Nucala (mepolizumab) and Dupixent (dupilumab) are brand-name subcutaneous injections. They’re both prescribed for asthma and chronic rhinosinusitis with nasal polyps. Each drug may also be prescribed for other uses.
This article explains the main similarities and differences between Nucala and Dupixent. If you’re considering treatment with one of these drugs, discussing this information with your doctor can help you decide if one of these drugs may be right for you.
Note: For more comprehensive information about these two drugs, you can refer to our Nucala and Dupixent articles.
Key differences between Nucala and Dupixent
These are a few of the main differences between Nucala and Dupixent:
- Conditions treated: Nucala and Dupixent are used to treat eosinophilic asthma and chronic rhinosinusitis with nasal polyps. Each drug also has other uses. (See the “Uses of Nucala vs. Dupixent” section.)
- Forms: Both Nucala and Dupixent come as a solution inside a prefilled injection pen or syringe. Nucala also comes as a powder inside a vial. (See the “Dosage, forms, and administration” section.)
- Dosage: Dupixent is typically used more often than Nucala. (See the “Dosages, forms, and administration” section.)
Here’s information about the biosimilar status for Nucala and Dupixent, as well as details on their active ingredients. (Biosimilars are like generic versions of biologic drugs.)
| Nucala | Dupixent | |
|---|---|---|
Biosimilar available | no | no |
| Active ingredients | mepolizumab | dupilumab |
| Drug class | monoclonal antibody | monoclonal antibody |
Nucala and Dupixent have been approved by the Food and Drug Administration (FDA) to treat the following conditions in certain situations.
- Both Nucala and Dupixent are FDA approved to treat:
- eosinophilic asthma in adults
- chronic rhinosinusitis with nasal polyps (CRwNP) in adults
- Nucala is also FDA approved to treat:
- eosinophilic granulomatosis with polyangiitis (also known as Churg-Strauss syndrome) in adults
- hypereosinophilic syndrome (HES) in adults
- Dupixent is also FDA approved to treat:
- corticosteroid-dependent asthma in adults
- atopic dermatitis (eczema) in adults
- eosinophilic esophagitis (EoE) in adults
- prurigo nodularis in adults
- eosinophilic chronic obstructive pulmonary disease (COPD) in adults
Nucala or Dupixent and children
Nucala and Dupixent are FDA approved to treat certain conditions in children.
Specifically, both Nucala and Dupixent are approved to treat eosinophilic asthma in children ages 6 years and older. Nucala is also approved to treat HES in children ages 12 years and older.
In addition, Dupixent is approved to treat the following:
Note: For more information about the drugs’ uses, see our articles about Nucala and Dupixent. You can also view these articles about Dupixent for asthma and Dupixent for EoE.
Here’s a quick look at the dosage and administration of Nucala and Dupixent for the conditions both drugs treat.
Dosage for eosinophilic asthma in adults
Below are the dosages of Nucala and Dupixent for treating eosinophilic asthma in adults. Strengths of each drug are listed in milligrams (mg) and mg per milliliter (mL).
| Nucala for eosinophilic asthma | Dupixent for eosinophilic asthma | |
|---|---|---|
| Forms | • powder inside a vial, which is mixed with sterile water to form a solution given as a subcutaneous injection • solution inside a prefilled autoinjector or syringe given as a subcutaneous injection | solution inside a prefilled injection pen or syringe given as a subcutaneous injection |
| Strengths | vial: • 100 mg prefilled autoinjector: • 100 mg/mL prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL | prefilled injection pen or syringe: • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | 100 mg per injection | 400 mg or 600 mg for the first injection, then 200 mg or 300 mg per injection after that |
| Frequency | 1 injection every 4 weeks | 1 injection every 2 weeks |
| Given by | healthcare professional, self, or caregiver (see below) | healthcare professional, self, or caregiver (see below) |
Your doctor will show you or a caregiver how to inject Nucala or Dupixent at home, or you may go to their office for injections.
You’ll receive Nucala or Dupixent as an injection under the skin of your abdomen or thigh. Your doctor or a caregiver can also inject either drug under the skin of your upper arm.
