Dupixent side effects and how to avoid them
Dupixent is a biologic drug that is produced from living organisms. Just like conventional drugs, all biologic drugs must be approved by the Food and Drug Administration (FDA) for safety and effectiveness.
Dupixent reduces the amount of inflammation your immune system can cause by blocking two proteins called interleukin-4 (IL-4) and interleukin-13 (IL-13) in the inflammation process. This helps to reduce the severity of your symptoms. It can reduce eczema outbreaks, reduce asthma symptoms and help you breathe more easily, and help you to recover from chronic rhinosinusitis with nasal polyposis.
Dupixent can cause adverse reactions as can all medications. It’s important to talk to your healthcare professional for medical advice about possible side effects that trouble you or are persistent. Learn more about Dupixent’s adverse effects and how to avoid them.
What is Dupixent?
Dupixent is the brand name of an injectable medicine used to reduce inflammation. It is prescribed to:
- Adults and children 6 years and older to treat moderate-to-severe atopic dermatitis (eczema) when topical treatments can not be used or are not effective enough. Dupixent can be used with or without topical corticosteroids
- Adults and children 12 years and older to treat eosinophilic asthma or asthma that requires oral corticosteroids
- Adults to treat a nasal and sinus condition called chronic rhinosinusitis with nasal polyposis, alongside other medications for the condition, such as antibiotics
What is a biologic drug?
Biologics or biological medicines originate from living cells, such as humans, animals, or microorganisms using biotechnology, whereas chemically derived drugs are created in laboratories. Chemically derived or traditional drugs are described as small molecule drugs. Biologic drugs on the other hand are much larger in size, containing more complex molecules, making them challenging and costly to make. The growth of the cells in biologic medications can take several weeks and requires constant monitoring. The protein that makes up the drug is extracted and purified until the final biologic drug is obtained.
Biological products include a wide range of products including:
- Blood components
- Gene therapy
- Proteins, like monoclonal antibodies and cell signaling proteins
The manufacturing process of biological drugs makes it impossible to guarantee that each batch of a biologic drug will be identical to the last, which means every dose of a biologic medicine has slight variations.
Dupixent active ingredients
The active ingredient in Dupixent is called dupilumab. It is a type of drug called a monoclonal antibody that has been designed to attach to a specific type of white blood cell in your body called a B cell.
Your immune system produces B cells to help trigger inflammation. But when you take Dupixent, the dupilumab it contains attaches to B cells at areas on their surface called receptors. This blocks the receptors and stops them from receiving the chemical trigger to begin the inflammatory process. This reduces how much inflammation your immune system can cause, easing the symptoms of inflammatory disease.
How should I use Dupixent?
Dupixent is a prescription drug that is taken by injecting it under the skin (subcutaneous injection) in the thigh, stomach area, or upper arm, using a prefilled syringe or pre-filled injection pen. Dupixent should be used exactly as prescribed by your doctor. Your healthcare professional will work out the dose of Dupixent and your dosing schedule.
Dupixent is available as
- A single dose pre-filled syringe (100 mg, 200 mg, or 300 mg) with a needle shield
- A single-dose pre-filled pen (200 mg or 300 mg) for ages 12+ years
Before Dupixent is started your doctor will arrange proper training on preparing and injecting. Your healthcare provider will decide if you or your caregiver can give the Dupixent injections.
It is advised that Dupixent is given by or under adult supervision in children and adolescents 12 years of age and older. A caregiver should administer Dupixent pre-filled syringes to children 6-11 years of age.
What do I do if I miss a dose?
This depends on your dosing schedule but as a guide:
- If you take this drug every 2 weeks – take the missed dose as soon as you think about it. If it has been 7 days or more since your missed dose, skip the missed dose and go back to your normal time
- If you take this drug every month – take the missed dose as soon as you think about it. If it has been 7 days or more since your missed dose, take the missed dose and start a new schedule based on when you took the dose
Your doctor will advise you on exactly what should be done if a dose is missed.
Common side effects of Dupixent
As with all medications, Dupixent can cause side effects. Only some people get side effects, however, and these side effects can vary by person.
The most common possible side effects caused by Dupixent include:
- Injection site reactions, such as swelling and pain
- Inflammation in your eyes and eyelids (blepharitis)
- Conjunctivitis (pink eye)
- Dry eye
- Cold sores around your lips and in your mouth
- A sore throat
- Trouble sleeping (insomnia)
- Joint pain
- Inflammation in your stomach (gastritis), that can cause indigestion and nausea
In rare instances, Dupixent can cause more serious side effects. These include:
- Severe allergic reactions to the medication, symptoms include skin rashes, hives, fever, swelling in the face, mouth, and throat, and breathing problems
- Hypersensitivity reactions such as serum sickness (an immune system reaction that causes fever, rash, and joint pain or swelling)
- New or worsening eye problems, including eye pain, keratitis (inflammation of the cornea), and changes in vision
- Inflammation of your blood vessels (vasculitis) – this is rare, but most likely to happen in patients with asthma who also take a corticosteroid medication
Your doctor will assess the benefits of taking Dupixent against your risk of side effects.
Side effects related to a specific condition
In clinical trials the side effects for specific conditions treated by Dupixent differ:
The most common adverse effects in adult patients treated for Atopic dermatitis were injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, and other herpes simplex virus infection, and dry eye.
The most common adverse effects were injection site reactions, oropharyngeal pain, and eosinophilia.
