Dupilumab (Dupixent) belongs to a class of drugs called monoclonal antibodies, which are lab-made versions of proteins your body makes to fight off disease. Doctors prescribe it to treat several health conditions caused by inflammation. You might take it to treat asthma symptoms when other medicines haven’t been able to control them. It’s also used for the skin disease eczema (atopic dermatitis) when other treatments haven’t worked.
The name of the drug is pronounced doo-PILL-you-mab.
Here are answers to some of the most common questions people ask about dupilumab.
What Conditions Does Dupilumab (Dupixent) Treat?
Doctors prescribe dupilumab to treat several conditions in which inflammation plays a role, including:
- Asthma
- Atopic dermatitis (eczema)
- Chronic rhinosinusitis with nasal polyps (CRSwNP), a sinus disease that includes growths inside the nasal passages
- Eosinophilic esophagitis (EoE), an allergic condition that affects the esophagus (the tube that runs between your mouth and stomach)
How Does Dupilumab (Dupixent) Work?
Dupilumab targets certain proteins in your body that play a role in causing inflammation (swelling). Normally, inflammation is a healthy part of your body's response to injury or infection. But when you have a condition like asthma and eczema, your immune system triggers inflammation even when there’s no reason to.
This medication keeps these two inflammatory proteins from transmitting messages. In this way, it stops your immune system from overreacting. When you have less inflammation, you have fewer symptoms like trouble breathing, skin rash, and itchiness.
How Do You Take Dupilumab (Dupixent)?
You’ll take dupilumab as a shot just under your skin. It comes in a prefilled syringe or injector pen. You get your first dose at your doctor’s office. They’ll train you to give the shot to yourself (or to your child). After that, you may be able to do the injections at home.
You or a caregiver can inject dupilumab in the front of your thigh, your stomach (avoiding the area around your belly button), or the back of your upper arm. Rotate the injection site for each shot to lower your chances of getting irritation or soreness on your skin. Avoid areas that are tender, bruised, discolored, hard, or where you have scars or stretch marks.
If you keep your medication in the refrigerator, take it out and let it warm to room temperature for 30-45 minutes before you use it. Don’t warm it in the microwave or in hot water. Inspect the medication before using it to make sure it’s not expired, cloudy, or discolored, and doesn’t have any solid bits in it. The prefilled syringe or pen should be fully intact.
Use each syringe or pen once and throw it away in a puncture-resistant container. Carefully follow the medication label and ask your doctor or pharmacist to explain anything that’s unclear.
You can’t use dupilumab to stop an asthma attack once it starts. Keep using fast-acting rescue drugs as your doctor prescribes.
How Often Do You Take Dupilumab (Dupixent)?
How often you take it depends on what condition you use it for.
For asthma, adults and kids 12 and older get a higher-than-normal dose (called a loading dose) for their first treatment. Then they’ll get a shot once every 2 weeks. Kids 6-11 don’t need a loading dose. They usually get a shot every 2-4 weeks depending on their size.
For eczema, adults and kids over age 6 get a loading dose of two shots, followed by an injection every 2 or 4 weeks based on age and weight. Kids ages 6 months to 5 years will get the treatment every 4 weeks.
Adults with chronic rhinosinusitis with polyps will probably need a shot every 2 weeks. Adults and kids 12 and over with eosinophilic esophagitis generally get a weekly shot.
You’ll need to keep taking dupilumab long-term for symptom relief.
Who Makes Dupilumab (Dupixent)?
The drug companies Sanofi and Regeneron Pharmaceuticals make this medication in partnership.
Is There a Generic Version of Dupilumab (Dupixent)?
Dupilumab is a biologic, a kind of drug made using living cells. This type of drug often doesn’t have a generic version. No generic or biosimilar version is available.
How Much Does Dupilumab (Dupixent) Cost?
The retail price for this drug is $3,587.92 for a pack of two pens or syringes. But most people don’t pay that much. Your out-of-pocket costs depend on your health insurance and whether your insurer considers dupilumab a “preferred” drug.
Your insurance company may have you try step therapy (also called “fail first”) before it will cover dupilumab. This means you first take a different, often less expensive drug. You only get dupilumab if the other drug doesn’t work. Here’s a look at how much you could pay:
- Commercial or employer-provided insurance: Most people with commercial insurance or the kind offered through your job pay $100 or less each month.
- Medicaid: The cost for most people covered by Medicaid ranges from $4 to $9 a month.
- Medicare Part D: If you have Medicare Part D, you may pay $100 or less each month.
- No insurance: You’ll need to pay the retail price plus any extra pharmacy charges unless you qualify for an assistance program.
If you can’t afford dupilumab, the drugmaker offers help through a patient assistance program or copay card.
What Should You Tell Your Doctor Before Taking Dupilumab (Dupixent)?
To keep you safe and avoid side effects, there are certain things your doctor or pharmacist should know about before you take dupilumab. Tell them if you:
- Have any medication allergies, including to dupilumab or any of its ingredients. Those include L-arginine hydrochloride, L-histidine, polysorbate 80, sodium acetate, and sucrose.
- Take other prescription or over-the-counter medicines, vitamins, supplements, or herbal products
- Have eye problems, any form of the herpes virus, hookworms, roundworms, whipworms, threadworms, or asthma
- Are pregnant, planning a pregnancy, or breastfeeding
- Are planning to get any vaccines
- Take a corticosteroid or other asthma medicine
With dupilumab, you may be able to cut down on the corticosteroids you take to prevent asthma attacks. But don’t lower your dose or stop taking them unless your doctor tells you to.
What Are the Side Effects of Dupilumab (Dupixent)?
Like any drug, dupilumab may cause side effects for some people. Most aren’t serious and may go away within a few weeks as your body gets used to the drug.
Tell your doctor if the following symptoms last a long time or seem serious:
- Redness or pain in the area where the needle went in
- Sore throat, runny nose, cough, or fever
- Sores on your lip or mouth
- Tooth pain
- Trouble falling or staying asleep
- Rash or color changes on your face
- Feeling lightheaded, woozy, or dizzy
- Loose or watery bowel movements
- Muscle pain
Serious symptoms may require emergency help. Call for help right away if you have:
- Eye problems that come on suddenly or get worse, such as pain, blurry vision or other vision changes, pink or red eyes, swollen eyelids, or color changes to your eyelids
- Rash
- Trouble catching your breath
- Fever
- Pain in your chest
- Numbness or a “pins and needles” feeling in your arms or legs
- Joint pain that’s new or gets worse
If you have any of these symptoms, stop using dupilumab and get medical help right away:
- Face, eyelid, tongue, or throat swelling
- Trouble swallowing or breathing
- Fainting or feeling like you’re going to faint
- Rash, hives, or itching
- Chest or throat tightness
- A fast heart rate
- Feeling sick to your stomach or throwing up
- Stomach cramps
- Swollen lymph nodes
- Fever
Who Shouldn’t Take Dupilumab (Dupixent)?
Don’t take this drug If you’re allergic to dupilumab or any of its ingredients.
If you’re pregnant or breastfeeding, talk to your doctor about the pros and cons of taking dupilumab. Some monoclonal antibodies can be passed to a fetus in the womb, and doctors aren’t sure whether that’s safe. But you can also have pregnancy complications if your asthma isn’t well controlled. Doctors also don’t know whether the drug could pass into breast milk or if it could have side effects on a nursing baby.
