Dupilumab

What is Dupilumab for?

Dupilumab is used to treat atopic dermatitis (eczema), prurigo nodularis (a skin condition that presents with itchy, hard, and raised bumps), chronic spontaneous urticaria (hives), asthma, chronic rhinosinusitis with nasal polyposis (long-term sinus problems with nose polyps), and chronic obstructive pulmonary disease (COPD). 

Dupilumab belongs to a class of medications called biologics. Biologics are genetically-engineered proteins. Dupilumab reduces inflammation by blocking the activity of the proteins called Interleukin-4 (IL-4) and Interleukin-13 (IL-13).

Dupilumab does not work immediately, and it may take several weeks before you notice any improvement in symptoms.

How should I take or use Dupilumab?

• Dupilumab comes as a single dose injection in a pre-filled syringe or pen.
• Dupilumab is a clear and colorless to pale yellow solution. Do not use if dupilumab is discolored or cloudy, or if it contains flakes or particles.
• It is administered under the skin as a subcutaneous injection, into the thigh or abdomen, except for 5 cm around your belly button. If somebody else is administering the injection for you, he/she can inject in the outer area of your upper arm.
• Rotate the injection site with each injection. Avoid injecting into areas where the skin is tender, damaged, bruised, scarred, or in an area of skin that is affected by atopic dermatitis or other skin problems.
• You and your doctor or nurse will decide if you can inject Dupilumab yourself. You or your caregiver should receive training on how to inject the medication from your doctor, pharmacist, or specialty nurse before attempting the administration on your own.
• Do not stop using the medication without discussing it with your doctor. Your doctor will decide how much Dupilumab you need and for how long it has to be used for. Stopping Dupilumab suddenly may cause the symptoms of your condition to return.

What should I do if I forget to take or use Dupilumab?

• If your dupilumab is administered every 2 weeks,
  • Administer the injection within 7 days from the missed dose, then resume your original schedule.
  • If the missed dose is not administered within 7 days, wait until the next dose on the original schedule.
• If your dupilumab is administered every 4 weeks,
  • Administer the injection within 7 days from the missed dose, then resume your original schedule.
  • If the missed dose is not administered within 7 days, administer the dose and start a new schedule based on this date.

What precautions should I take when taking or using Dupilumab?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication.
• You have eye problems.
• You have a parasitic helminth (worm) infection.
• You are planning to receive any vaccination.
• You are pregnant, planning to become pregnant, or breastfeeding. 

If you have asthma and are taking medications for asthma, do not change or stop your asthma medications without discussing with your doctor.

What food or medication should I avoid when I take or use Dupilumab?

Please inform your doctor or pharmacist if you are taking other medications as they may interact with Dupilumab. These include

• Over-the-counter medications
• Nutritional supplements
• Traditional or herbal remedies

Discuss with your doctor before receiving any vaccination. 

What are some common side effects of Dupilumab?

Common side effects include:

• Injection site reactions like swelling, itching, or bruising, which usually subside in 3-5 days.
• Eye dryness, redness and itching
• Eyelid itching, redness and swelling
• Cold sores (small fluid-filled blisters on the lips or around the mouth)
• Signs of a common cold
• Headache 
• Muscle or back pain
• Diarrhea

Inform your doctor if any side effect persists, if you are unable to tolerate them or the side effects become serious. 

What are some rare but serious side effects that I need to seek medical advice immediately?

• Worsening eye problems such as eye pain or changes in vision
• Allergic reactions such as
  • Difficulty breathing
  • Fainting, dizziness, feeling lightheaded
  • Swollen face/eyes/lips/tongue
  • Itchy rashes over your whole body
• Face rash or redness
• Psoriasis that is new or worsening
• Shingles (painful, blistering rash in one part of the body)
• Joint pain that is new or worsening

How should I store Dupilumab?

• Store in the refrigerator between 2°C and 8°C. Do not freeze.
• Do not shake the Dupilumab syringe or pre-filled pen.
• Keep in the original packaging to protect from light.

How do I throw away Dupilumab safely?

• You may throw the used syringes or pre-filled pen in a metal tin or thick plastic container (e.g., detergent bottles).
• You can also buy a container that is specially designed to prevent any accidental injuries due to contact with discarded knives and needles, known as a Sharps Box.