Dupixent® (dupilumab) is an injectable medication for atopic dermatitis (eczema). Before starting, it’s important to understand how it works, its benefits, and its risks. Here’s what you should know.
How It Works
Dupixent is a monoclonal antibody that blocks IL-4 and IL-13 signaling, two key inflammatory mediators involved in atopic dermatitis.
Common Side Effects
- Injection site reactions. Redness, swelling, pain, and bruising at the injection site are the most common side effect, occurring in up to 38% of patients. This goes away by itself.
- Non-infectious pink eye and other eye problems, including itching, dry eye, and blurred vision. Report new or worsening eye symptoms; you will need to see your eye doctor if they occur.
- A facial rash that isn’t your typical eczema. This can be treated, so alert us if it happens.
Serious Adverse Reactions
- Rashes (distinct from your eczema) can be severe. Stop taking Dupixent if you get any new serious rashes.
- Joint pain.
Parasitic Infections
Hypothetically, Dupixent blocks a part of the immune system that protects us from parasites, but this is not confirmed. For that reason, traveling to an area with a greater risk of parasitic infection is not recommended.
Vaccinations
The package insert recommends avoiding live vaccines while taking Dupixent. However, a 2019 study demonstrated that dupilumab does not interfere with the development of post-vaccine antibodies and should not be stopped if a vaccine is required.
Corticosteroid Use
- Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon starting Dupixent.
- If appropriate, corticosteroid dose reductions should be gradual and performed under direct medical supervision.
- If you have co-morbid asthma, do not adjust or stop asthma treatments without consulting your physician.
How to Use It
- Available as a pre-filled pen (ages 2+ years) or a pre-filled syringe (ages 6+ months).
- Inject into the thigh or abdomen, except for the 2 inches around the navel. The outside of the upper arm can be used if a caregiver administers the injection.
- Allow Dupixent to reach room temperature for 30–45 minutes before injecting, without removing the needle cap.
- Rotate injection sites with each dose.
- DO NOT inject into tender, damaged, bruised, or scarred skin.
- Proper injection technique training will be provided.
Monitoring
- Monitoring is required. Alert us or your primary physician if you notice symptoms of infection or other concerning signs, including new or worsening eye problems, joint pain, new skin lesions, or signs of an allergic reaction.
- Continuing Dupixent requires office visits at least 2 times per year to document that the treatment is working.
- There are no routine laboratory tests required for Dupixent monitoring, and no known drug-to-drug interactions.
Important Reminders
- Dupixent is not a cure for atopic dermatitis.
- Dupixent is not considered immunosuppressive in the traditional sense, as it does not broadly suppress the immune system. Rather, it is more targeted to the inflammation that causes atopic dermatitis.
- Skin care used to support the skin barrier should be continued or started alongside Dupixent.
- Dupixent can be used with or without topical corticosteroids; topical calcineurin inhibitors may be used.
Have questions about Dupixent, or want to talk through whether it’s right for you? You can book online or call the office at 423-528-8833. This page is for general education, not a substitute for a personal exam.