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EspañolDupixent is a brand-name prescription drug used to treat moderate to severe atopic dermatitis, certain types of severe asthma, and allergic swelling of the nasal passages with polyps (chronic rhinosinusitis with nasal polyposis). Each of these conditions is associated with a heightened immune response. Dupilumab, the active ingredient in Dupixent, dials back the immune response by blocking critical chemical signals that activate immune cells. Dupixent is administered as an injection beneath the skin every two to four weeks with single-dose pre-filled syringes or injector pens. Dupixent is intended to be self-injected at home by adult patients or administered to patients by caregivers.
RELATED: What is Dupixent? | Get Dupixent discounts
Dupixent forms and strengths
There is only one dosage form of Dupixent available: subcutaneous injection. A Dupixent injection is administered by a healthcare provider, caretaker, or patient using either single-dose pre-filled syringes or injection pens.
Injection pen: 200 milligrams (mg) per 1.14 milliliters (mL), 300 mg/2 mL
Pre-filled syringe with needle shield: 200 mg /1.14 mL, 300 mg/2 mL
Dupixent dosage for adults
Dupixent is FDA approved to treat adults and children 6 years of age and older for moderate to severe atopic dermatitis. It is also approved as an add-on maintenance treatment for adults and children with severe asthma or adults with poorly managed chronic rhinosinusitis with nasal polyposis. Although used for severe asthma, Dupixent is not intended to relieve asthma attacks while they’re happening.
| Dupixent dosage chart | ||
|---|---|---|
| Indication | Starting dosage | Standard dosage |
| Moderate to severe atopic dermatitis | 600 mg subcutaneously | 300 mg subcutaneously once every 2 weeks |
| Moderate to severe eosinophilic asthma | 400 mg or 600 mg subcutaneously | 200 mg or 300 mg subcutaneously once every 2 weeks |
| Moderate to severe corticosteroid-dependent asthma | 600 mg subcutaneously | 300 mg subcutaneously once every 2 weeks |
| Moderate to severe asthma with moderate to severe atopic dermatitis | 600 mg subcutaneously | 300 mg subcutaneously once every 2 weeks |
| Moderate to severe asthma with chronic rhinosinusitis with nasal polyposis | 600 mg subcutaneously | 300 mg subcutaneously once every 2 weeks |
| Chronic rhinosinusitis with nasal polyposis | 300 mg subcutaneously | 300 mg subcutaneously once every 2 weeks |
Source: DailyMed
Dupixent dosage for moderate to severe atopic dermatitis
Atopic dermatitis (AD) is a type of eczema characterized by itching, redness, and dry skin. Moderate and severe AD involve larger areas of the skin and more frequent flare-ups than mild AD. Severe atopic dermatitis often includes severe and intolerable itchiness, fluids exuding from the affected skin, and infections.
Dupixent is FDA approved to treat moderate to severe atopic dermatitis when first-line treatment options such as topical corticosteroids, are not working well or can’t be used. Dupilumab is an antibody that blocks the effects of interleukin-4 (IL-4) and interleukin 13 (IL-13), cytokine proteins that stimulate white blood cells, especially eosinophils and T-cells, to proliferate and attack healthy skin tissues, causing the pain and swelling associated with AD.
Standard dosage for moderate to severe atopic dermatitis: an initial dose of 600 mg followed by 300 mg injections every two weeks
Dupixent dosage for severe asthma
Dupixent is used along with other drugs to treat severe eosinophilic asthma, corticoid-dependent asthma, or certain types of comorbid asthma.
Asthma is a contact allergy in which the tissues in the airways react to a foreign substance. Severe asthma is diagnosed when the attacks occur very frequently both during the day and while sleeping. Eosinophilic asthma is a rare form of asthma in which eosinophils, a type of immune cell, dominate the immune response in the airways. Eosinophilic asthma is often severe and unresponsive to corticosteroid treatment. As with atopic dermatitis, dupilumab blocks the IL-4 and IL-13 proteins that activate eosinophils and T-cells. This reduces the swelling and damage in the lung’s airways.
