9 Dupixent Side Effects and How to Manage Them

If you or your child are living with an inflammatory condition, such as asthma, you may be prescribed a biologic medication if other treatments haven’t worked. Dupixent (dupilumab) is one biologic your prescriber may consider. It works by targeting sources of type 2 inflammation — an overactive immune response involving specific immune cells in the body.

Biologics work differently from oral, inhaled, or topical medications you may be used to taking. Because of this, you may be concerned about potential side effects. The good news is that most Dupixent side effects can be managed at home. And while serious Dupixent side effects are possible, they’re typically rare.

Dupixent side effects at a glance

Dupixent can cause a range of side effects, from mild to life-threatening. They can also vary, depending on the condition being treated. Serious side effects are rare, but they’re something to watch out for.

Common or mild Dupixent side effects include:

• Injection site reactions

• Eye problems

• Joint or muscle pain

• Dizziness

• Diarrhea

• Infections, such as upper respiratory tract infections

• Gastritis

• Insomnia 

Less common but potentially serious Dupixent side effects include:

• Eosinophilia (increased number of eosinophils, a type of white blood cell)

• Serious infections, such as parasitic infections and herpes infections

• Hypersensitivity reactions, such as angioedema (swelling) and anaphylaxis

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Common side effects, such as injection site reactions, are usually short-lived. But for more serious side effects, your care team might want you to stop using Dupixent in certain situations. Below, we review nine potential Dupixent side effects and how to manage them.

1. Injection site reactions

As with other injectable medications, injection site reactions are common with Dupixent. For people ages 12 and older with asthma, they were more common with the first Dupixent dose in initial studies.

Injection site reactions can happen near the spot where you inject Dupixent. Examples of reactions include:

• Redness

• Swelling

• Itching

• Pain

• Inflammation

These types of reactions usually go away on their own within a day or two. In the meantime, you can manage your symptoms with a warm or cold compress, over-the-counter (OTC) pain relievers, and topical anti-itch creams, as needed. But you should tell your prescriber if your symptoms aren’t going away or seem to be getting worse.

You can inject Dupixent into your thigh, stomach, or upper arm. Changing the spot where you inject Dupixent each time can lessen the chance for injection site reactions. Rotating spots will give your skin a chance to heal from your last injection. Avoid injecting into areas of skin that are bruised, tender, or scarred, since this may affect how you absorb your dose.

2. Eye problems

A variety of eye problems can occur during treatment with Dupixent. Researchers aren’t sure why this happens, but there are several theories. Eye problems that have been reported during clinical studies of Dupixent include:

• Pink eye

• Blepharitis (swollen, irritated eyelids)

• Keratitis (inflammation of the cornea)

• Itchy eyes

• Dry eyes

• Herpes infections that affect the eyes

EXPERT PICKS: WHAT TO READ NEXT

• How to save: Dupixent (dupilumab) is one of several biologics used to treat asthma and other inflammatory conditions. Here’s how to make your asthma biologic prescription more affordable.

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• Biologics for eczema: Dupixent is one of several biologics FDA approved for eczema. Learn how they compare.

You may be able to manage mild eye symptoms, such as dry or itchy eyes, with OTC eye drops. Your pharmacist can help you select the right product for your needs. However, it’s still a good idea to tell your healthcare team if you notice any new or worsening eye symptoms, such as redness, discharge, or itching. In some cases, you may need to see an eye specialist.

3. Joint and muscle pain

Dupixent can also cause joint or muscle pain. In clinical trials, up to 3% of people reported joint pain, and up to 3% reported muscle pain. According to the manufacturer, some people who used Dupixent in clinical trials had trouble getting around due to their joint symptoms, and some had to be hospitalized.

Joint pain can start within days to months after your first Dupixent dose. It’s possible that the pain will resolve itself while you continue taking the medication. But it’s still a good idea to let your healthcare team know, especially if it’s bothersome or getting worse.

