insurance, including those under Medicare and Medicaid, can reach out directly to these foundations for financial assistance.

Is Dupixent covered by Medicare?

Yes. Dupixent is covered by 99% of Medicare prescription drug plans, including Medicare Part D. About 80% of people on Medicare Part D are likely to have monthly costs from $0 to $100 for Dupixent. About 20% of people on Medicare Part D may have monthly expenses of $100 or more.

People on Medicare Part D may be eligible for the Social Security Administration’s Extra Help (also known as Low-Income Subsidy, or “LIS”), a patient support program. People eligible for Extra Help typically pay between $0 and $9 for their prescriptions.

Is Dupixent covered by Medicaid?

For people on Medicaid, the cost of Dupixent may range from $4-$9 per month. Some states may offer even lower copays or eliminate the copay altogether. Find out if you qualify for Medicaid and learn more about copays under Medicaid in your state.