Some severe asthma conditions are considered “corticosteroid-dependent” when a patient requires daily doses of oral corticosteroids to fend off asthma attacks. Corticosteroid-dependent asthma may require higher doses of Dupixent than eosinophilic asthma.
When someone has a combination of asthma, atopic dermatitis, and rhinoconjunctivitis (sneezing, nasal congestion, red and swollen eyes), it is known as the “atopic triad.” Many people with one of these conditions will eventually develop one or more of the others. Dupixent is also used as an add-on treatment for people diagnosed with both severe asthma and moderate to severe atopic dermatitis or chronic rhinosinusitis with nasal polyposis.
Standard dosage for severe eosinophilic asthma: 400 mg initial dose followed by 200 mg injections every two weeks or 600 mg initial dose followed by 300 mg injections every two weeks
Standard dosage for severe corticosteroid-dependent asthma: 600 mg initial dose followed by 300 mg injections every two weeks
Standard dosage for severe comorbid asthma with moderate to severe atopic dermatitis or chronic rhinosinusitis with nasal polyposis: 600 mg initial dose followed by 300 mg injections every two weeks
Dupixent dosage for rhinosinusitis with nasal polyposis
Rhinosinusitis with nasal polyposis involves the nose and sinuses, causing a runny nose, nasal congestion, sinus congestion, and swellings called polyps that are caused by an overactive immune system. Dupixent is used as an add-on maintenance therapy to traditional treatments such as corticosteroids in people with poorly controlled rhinosinusitis with nasal polyposis. By interfering with the molecule that activates part of the immune response, dupilumab helps to reduce the size and incidence of nasal polyps in adult patients.
Standard dosage for rhinosinusitis with nasal polyposis: 300 mg injections every two weeks
Dupixent dosage for children
Dupixent is used in children as young as 6 years of age to treat moderate to severe atopic dermatitis and as an add-on maintenance treatment for severe eosinophilic, corticosteroid-dependent, or comorbid asthma. Adolescents 12 years of age and older will get the same doses as adults, but doses for younger children are based on body weight.
| Dupixent pediatric dosage chart | ||||
|---|---|---|---|---|
| Indication | Age | Weight | Starting dosage | Standard dosage |
| Moderate to severe atopic dermatitis | 6-11 years | 15–30 kg | 600 mg subcutaneous injection | 300 mg subcutaneous injection once every 4 weeks |
| 30-60 kg | 400 mg subcutaneous injection | 200 mg subcutaneous injection once every 2 weeks | ||
| > 60 kg | 600 mg subcutaneous injection | 300 mg subcutaneous injection once every 2 weeks | ||
| 12 years and or older | Dosage is not based on weight | 600 mg subcutaneous injection | 300 mg subcutaneous injection once every 2 weeks | |
| Moderate to severe eosinophilic asthma | 12 years and older | Dosage is not based on weight | 400 mg or 600 mg subcutaneous injection | 200 mg or 300 mg subcutaneous injection once every 2 weeks |
| 6-11 years | 15–30 kg | 100 mg or 300 mg subcutaneous injection | 100 mg subcutaneous injection every 2 weeks or 300 mg subcutaneous injection every 4 weeks | |
| > 30 kg | 200 mg subcutaneous injection | 200 mg subcutaneous injection every 2 weeks | ||
| Moderate to severe corticosteroid-dependent asthma | 12 years and older | Dosage is not based on weight | 600 mg subcutaneous injection | 300 mg subcutaneous injection once every 2 weeks |
| Moderate to severe asthma with moderate to severe atopic dermatitis | 12 years and older | Dosage is not based on weight | 600 mg subcutaneous injection | 300 mg subcutaneous injection once every 2 weeks |
Source: DailyMed
Dupixent dosage restrictions
Dupixent does not have any dosage restrictions nor does it require dosage adjustments. The only contraindications are allergies to dupilumab or any of the preservatives or inactive ingredients (excipients) in the injection solution. Because of possible problems, healthcare professionals use Dupixent with caution in people with conjunctivitis, keratitis, helminth infections (worms), or eosinophilia (too many eosinophils in the body). People with any of these problems should immediately tell a healthcare provider about any worsening of their eye problems or any hypersensitivity reactions such as rash, hives, trouble breathing, drop in blood pressure, or serum sickness (an immune reaction from the medication).