Depending on the severity of your symptoms, your prescriber might have you stop taking Dupixent to see if your joint pain resolves. Keep in mind that health conditions such as asthma and eczema may increase the risk of joint conditions, such as osteoporosis. Your healthcare team can determine if your joint pain is from Dupixent or another cause.

4. Dizziness

Some people taking Dupixent for prurigo nodularis (a skin condition that causes itchy bumps) have reported dizziness as a side effect. Keep in mind that dizziness can have many causes. It may be caused by Dupixent, a different medication, or a health condition.

If you become dizzy or feel like the room is spinning, try to sit, lie down, or hold on to something until the feeling passes. It’s also a good idea to see how Dupixent affects you before performing activities where dizziness could be risky, such as driving a car. Be extra careful if you take other medications that can make you feel dizzy.

Tell your healthcare team if your dizziness isn’t going away or seems to be getting worse.

5. Diarrhea

Some people taking Dupixent for prurigo nodularis have also reported diarrhea. It isn’t clear why Dupixent might cause this side effect. But if it happens, it may help to avoid certain trigger foods that worsen diarrhea, such as dairy and greasy foods.

If you experience diarrhea that doesn’t get better after 2 days, or you develop other symptoms including stomach pain or fever, contact your care team. In some cases, they may suggest an OTC diarrhea medication for relief.

Keep in mind: If your child or teen develops diarrhea from Dupixent, avoid giving them bismuth subsalicylate (Pepto-Bismol, Kaopectate). That’s because salicylates have been linked to Reye's syndrome, a potentially life-threatening condition, in people under 19 years old. Talk to your child’s healthcare team about safer options.

6. Infections

Dupixent may raise your risk of infections. Upper respiratory tract infections (URTIs) are the most common type. While less frequent, herpes infections affecting the eyes, mouth, or genitals, as well as parasitic infections have also been reported. However, there’s some evidence suggesting that the overall infection risk may not be higher with Dupixent.

It’s also important to note that certain health conditions that Dupixent treats, such as eczema, have a higher risk of infections in general. What’s more, medications often taken with Dupixent, such as oral corticosteroids, can also increase infection risk.

Tell your healthcare team if you notice signs of an infection. URTIs often go away on their own, but OTC cold and flu products may be helpful in managing your symptoms. Other infections, such as herpes or parasites, may require medical treatment.

7. Hypersensitivity reactions

Hypersensitivity reactions, ranging from itching to severe allergic reactions (anaphylaxis), can occur with Dupixent. Angioedema (swelling under the skin) and skin rashes are also possible.

While anaphylaxis from Dupixent is possible, it’s rare. One study looked at 16 years of safety data for five asthma biologics in the FDA Adverse Event Reporting System. From 2015 to 2020, a time period during which Dupixent was on the market, Dupixent had the lowest number of reported anaphylaxis cases.

If you think you might be experiencing a serious allergic reaction to Dupixent, call 911 or have someone take you to the nearest ER. Symptoms may include trouble breathing, swelling of your face or throat, and hives.

8. Gastritis

Gastritis (inflammation of the stomach lining) has been reported by people using Dupixent. Symptoms may include:

• Stomach pain

• Nausea

• Bloating or feeling of fullness

• Loss of appetite

Tell your healthcare team if you experience any of these symptoms after starting Dupixent, especially if they last more than a few days. To help ease symptoms in the meantime, they may recommend trying OTC antacids or acid reducers.

9. Insomnia

Some people using Dupixent have reported trouble sleeping, or insomnia. This isn’t a common side effect, but poor sleep can significantly affect how you feel day to day.

If you find yourself having difficulty falling or staying asleep with Dupixent, talk to your healthcare team. They can help assess whether Dupixent or another factor, such as other medications or underlying health conditions, might be contributing.

In the meantime, you can try sleep hygiene techniques to improve your rest, including:

• Sticking to a regular bedtime

• Avoiding screens and caffeine in the evening

• Creating a quiet, comfortable sleep environment

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Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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