Dupixent (dupilumab) is a biologic medication FDA-approved to treat six different conditions: moderate-to-severe atopic dermatitis (eczema), asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis, and chronic obstructive pulmonary disease (COPD). All six conditions share a common thread: they’re driven by overactive type 2 inflammation, a specific branch of the immune system that Dupixent targets. It works by blocking a signaling protein that triggers this inflammatory pathway, calming the immune overreaction behind each condition.
Atopic Dermatitis (Eczema)
Eczema was the first condition Dupixent was approved to treat, and it remains one of its most common uses. It’s indicated for moderate-to-severe atopic dermatitis in patients as young as 6 months old whose skin hasn’t responded well enough to prescription creams and ointments, or for whom those topical treatments aren’t a good option. You can use it alongside topical corticosteroids or on its own.
For adults, treatment starts with two injections on day one (a combined loading dose of 600 mg), followed by a single 300 mg injection every two weeks. Kids aged 6 to 17 follow a weight-based schedule: children under 30 kg receive injections every four weeks, while those 30 kg and above inject every two weeks. A phase 3 trial published in The Lancet confirmed that Dupixent significantly improved eczema signs and symptoms even in children younger than 6, which led to the expanded age approval down to 6 months.
Moderate-to-Severe Asthma
Dupixent is approved as an add-on maintenance treatment for moderate-to-severe asthma in patients aged 6 and older. It’s not for every type of asthma. It’s specifically designed for people whose asthma is driven by elevated eosinophils (a type of white blood cell involved in allergic inflammation) or for those who depend on oral corticosteroids to keep their asthma under control. Your doctor will typically check your blood eosinophil levels to determine whether you’re a good candidate.
One important distinction: Dupixent is a long-term controller, not a rescue medication. It will not help during an acute asthma attack or an episode of status asthmaticus. You still need a fast-acting inhaler for sudden breathing problems.
Chronic Rhinosinusitis With Nasal Polyps
Nasal polyps are soft, noncancerous growths in the lining of the sinuses that can block airflow, kill your sense of smell, and cause persistent congestion and facial pressure. Dupixent is approved for adults and adolescents 12 and older with chronic rhinosinusitis and nasal polyps that aren’t adequately controlled by other treatments.
Two large phase 3 trials (SINUS-24 and SINUS-52) tested Dupixent against placebo in patients with severe disease. By 24 weeks, people on Dupixent had significantly less nasal congestion compared to the placebo group, with highly consistent results across both studies. Many patients also reported meaningful improvement in their ability to smell, which is often one of the most frustrating symptoms of nasal polyps. The standard dose is 300 mg injected every two weeks.
Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic condition where a buildup of immune cells in the esophagus causes inflammation, swelling, and difficulty swallowing. Food can feel like it’s getting stuck in your chest, and over time the esophagus can narrow. Dupixent is approved for patients aged 1 year and older who weigh at least 15 kg. It’s the first biologic approved for EoE, which previously relied mainly on dietary restrictions, acid-suppressing medications, and swallowed steroids.
For adults and older adolescents weighing 40 kg or more, the dosing schedule is more frequent than for other conditions: one 300 mg injection every week rather than every two weeks.
Prurigo Nodularis
Prurigo nodularis causes intensely itchy, hard lumps on the skin that develop from repeated scratching. The itch-scratch cycle is relentless, and available treatments have historically been limited. Dupixent is approved for adults with this condition.
Pooled results from two phase 3 trials (LIBERTY-PN PRIME and PRIME2) showed clear benefits at 24 weeks. Among patients on Dupixent, 58.8% achieved a clinically meaningful reduction in itch, compared to 19% on placebo. Nearly half (46.4%) achieved clear or almost clear skin, versus 17.1% in the placebo group. About 35% of Dupixent-treated patients hit both benchmarks, compared to fewer than 9% on placebo.
Chronic Obstructive Pulmonary Disease
COPD is the most recently added indication. Dupixent is approved as an add-on maintenance treatment for adults with inadequately controlled COPD and an eosinophilic phenotype, meaning their disease is characterized by elevated eosinophils rather than being purely driven by smoking-related damage. This is a meaningful distinction because not all COPD responds to this type of therapy. Like its use in asthma, Dupixent is not a rescue treatment and won’t relieve acute breathing episodes. The standard adult dose is 300 mg every two weeks.
How Dupixent Is Given
Dupixent is a subcutaneous injection, meaning it goes just under the skin, typically in the thigh or abdomen. After your first dose is given under medical supervision, most people self-inject at home using a prefilled syringe or autoinjector. Injection frequency depends on the condition being treated: every two weeks for most indications, every week for eosinophilic esophagitis, and every four weeks for some smaller children with eczema.
The medication needs to be stored in the refrigerator between 36°F and 46°F. If needed, you can keep it at room temperature (up to 77°F) for up to 14 days. Any syringe left out longer than that should be thrown away. Most people let the syringe sit at room temperature for about 30 to 45 minutes before injecting, since cold injections can sting more.
Common Side Effects
Dupixent’s side effect profile is generally considered milder than older immunosuppressive treatments. The most frequently reported issues are injection site reactions, including redness, swelling, or itching where the needle goes in. These tend to be mild and usually improve over time as your body adjusts.
Eye-related side effects are more specific to Dupixent than to most other biologics. Conjunctivitis (pink eye) and eye dryness or irritation have been reported, particularly in patients being treated for atopic dermatitis. If you develop persistent redness, itching, or watering of the eyes, your prescriber may recommend lubricating eye drops or refer you to an eye specialist. Cold sores (oral herpes flare-ups) have also been noted at higher rates in clinical trials. Unlike some other immune-modifying drugs, Dupixent does not broadly suppress the immune system, which means it carries a lower risk of serious infections.