Nucala (mepolizumab) and Dupixent (dupilumab) are prescription drugs used to treat chronic rhinosinusitis with nasal polyps, asthma, and COPD. Both drugs come as a liquid solution for injection under your skin. Nucala and Dupixent are not available as biosimilars.
This article explains the main ways Nucala and Dupixent are alike and different. Your doctor can discuss the benefits and risks of these and other treatment options based on your individual diagnosis and medical history.
For more information about these drugs, including details about their uses, see this Nucala article and this Dupixent article.
Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologics.
- Nucala:
- Available as a biosimilar: no
- Active ingredient: mepolizumab
- Dupixent:
- Available as a biosimilar: no
- Active ingredient: dupilumab
Nucala and Dupixent are both prescribed to treat the following conditions:
Each drug has other uses as well.
The following table includes details on the conditions each drug treats in certain adults.
| Use | Nucala | Dupixent |
|---|---|---|
| CRwNP | ✓ | ✓ |
| eosinophilic asthma | ✓ | ✓ |
| eosinophilic COPD | ✓ | ✓ |
| corticosteroid-dependent asthma | ✓ | |
| atopic dermatitis (eczema) | ✓ | |
| eosinophilic esophagitis (EoE) | ✓ | |
| prurigo nodularis | ✓ | |
| chronic (ongoing) hives without a known cause | ✓ | |
| bullous pemphigoid | ✓ | |
| eosinophilic granulomatosis with polyangiitis (also known as Churg-Strauss syndrome) | ✓ | |
| hypereosinophilic syndrome (HES) | ✓ |
To learn more about using Nucala or Dupixent to treat your condition, talk with your doctor.
You can also see these articles about using Dupixent for nasal polyps and Dupixent for eczema.
Nucala and Dupixent are used to treat eosinophilic asthma in children ages 6 years and older.
Nucala is also used to treat HES in children ages 12 years and older.
Dupixent is also used to treat the following in children:
- CRwNP in children ages 12 years and older
- corticosteroid-dependent asthma in children ages 6 years and older
- atopic dermatitis in children ages 6 months and older
- EoE in children ages 1 year and older who weigh at least 15 kilograms (kg), about 30 pounds (lb)
- chronic hives without a known cause in children ages 12 years and older
For more information about the use of either drug in children, talk with your child’s doctor.
Here’s an overview of Nucala and Dupixent dosages and how you would use these drugs for the conditions they both treat.
Nucala and Dupixent are also used to treat several other conditions, but these aren’t addressed in the following section. To learn more about the dosages for all conditions these drugs treat, see the Nucala dosage article and Dupixent dosage article.
Note: For certain conditions, the starting dose of Dupixent is higher than the maintenance (ongoing) dose. This higher starting dose, called a loading dose, helps the drug reach a steady level in your body more quickly.
Dosage for chronic rhinosinusitis with nasal polyps (CRwNP) in adults
The following table shows the dosages of Nucala and Dupixent for CRwNP in adults. Strengths are listed in milligrams (mg) and mg per milliliter (mL).
| Nucala for CRwNP | Dupixent for CRwNP | |
|---|---|---|
| Forms | • liquid solution inside a prefilled syringe or auto-injector, given as an injection under your skin • powder inside a vial, which is mixed with sterile water to form a solution given as an injection under your skin | liquid solution inside a prefilled syringe or injection pen, given as an injection under your skin |
| Strengths | prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL prefilled auto-injector: • 100 mg/mL vial: • 100 mg | • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | 100 mg per injection | 300 mg per injection |
| Frequency | every 4 weeks | every 2 weeks |
Your doctor will show you or a caregiver how to inject Nucala or Dupixent. You may also receive injections in a clinic or doctor’s office.
You’ll inject Nucala or Dupixent under the skin of your abdomen or upper thigh. A caregiver may inject either drug under the skin of your upper arm
Dosage for eosinophilic asthma in adults
The following table shows the dosages of Nucala and Dupixent for eosinophilic asthma in adults. Strengths are listed in milligrams (mg) and mg per milliliter (mL).
| Nucala for eosinophilic asthma | Dupixent for eosinophilic asthma | |
|---|---|---|
| Forms | • liquid solution inside a prefilled syringe or auto-injector, given as an injection under your skin • powder inside a vial, which is mixed with sterile water to form a solution given as an injection under your skin | liquid solution inside a prefilled syringe or injection pen, given as an injection under your skin |
| Strengths | prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL prefilled auto-injector: • 100 mg/mL vial: • 100 mg | • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | 100 mg per injection | 400 mg or 600 mg once (a loading dose), then 200 mg or 300 mg for each injection after |
| Frequency | every 4 weeks | every 2 weeks |
Your doctor will show you or a caregiver how to inject Nucala or Dupixent. You may also receive injections in a clinic or doctor’s office.