Chronic rhinosinusitis with nasal polyposis
The most common adverse effects were injection site reactions, eosinophilia, insomnia, toothache, gastritis, arthralgia, and conjunctivitis.
Dupixent drug interactions
Dupixent can interact with other medications. This can change how Dupixent and the other medications work and can make some side effects more likely. Tell your prescribing doctor about all drugs you are taking, particularly:
- Any other medications you take for your inflammatory condition
- Any oral, topical, or inhaled corticosteroid medicines
Dupixent warnings & precautions
Dupixent is a maintenance medication used to help lessen and control your asthma symptoms. It should not be used to treat sudden and severe onsets of asthma (such as an asthma attack). Use your rescue inhaler to treat sudden and severe asthma symptoms, or whatever rescue medication your doctor has prescribed to you.
Dupixent should not be given to children under 6 years of age to treat eczema, children under 12 years of age to treat asthma, or children under 18 years of age to treat chronic rhinosinusitis with nasal polyposis.
This medication is not suitable for everyone. Do not take Dupixent if you are allergic to the active ingredient dupilumab, or any of the other ingredients in Dupixent. Talk to your doctor before taking Dupixent if you:
- Are taking any of the medications that could interact with Dupixent
- Have or have ever had any eye problems
- Have recently had or are due to have a live vaccination
- Have a parasitic infection (helminth)
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
Use of Dupixent in pregnancy and breastfeeding
It is not known if Dupixent is safe to take during pregnancy or while breastfeeding. If you’re pregnant, breastfeeding, or planning either, talk with your doctor. They can recommend the safest way to treat your condition during this time.
Dupixent food interactions
Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Dupixent, there are no specific foods that you must exclude from your diet when receiving this medication.
Where can I get more information?
Your pharmacist or healthcare provider can provide more drug information about Dupixent.
How to avoid Dupixent side effects
1. Stick to the recommended dosage
Take your prescribed dose of Dupixent that has been recommended by your healthcare professional. Taking your medication consistently will make a big difference in how well Dupixent works for you.
Your healthcare provider may adjust your dose of Dupixent or your other medications to find the best dosage for your specific needs.
2. Discuss medical history
Discussing your medical history with your healthcare provider is important to help them understand how well Dupixent will work for you. Give a complete list of all the prescription drugs, including over-the-counter meds, supplements, and medical conditions you may have. Talking with your doctor will allow them to pick up any drug interactions with Dupixent and help manage any possible side effects.
3. Rotate injection sites
The importance of rotating insulin injection sites is to maintain effective drug absorption. Small fatty lumps or hard lumps could develop in areas that are continuously used as injection sites. This can interfere with drug absorption and also cause discomfort. Rotate between injecting sites of the thigh, stomach area, or upper arm. Always clean your skin with an alcohol wipe. Please do not touch the injection site again or blow on it before the injection. Let your skin dry before injection and do not rub your skin after the injection.
4. Use Dupixent at room temperature
To ensure comfortable injection of Dupixent remove the Dupixent pen injector or prefilled syringe from the refrigerator about 45 minutes before injection. This will allow the medicine to warm to room temperature. Injecting cold medicine is painful.
5. A caregiver must inject Dupixent for children
Although Dupixent can be self-injected, caregivers should always give the injection to children and adolescents to maximize both safety and effectiveness.
6. No live vaccines
Live vaccines should not be given to Dupixent patients right before or during treatment, these include:
- Chickenpox (varicella) vaccines
- FluMist (the flu vaccine given as a nasal spray)
- MMR vaccines (measles, mumps, and rubella)
- Japanese encephalitis vaccine
- Rotavirus vaccines
- Smallpox vaccine
- Yellow fever vaccine
7. Cold compress on your eye
Dupixent can commonly cause inflammation in your eyes and eyelids (blepharitis), conjunctivitis (pink eye), and dry eye. It is usually not serious but more irritating. You may find relief with just a cool compress or over-the-counter eye relief drops. A more severe eye infection may require prescription medication.
If you notice vision changes or develop eye pain, contact your doctor. They can suggest the next steps to help manage your eye problems.
8. Stay active
To avoid joint pain while taking Dupixent some of the following things may help;
- Daily stretching
- Make sure you are physically active to help keep your joints strong
- Look at over-the-counter (OTC) options for pain relief
9. Tell your doctor if you suffer from cold sores
Cold sores around the lip and mouth can occur when taking Dupixent. If you’re concerned about this particularly if you’re prone to getting them, talk with your doctor. They can recommend the best treatment plan to have in place. This way, you’ll know what to do at the first sign of a cold sore.
10. Pay attention to your body
Paying attention to how your body feels when taking Dupixent is important. For example, listen to your body and rest your joints when needed if they’re painful. Talk to your doctor straight away if you start to experience any side effects of Dupixent when taking it, or if you feel the medication is not working for you.
11. Store Dupixent correctly
Refrigerate Dupixent at 36°F to 46°F in the original carton to protect from light.
If needed Dupixent may be kept at room temperature up to 77°F (25°C) for a maximum of 14 days. Do not store above 77°F (25°C). After removal from the refrigerator, Dupixent must be used within 14 days or discarded. Keep Dupixent away from heat or direct sunlight. Do not freeze. Do not shake.
Knowing how to store your medication is important to make sure it remains as effective as possible. Using expired or improperly stored medication could result in the medication not working properly and even causing unwanted side effects.