Dosage for chronic rhinosinusitis with nasal polyps (CRwNP) in adults
Below are the dosages of Nucala and Dupixent for treating CRwNP in adults. Strengths of each drug are listed in mg and mg per mL.
| Nucala for CRwNP | Dupixent for CRwNP | |
|---|---|---|
| Forms | • powder inside a vial, which is mixed with sterile water to form a solution given as a subcutaneous injection • solution inside a prefilled autoinjector or syringe given as a subcutaneous injection | solution inside a prefilled injection pen or syringe given as a subcutaneous injection |
| Strengths | vial: • 100 mg prefilled autoinjector: • 100 mg/mL prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL | prefilled injection pen or syringe: • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose | 100 mg per injection | 300 mg per injection |
| Frequency | 1 injection every 4 weeks | 1 injection every 2 weeks |
| Given by | healthcare professional, self, or caregiver (see below) | healthcare professional, self, or caregiver (see below) |
Your doctor will show you or a caregiver how to inject Nucala or Dupixent at home, or you may go to their office for injections.
You’ll receive Nucala or Dupixent as an injection under the skin of your abdomen or thigh. Your doctor or a caregiver can also inject either drug under the skin of your upper arm.
Children’s dosage
Below are details about the dosage of Nucala and Dupixent for the condition both drugs treat in children.
Dosage for eosinophilic asthma in children
Below are the dosages of Nucala and Dupixent for treating eosinophilic asthma in children ages 6 years and older. Strengths of each drug are listed in mg and mg per mL.
Certain dosages are based on a child’s age or weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb).
| Nucala for eosinophilic asthma | Dupixent for eosinophilic asthma | |
|---|---|---|
| Forms | • powder inside a vial, which is mixed with sterile water to form a solution given as a subcutaneous injection • solution inside a prefilled autoinjector or syringe given as a subcutaneous injection | solution inside a prefilled injection pen or syringe given as a subcutaneous injection |
| Strengths | vial: • 100 mg prefilled autoinjector: • 100 mg/mL prefilled syringe: • 40 mg/0.4 mL • 100 mg/mL | prefilled injection pen or syringe: • 200 mg/1.14 mL • 300 mg/2 mL |
| Dose in children ages 6 to 11 years | 40 mg per injection | weight less than 15 kg (about 30 lb): talk with your child’s doctor weight 15 kg to less than 30 kg (about 60 lb): 300 mg per injection weight 30 kg or more: 200 mg per injection |
| Dose in children ages 12 years and older | 100 mg per injection | 400 mg or 600 mg for the first injection, then 200 mg or 300 mg per injection after that |
| Frequency | 1 injection every 4 weeks | 1 injection every 2 to 4 weeks |
| Given by | healthcare professional, self, or caregiver (see below) | healthcare professional, self, or caregiver (see below) |
Your child’s doctor will show you or your child how to inject Nucala or Dupixent at home. Your child may also go to their doctor’s office for injections. Nucala and Dupixent can be given as an injection under the skin of your child’s abdomen, thigh, or upper arm.
Both Nucala and Dupixent are monoclonal antibodies that treat similar conditions. These drugs can cause some of the same side effects, as well as some different ones. Some of the side effects reported in clinical trials of these drugs are mentioned below.
For more details about side effects of the two drugs, see our side effect articles about Nucala and Dupixent. You can also refer to the Nucala prescribing information and Dupixent prescribing information.
Mild side effects
The following table lists some of the more commonly reported mild side effects of Nucala and Dupixent. The table may also include mild side effects that are less common but that you might have concerns about in some cases.
| Mild side effects | Nucala | Dupixent |
|---|---|---|
| back pain | ✓ | ✓ |
| fatigue | ✓ | |
| headache | ✓ | ✓ |
| high level of eosinophils (a type of white blood cell) | ✓ | |
| gastritis (stomach inflammation) | ✓ | |
| insomnia | ✓ | |
| joint pain | ✓ | ✓ |
| pain in the mouth or throat | ✓ | ✓ |
| toothache | ✓ | |
| injection site reactions, such as bruising, pain, or swelling | ✓ | ✓ |
These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Serious side effects
The following table lists the reported serious side effects of Nucala and Dupixent.
| Serious side effects | Nucala | Dupixent |
|---|---|---|
| shingles | ✓ | ✓ |
| eye problems, such as keratitis | ✓ | |
| conditions caused by having too many eosinophils, such as vasculitis | ✓ |
If you have serious side effects while using Nucala or Dupixent, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
ALLERGIC REACTIONFor some people, Nucala or Dupixent can cause an allergic reaction.
