Dupilumab

Generic name: Dupilumab
Brand names: Dupixent
Dosage form: subcutaneous injection
Drug class: Interleukin inhibitors

Usage of Dupilumab

Dupilumab (Dupixent) is a biological medication called a monoclonal antibody that is used to treat atopic diseases.

Dupilumab helps treat atopic diseases by stopping the inflammation linked to these diseases.

Dupilumab works by binding to a protein in your body called interleukin-4 receptor alpha (IL-4Rɑ), which makes it an IL-4Rɑ antagonoist. This blocks the action of two proteins called interleukin-4 (IL-4) and interleukin-13 (IL-13), which are involved in signaling the body to release substances that cause inflammation. It helps to stop inflammation before it even begins.

Dupilumab was approved by the US Food and Drug Administration (FDA) in 2017. The FDA has not approved any biosimilars of dupilumab which are drugs that have the same effect on a person, but which are only highly similar and not identical.

Dupilumab side effects

Serious side effects of dupilumab include:

Allergic reactions. Dupilumab can cause allergic reactions that can sometimes be severe. Stop using dupilumab and tell your healthcare provider or get emergency help right away if you get any of the following signs or symptoms:

breathing problems or wheezing

fast pulse

fever

general ill feeling

swollen lymph nodes

swelling of the face, lips, mouth, tongue, or throat

hives

itching

nausea or vomiting

fainting, dizziness, feeling lightheaded

joint pain

skin rash

cramps in your stomach-area

Eye problems. Tell your healthcare provider if you have any new or worsening eye problems, including eye pain or changes in vision, such as blurred vision. Your healthcare provider may send you to an ophthalmologist for an eye exam if needed.

Inflammation of your blood vessels. Rarely, this can happen in people with asthma who receive dupilumab. This may happen in people who also take a steroid medicine by mouth that is being stopped or the dose is being lowered. It is not known whether this is caused by dupilumab. Tell your healthcare provider right away if you have:

rash

worsening shortness of breath

persistent fever

chest pain

a feeling of pins and needles or numbness of your arms or legs

Joint aches and pain. Joint aches and pain can happen in people who use dupilumab. Some people have had trouble walking or moving due to their joint symptoms, and in some cases needed to be hospitalized. Tell your healthcare provider about any new or worsening joint symptoms. Your healthcare provider may stop dupilumab if you develop joint symptoms.

The most common side effects of dupilumab include:

injection site reactions

eye and eyelid inflammation, including redness, swelling, and itching, sometimes with blurred vision

pain in the throat (oropharyngeal pain)

cold sores in your mouth or on your lips

high count of a certain white blood cell (eosinophilia)

trouble sleeping (insomnia)

toothache

gastritis

joint pain (arthralgia)

parasitic (helminth) infections

The following additional side effects have been reported with dupilumab:

facial rash or redness

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all of the possible side effects of dupilumab.

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

Before taking Dupilumab

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether dupilumab will harm your unborn baby.

There is a pregnancy exposure registry for women who take dupilumab during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Your healthcare provider can enroll you in this registry. You may also enroll yourself or get more information about the registry by calling 1-877-311-8972 or going to https://mothertobaby.org/ongoing-study/dupixent/.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known whether dupilumab passes into your breast milk.

Relate drugs

How to use Dupilumab

Atopic Dermatitis

Adults: The recommended dose of dupilumab is an initial dose of 600 mg (two 300 mg injections), followed by 300 mg given every other week.

Pediatric patients 6 months to 5 years of age: Body weight Initial and subsequent dose 5 to less than 15 kg 200 mg (one 200 mg injection) every 4 weeks 15 to less than 30 kg 300 mg (one 300 mg injection) every 4 weeks

Pediatric patients 6 years to 17 years of age: Body weight Initial loading dose Subsequent doses 15 to less than 30 kg 600 mg (two 300 mg injections) 300 mg every 4 weeks 30 to less than 60 kg 400 mg (two 200 mg injections) 200 mg every other week 60 kg or more 600 mg (two 300 mg injections) 300 mg every other week

Asthma

Dosage in adult and pediatric patients 12 years and older Initial loading dose Subsequent doses 400 mg (two 200 mg injections) 200 mg every 2 weeks Or 600 mg (two 300 mg injections) 300 mg every 2 weeks

Dosage for patients with oral corticosteroid-dependent asthma or with co-morbid moderate-to-severe atopic dermatitis or adults with co-morbid chronic rhinosinusitis with nasal polyposis

Initial loading dose Subsequent doses 600 mg (two 300 mg injections) 300 mg every 2 weeks

Dosage in pediatric patients 6 year to 11 years of age

Body weight Initial dose and subsequent doses 15 to less than 30 kg 100 mg every other week Or 300 mg every four weeks ≥30 kg 200 mg every other week

For pediatric patients 6 to 11 years old with asthma and co-morbid moderate-to-severe atopic dermatitis follow the dosing instructions listed above for pediatric patients with atopic dermatitis

Chronic Rhinosinusitis with Nasal Polyposis

Recommended dosage for adult patients is 300 mg given every other week.

Eosinophilic esophagitis

Recommended dosage for adult and pediatric patients 12 years of age and older, weighing at least 40 kg, is 300 mg given every week.

What other drugs will affect Dupilumab

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Especially tell your healthcare provider if you:

are taking oral, topical, or inhaled corticosteroid medicines

have asthma and use an asthma medicine

have atopic dermatitis or CRSwNP, and also have asthma

Do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare provider. This may cause other symptoms that were controlled by the corticosteroid medicine or other asthma medicine to come back.

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