Parenteral Manual

Dupilumab (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Dupixent
Classification: 
Interleukin - 4 receptor alpha antagonist
Original Date: 
December 2019
Indications: 
  • Treatment of moderate to severe atopic dermatitis in patients 12 years and older whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
  • Add-on therapy in the maintenance treatment of moderate to severe asthma in patients 12 years and older who have an eosinophilic phenotype or with oral corticosteroid dependent asthma.
Reconstitution and Stability: 
  • Available as single-use (preservative-free) pre-filled syringes (300 mg/2 mL and 200 mg/1.14 mL). Clear to pale yellow in colour.
  • Store syringes in original packaging refrigerated (2 – 8ºC). DO NOT FREEZE. DO NOT SHAKE.
  • Protect from light.
  • May be stored at room temperature (up to 25ºC) for a maximum single period of 14 days in the original packaging protected from light. Once stored at room temperature, do NOT return product to refrigerator. Discard after 14 days.
Compatibility: 
  • N/A
Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC YES
IM NO
IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Atopic Dermatitis

Body Weight Initial Dose Subsequent Dose (every 2 weeks)
Less than 60 kg 400 mg 200 mg
Greater than or equal to 60 kg 600 mg 300 mg

Asthma

 - Initial dose of 400 mg followed by 200 mg every 2 weeks

OR

 - Initial dose of 600 mg followed by 300 mg every 2 weeks

Corticosteroid-dependent asthma: initial dose of 600 mg followed by 300 mg every 2 weeks

Potential hazards of parenteral administration: 
  • Injection site reactions, conjunctivitis, blepharitis, oral herpes, oropharyngeal pain, keratitis, eye pruritus, other herpes simplex virus infections and dry eye.
  • Avoid the use of live vaccines in patients treated with dupilumab.
Notes: 

Should not be used as treatment for acute asthma symptoms or acute exacerbations.
Systemic, topical or inhaled corticosteroids should not be abruptly discontinued upon initiation of therapy with dupilumab.
Treat patients with pre-existing helminth infections before initiating therapy.

To be administered subcutaneously into thigh, abdomen (greater than or equal to 5 cm from navel) or upper arm. Rotate injection sites.

Missed dose - administer the dose within 7 days from the missed dose and continue with the regular schedule. If the missed dose exceeds 7 days, wait until the next dose of the original schedule.

 

 

References: 

Dupixent, Product Information, Regeneron Pharmaceuticals, Inc. 2019

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