In general, symptoms of allergic reaction can be mild or serious.
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Nucala or Dupixent, your doctor may recommend a different medication instead.
Below are answers to some common questions about Nucala and Dupixent.
How do Nucala and Dupixent compare with similar drugs, such as Fasenra and Xolair?
Nucala, Dupixent, Fasenra, and Xolair are monoclonal antibody drugs. They’re all subcutaneous injections approved to treat certain types of asthma. Each drug has other uses as well.
Below are a few ways these medications compare.
| Nucala | Dupixent | Fasenra | Xolair | |
|---|---|---|---|---|
| Active ingredients | mepolizumab | dupilumab | benralizumab | omalizumab |
| Approved uses | • eosinophilic asthma in adults and children ages 6 years and older • chronic rhinosinusitis with nasal polyps (CRwNP) in adults • eosinophilic granulomatosis with polyangiitis (EGPA) in adults • hypereosinophilic syndrome (HES) in adults and children ages 12 years and older | • eosinophilic and corticosteroid-dependent asthma in adults and children ages 6 years and older • CRwNP in adults and children ages 12 years and older • atopic dermatitis in adults and children ages 6 years and older • eosinophilic esophagitis (EoE) in adults and certain children ages 1 year and older • prurigo nodularis in adults • eosinophilic chronic obstructive pulmonary disease (COPD) in adults | • eosinophilic asthma in adults and children ages 6 years and older • EGPA in adults | • asthma in adults and children ages 6 years and older • CRwNP in adults • certain food allergies in adults and children ages 1 year and older • chronic (ongoing) hives without a known cause in adults and children ages 12 years and older |
If you have other questions about how these drugs compare, talk with your doctor or pharmacist. They can tell you about other factors, such as cost, that may affect which treatment is right for your condition.
Can I use Nucala and Dupixent together?
The possibility of using Nucala and Dupixent together depends on your condition and your doctor’s recommendation.
Both Nucala and Dupixent are used to treat eosinophilic asthma and CRwNP. The two drugs work in different ways to reduce inflammation related to these conditions.
Some reports suggest that using these drugs together may help with difficult-to-manage symptoms of asthma, CRwNP, and other conditions. However, the safety and effectiveness of this combination is still being studied.
If you have questions about using Nucala and Dupixent together, talk with your doctor. They can determine whether this combination is safe and appropriate for your specific condition.
Keep reading for details about the effectiveness of Nucala and Dupixent.
Review of studies: A
However, the results of research studies may not apply to your specific health situation. Your doctor can determine whether Nucala or Dupixent may be right for you.
Prescribing information: For details about how these drugs performed in clinical trials, see the prescribing information for Nucala and Dupixent. Keep in mind that trial results may not apply to your individual health situation.
Treatment guidelines: Another way to see whether a drug is considered effective is to look at treatment guidelines. When an organization includes certain drugs in treatment guidelines, this means that research has shown the drug to be safe and effective.
Nucala and Dupixent are recommended as treatment options for asthma in guidelines from the Global Initiative for Asthma. Both drugs are also listed as treatment options for CRwNP in guidance from the American Academy of Otolaryngology–Head and Neck Surgery.
How much Nucala costs or Dupixent costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy.
Both Nucala and Dupixent are brand-name drugs. Neither drug is available in a biosimilar form. (Biosimilars are like generic versions of biologic drugs.) Brand-name medications are often more expensive than biologics.
Nucala and Dupixent may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs have some of the same precautions, but they also have different ones. Some of these precautions are mentioned below.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Nucala or Dupixent.
| Precaution | Nucala | Dupixent |
|---|---|---|
| if you’ve had an allergic reaction to either drug or any of its ingredients | ✓ | ✓ |
| if you’re pregnant or thinking about becoming pregnant | ✓ | ✓ |
| if you’re breastfeeding or thinking about breastfeeding | ✓ | ✓ |
| if you have a parasitic infection | ✓ | ✓ |
| if you have joint pain | ✓ | |
| if you have an eye problem, such as keratitis | ✓ |
Switching between Nucala and Dupixent might be possible.
If you’d like to know more about switching between Nucala and Dupixent, talk with your doctor. They can give you additional details and help determine the best course of action for your personal situation. Even if two drugs treat the same condition or are in the same drug class, your body can still respond differently.
It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.
Disclaimer: Medical News Today 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.