[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Biologics for asthma](https://durgical.com/en/pharmacology/classes/biologics-for-asthma/) › Dupilumab

# Dupilumab

## Biologics for asthma?

Biologics for asthma

An antibody against the IL-4 receptor that blocks IL-4 and IL-13; used for atopic dermatitis, asthma, nasal polyps and other type 2 diseases.

Updated Nov 1, 2026

## Quick facts

**Group**
[Biologics for asthma](https://durgical.com/en/pharmacology/classes/biologics-for-asthma/)

**Target**
Interleukin-4 receptor alpha chain (IL-4Rα)

**Used for**
Moderate to severe atopic dermatitis

**Key effects**
Injection-site reactions · Conjunctivitis · Cold sores

**Monitor**
Eye symptoms at every visit

**ATC**
D11AH05

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Interleukin-4 receptor alpha chain (IL-4Rα)**Dupilumab

ⓘ The figure shows the Fab fragment of dupilumab bound to the human IL-4 receptor alpha chain.

**Target in 3D:** Interleukin-4 receptor alpha chain (IL-4Rα). PDB structure 6WGL (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6WGL) · Drag to rotate · pinch to zoom

Dupilumab is a fully human monoclonal antibody that binds IL-4 receptor alpha, the chain shared by the type I receptor (for IL-4) and the type II receptor (for IL-4 and IL-13). Blocking both cytokines reduces IgE production, mucus, airway hyperresponsiveness, skin barrier damage and itch. Because eosinophils are kept out of tissues, blood eosinophil counts can rise temporarily.

- Dupilumab binds IL-4 receptor alpha
- Both IL-4 and IL-13 lose their signal
- IgE, mucus and skin inflammation fall
- Asthma flare-ups and eczema improve

## Indications

- Moderate to severe atopic dermatitis [Atopic dermatitis →](https://durgical.com/en/conditions/atopic-dermatitis/)
- Moderate to severe asthma with a type 2 or eosinophilic phenotype, or steroid-dependent [Asthma →](https://durgical.com/en/conditions/asthma/)
- Chronic rhinosinusitis with nasal polyps [Chronic rhinosinusitis and nasal polyps →](https://durgical.com/en/conditions/chronic-rhinosinusitis-and-nasal-polyps/)
- Eosinophilic esophagitis [Eosinophilic oesophagitis →](https://durgical.com/en/conditions/eosinophilic-oesophagitis/)
- COPD with raised blood eosinophils [Chronic obstructive pulmonary disease (COPD) →](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/)

## Adverse effects

### Common

- Injection-site reactions
- Conjunctivitis and other eye inflammation
- Cold sores (oral herpes)
- Joint pain; transient rise in blood eosinophils

### Serious (rare, important)

- Eye problems with pain, blurred vision or vision change: urgent review
- Eosinophilic conditions (rash, breathlessness, numbness, chest pain), sometimes when oral steroids are reduced
- Hypersensitivity reactions, including anaphylaxis (rare)

## Contraindications

- Hypersensitivity to dupilumab
- Not for acute bronchospasm
- Existing helminth infection is treated first

## Key interactions

**Live vaccines**
Avoided during treatment; vaccinations are reviewed before starting

**Oral and inhaled corticosteroids**
Not stopped abruptly; reduction is gradual

## What is monitored

- Eye symptoms at every visit
- Asthma control and skin disease scores
- Blood eosinophils if symptoms of eosinophilic disease appear

## Administration and safety

- Subcutaneous injection by prefilled syringe or pen, at home after training
- The device is brought to room temperature before injection and not shaken
- Injection sites are rotated

## Pregnancy and breastfeeding

Antibodies cross the placenta, especially late in pregnancy; pregnancy data are limited and use is decided with the specialist.

## Nursing care

- Teach to report red, painful eyes or vision change
- Review vaccinations before starting, and avoid live vaccines during treatment
- Teach injection technique and site rotation

## Pharmacokinetics

**Absorption**
Subcutaneous injection, slowly absorbed

**Elimination**
Target-mediated and by proteolysis like other antibodies

**Onset and duration**
Improvement over weeks

## Memory aid

DUPIlumab: DUal block (IL-4 and IL-13), watch the eyes.

## Test yourself

Think of the answer, then tap the question to see it.

## How does dupilumab block both IL-4 and IL-13?

It binds IL-4 receptor alpha, the chain shared by both cytokines' receptors.

## Which eye side effect is typical of dupilumab?

Conjunctivitis (and other eye inflammation).

## Which three diseases does dupilumab treat?

Atopic dermatitis, asthma and chronic rhinosinusitis with nasal polyps (also eosinophilic esophagitis, COPD).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/dupilumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 2

- [Omalizumab](https://durgical.com/en/pharmacology/omalizumab/)
- [Mepolizumab](https://durgical.com/en/pharmacology/mepolizumab/)

## Related conditions 5

- [Atopic dermatitis](https://durgical.com/en/conditions/atopic-dermatitis/)
- [Asthma](https://durgical.com/en/conditions/asthma/)
- [Chronic rhinosinusitis and nasal polyps](https://durgical.com/en/conditions/chronic-rhinosinusitis-and-nasal-polyps/)
- [Eosinophilic oesophagitis](https://durgical.com/en/conditions/eosinophilic-oesophagitis/)
- [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/)

[← Back to the class: Biologics for asthma](https://durgical.com/en/pharmacology/classes/biologics-for-asthma/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Dupilumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617021.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=D11AH05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/dupilumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/dupilumab/