Dupixent is a self-injected medication that you give yourself at home using either a pre-filled pen or a pre-filled syringe. Most adults inject it once every two weeks, though the exact schedule depends on what condition you’re treating and your body weight. Your first dose is typically a “loading dose,” meaning two injections given on the same day at different sites, followed by single injections on your ongoing schedule.
Pre-filled Pen vs. Pre-filled Syringe
Dupixent comes in two device options, and the injection technique differs between them.
With the pre-filled syringe, you pinch a fold of skin at your injection site and insert the needle at about a 45-degree angle. You then push the plunger rod down slowly and steadily until the syringe is completely empty. When you release the plunger, a needle shield automatically covers the needle before you pull it away from your skin.
The pre-filled pen is simpler. You place the pen flat against your skin at a 90-degree angle and press down firmly. You’ll hear a click when the injection starts. Keep the pen pressed against your skin and watch the viewing window: it will turn completely yellow, and you’ll hear a second click. After that second click, hold the pen in place for a count of 5 to make sure you get the full dose, then pull straight up. Adults and children 12 and older do not need to pinch the skin when using the pen.
Where to Inject
You have three possible injection sites: the front of your thigh, your stomach (at least 2 inches away from your belly button), or the outer upper arm. The upper arm is only an option if a caregiver is giving the injection, since it’s difficult to reach on your own. Rotate between these sites with each dose rather than injecting in the same spot repeatedly. If your loading dose requires two injections, give each one at a different site.
How to Prepare the Injection
Dupixent needs to be stored in the refrigerator between 36°F and 46°F (2°C to 8°C). Before injecting, take it out and let it warm to room temperature. Injecting cold medication is more uncomfortable than it needs to be. Do not use a microwave, hot water, or any direct heat source to warm it up.
If you need to, you can keep Dupixent at room temperature (up to 77°F) for a maximum of 14 days. After 14 days outside the fridge, it must be discarded. Before injecting, check the liquid through the viewing window. If it looks cloudy, discolored, or contains particles, don’t use it.
Dosing Schedules by Condition
Your dose and frequency depend on the condition being treated, your age, and your weight. Here’s how the most common schedules break down for adults.
Atopic dermatitis (eczema): A loading dose of 600 mg (two 300 mg injections) on day one, then 300 mg every two weeks.
Asthma: Either a 400 mg loading dose followed by 200 mg every two weeks, or a 600 mg loading dose followed by 300 mg every two weeks. The higher dose is used for people who depend on oral corticosteroids or who also have moderate-to-severe eczema or chronic sinus disease with nasal polyps.
Eosinophilic esophagitis (adults weighing 40 kg or more): 300 mg every week, with no loading dose.
Dosing for Children
Pediatric dosing is weight-based and varies by condition. A few key patterns are worth knowing.
For eczema in children ages 6 months to 5 years, there is no loading dose. Kids under 15 kg get 200 mg every 4 weeks, and those 15 to 30 kg get 300 mg every 4 weeks. Children 6 and older do receive a loading dose, and their maintenance schedule shifts from every 4 weeks to every 2 weeks as their weight increases past 30 kg.
For asthma in children 6 to 11, there is also no loading dose. Children under 30 kg receive 300 mg every 4 weeks, while those 30 kg and above get 200 mg every 2 weeks. Adolescents 12 and older follow the adult schedule, including a loading dose.
Because the weight tiers differ across conditions, your prescriber will determine the exact dose for your child.
What to Do If You Miss a Dose
If you miss your scheduled injection, you have a 7-day window to take it. Give the injection as soon as you remember within those 7 days, then resume your original schedule from there. If more than 7 days have passed since the missed dose, skip it entirely and wait for your next regularly scheduled injection.
Disposing of Used Devices
After each injection, place the used pen or syringe immediately into an FDA-cleared sharps disposal container. A rigid, puncture-resistant plastic container with a tight lid works if you don’t have a commercial sharps container. Never throw used needles or pens directly into household trash or recycling.
Once your container is about three-quarters full, seal it and dispose of it according to your local guidelines. Options typically include drop-off collection sites, household hazardous waste programs, mail-back programs, or special waste pickup services. Your local health department or trash removal service can tell you which options are available in your area.