Can Dupixent cause facial flushing?

Facial flushing was not reported during phase 3 clinical trials of Dupixent (dupilumab). However, after the medication became available, some patients reported redness in the face and neck. While some experienced flushing only after consuming alcohol, others reported no clear connection to alcohol intake.

If you experience facial flushing while taking Dupixent, it's important to consult with your healthcare provider for proper evaluation and management.

How Common Is Facial Flushing From Dupixent?

A 2021 systematic review found that 101 patients taking Dupixent in studies reported face or neck redness, symptoms consistent with flushing. Many of these patients had atopic dermatitis affecting the face or neck. The true incidence of facial flushing from Dupixent remains unknown.

• Some patients experienced improvement with treatment.
• Others reported worsening symptoms.
• 11 out of 101 patients discontinued Dupixent due to flushing.
• Other studies estimate about a 10% incidence rate of this side effect.

What Causes Facial Flushing From Dupixent?

The exact cause of facial flushing from Dupixent is unclear, but but several possible explanations include:

• Hypersensitivity reaction
• Local skin inflammation due to immune system changes
• Inflammation triggered by Malassezia yeast or Demodex mites
• Modulation of CYP2E1 enzyme that breaks down ethanol, causing a buildup of acetaldehyde

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When Does Facial Flushing Occur?

Case reports suggest that most individuals who develop facial flushing experience it around 22 weeks of treatment:

• Some cases occurred as early as 10 weeks or as late as 32 weeks.
• When related to alcohol consumption, flushing may happen soon after starting Dupixent and typically resolves within 20 minutes, even if drinking continues.

How Is Dupixent-Related Flushing Treated?

There are no established guidelines for treating this side effect, but some approaches that have been effective include:

• Topical corticosteroids
• Azole antifungals (e.g., itraconazole, fluconazole)
• Topical calcineurin inhibitors
• Topical PDE4 inhibitors
• Antibiotics

This is not all the information you need to know about Dupixent (dupilumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.