You’ll inject Nucala or Dupixent under the skin of your abdomen or upper thigh. A caregiver may inject either drug under the skin of your upper arm
Dosage for eosinophilic COPD in adults
The following table shows the dosages of Nucala and Dupixent for eosinophilic COPD in adults. Strengths are listed in milligrams (mg) and mg per milliliter (mL).
| Nucala for eosinophilic COPD | Dupixent for eosinophilic COPD | |
|---|---|---|
| Forms | • liquid solution inside a prefilled syringe or auto-injector, given as an injection under your skin • powder inside a vial, which is mixed with sterile water to form a solution given as an injection under your skin | liquid solution inside a prefilled syringe or injection pen, given as an injection under your skin |
| Strengths | prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL prefilled auto-injector: • 100 mg/mL vial: • 100 mg | • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | 100 mg per injection | 300 mg per injection |
| Frequency | every 4 weeks | every 2 weeks |
Your doctor will show you or a caregiver how to inject Nucala or Dupixent. You may also receive injections in a clinic or doctor’s office.
You’ll inject Nucala or Dupixent under the skin of your abdomen or upper thigh. A caregiver may inject either drug under the skin of your upper arm
Children’s dosage
The following table shows the dosages of Nucala and Dupixent for eosinophilic asthma in children ages 6 years and older. Strengths are listed in milligrams per milliliter (mg/mL).
| Nucala for eosinophilic asthma | Dupixent for eosinophilic asthma | |
|---|---|---|
| Forms | • liquid solution inside a prefilled syringe or auto-injector, given as an injection under your skin • powder inside a vial, which is mixed with sterile water to form a solution given as an injection under your skin | liquid solution inside a prefilled syringe or injection pen, given as an injection under your skin |
| Strengths | prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL prefilled auto-injector: • 100 mg/mL vial: • 100 mg | • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | depends on age | depends on age and body weight |
| Frequency | every 4 weeks | every 2 or 4 weeks |
Your child’s doctor will show you how to inject Nucala or Dupixent. Your child may also receive injections in a clinic or doctor’s office. Nucala or Dupixent can be injected under the skin of your child’s abdomen, upper thigh, or upper arm.
Nucala and Dupixent may cause side effects ranging from mild to serious.
For more information about possible side effects, see this Nucala side effects article and Dupixent side effects article.
Mild side effects
Nucala and Dupixent may cause mild side effects. The following table lists examples of mild side effects that have been reported with these drugs.
| Nucala | Dupixent | |
|---|---|---|
| dry nose | ✓ | |
| fatigue | ✓ | |
| muscle spasm | ✓ | |
| gastritis (stomach inflammation) | ✓ | |
| cold sores related to the herpes virus | ✓ | |
| high level of eosinophils (a type of white blood cell) | ✓ | |
| insomnia | ✓ | |
| headache | ✓ | ✓ |
| injection site reactions, such as pain or swelling | ✓ | ✓ |
| pain in the back, joints, mouth, or throat | ✓ | ✓ |
This table may not include all mild side effects of these drugs. For more information on mild side effects, see the Nucala prescribing information and Dupixent prescribing information.
Serious side effects
Serious side effects may also occur in people using Nucala or Dupixent. The following table includes serious side effects reported with these drugs.
| Nucala | Dupixent | |
|---|---|---|
| eye problems, such as keratitis | ✓ | |
| conditions caused by a high level of eosinophils, such as a certain type of pneumonia | ✓ | |
| shingles | ✓ | ✓ |
| psoriatic arthritis or psoriasis | ✓ |
To learn about your specific risk of serious side effects from Nucala or Dupixent, talk with your doctor or pharmacist.
Allergic reactionFor some people, Nucala and Dupixent can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Nucala or Dupixent.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Nucala or Dupixent, they may have you switch to a different treatment.
Nucala and Dupixent are both used to treat the following conditions:
Both drugs are included in treatment recommendations from the Allergy-Immunology Joint Task Force for people with CRwNP. They’re also recommended in the Global Initiative for Asthma guidelines as treatment options for eosinophilic asthma. In addition, the Global Initiative for COPD lists Nucala and Dupixent in its treatment recommendations for eosinophilic COPD.
It’s important to note that your results from Nucala or Dupixent may differ from those seen in studies. Talk with your doctor about whether one of these drugs is right for you.
Whether you have health insurance or not, cost may be a factor when you’re considering these drugs.
Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use.
Nucala and Dupixent are both brand-name biologic drugs without a biosimilar form. You’ll usually pay more for brand-name drugs than for biosimilars.
For other resources that might help you save on the price of these drugs, see the Nucala cost article and Dupixent cost article.
Nucala and Dupixent may not be right for you if you have certain medical conditions or other factors that affect your health. The prescribing information for these drugs refers to these factors as warnings.
These two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned here. Before starting Nucala or Dupixent, talk with your doctor if any of the following conditions or health factors apply to you.
- Warnings for Nucala:
- no unique warnings
- Warnings for Dupixent:
- if you have an eye problem, such as keratitis
- if you have joint pain
- Warnings for both Nucala and Dupixent:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or planning to become pregnant
- if you’re breastfeeding or planning to breastfeed
- if you have a parasitic infection
The short answer: It’s possible.
Details: Both Nucala and Dupixent are used to treat the following conditions:
It may be possible to switch from one drug to the other for these uses. However, doctors typically will not prescribe Nucala and Dupixent together. Your doctor can tell you more.
Reminder: You should not switch drugs or stop your current treatment unless your doctor recommends it.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.