How to take Dupixent
Dupixent injections are administered once every two or four weeks using a Dupixent 200 or 300 mg pen or pre-filled syringe. Adolescents should be supervised by an adult. For children younger than 12 years, administration of Dupixent should be carried out by a caregiver.
Take Dupixent as prescribed by the healthcare provider.
This medicine comes with a patient information insert. Please read this for important information about how to take this medicine, side effects, and what to do if there are problems.
This medicine also comes with detailed instructions for use. Read these carefully before administering each injection.
A healthcare provider will demonstrate how and where to inject this medicine. The manufacturers, Sanofi and Regeneron Pharmaceuticals, have comprehensive video tutorials on how to properly make an injection.
Inspect the pen or syringe and the medicine. Do not use the pen or syringe if it appears damaged or the green cap or needle cap is missing. The medicine should appear clear and colorless to pale yellow. Do not inject the medicine if it is cloudy, discolored, or has particles in it.
Make sure to use different injection sites for each injection. For self-injections, Dupixent can be injected into the thigh or stomach area, but not within two inches of the belly button. A caregiver can administer injections into any of these areas or the upper arms.
Do not inject into skin that is tender, bruised, swollen, hard, or hurt.
Store the Dupixent pens or pre-filled syringes in the refrigerator (36°F to 46°F) in their original carton. Do not freeze.
Dupixent can be stored at room temperature (up to 77°F) for up to 14 days. If it is not used before that time, dispose of the medicine.
Throw away the pen or syringe in a sharps container.
Dupixent dosage FAQs
How long does it take Dupixent to work?
It takes about two weeks for Dupixent to reach its maximum effects in suppressing the body’s inflammation response to allergens.
How long does Dupixent stay in your system?
Steady-state concentrations of dupilumab are reached in about four months of twice-a-month dosing. After that, it will take about nine to 13 weeks for the last dose of Dupixent to fall to undetectable levels.
What happens if I miss a dose of Dupixent?
A missed dose of Dupixent can be taken up to seven days before the next scheduled dose. The next dose can be taken as scheduled. When Dupixent is injected once every two weeks and there are less than seven days remaining before the next scheduled dose, skip the missed dose and take the next dose as scheduled. When Dupixent is injected once every four weeks and there are less than seven days remaining before the next scheduled dose, take the missed dose. This will reset the dosing schedule, so the next dose should be taken 30 days later.
What interacts with Dupixent?
For Dupixent, the only drug interactions of consequence are vaccines. Dupixent partly suppresses the immune system, so live vaccines can’t be given because of the risk for infection. Other vaccines may not be effective when taken with Dupixent, but clinical trials on some vaccines showed that there was no difference between the immune response in people taking Dupixent and the immune response in people injected with a placebo.
Is it safe to take Duplixent during pregnancy?
Dupixent is used with caution in pregnant women. There are no studies on the safety of dupilumab when given to pregnant women, but there are also no reports of harm to a fetus.
Women who are breastfeeding can take Dupixent, but healthcare professionals aren’t certain about its safety. There are no studies on the presence of dupilumab in human breast milk or its effects on a nursing infant. Because dupilumab is a large protein and most likely destroyed by an infant’s digestive system, healthcare providers generally regard it as likely safe to take while breastfeeding.
Related resources for Dupixent dosages:
Atopic dermatitis, StatPearls
Can anything relieve severe atopic dermatitis?, American Academy of Dermatology Association (AAD)
Dupixent, Epocrates
Dupixent, U.S. National Library of Medicine
Pathophysiology of asthma, StatPearls
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