Nucala vs. Dupixent: Differences, similarities, and side effects

In this article:

• Nucala vs. Dupixent: Key differences
• Nucala vs. Dupixent: Conditions treated
• Is Dupixent better than Nucala?
• Nucala vs. Dupixent: Insurance coverage and cost comparison
• Nucala vs. Dupixent side effects
• Nucala and Dupixent drug interactions
• Nucala and Dupixent Drug warnings
• Can you take Nucala and Dupixent together?

In this article

• Nucala vs. Dupixent: Key differences
• Nucala vs. Dupixent: Conditions treated
• Is Dupixent better than Nucala?
• Nucala vs. Dupixent: Insurance coverage and cost comparison
• Nucala vs. Dupixent side effects
• Nucala and Dupixent drug interactions
• Nucala and Dupixent Drug warnings
• Can you take Nucala and Dupixent together?

Nucala and Dupixent are brand-name medications used to treat a variety of conditions, including chronic rhinosinusitis with nasal polyposis and eosinophilic asthma, a type of asthma characterized by high levels of white blood cells called eosinophils. Both drugs are monoclonal antibodies that reduce inflammation, which may help decrease the number of asthma attacks and improve quality of life. 

Although both medications may be appropriate options, a healthcare provider will choose the best treatment based on an individual’s overall condition. Cost and insurance coverage may also influence the choice between these medications, as both drugs don’t have generic versions. 

Other differences may come into play when determining the most appropriate treatment option, including approved uses and side effects. 

Nucala vs. Dupixent: Key differences

The main differences between these biologic medications are their active ingredients, dosages, and storage parameters, among other factors. 

Nucala, manufactured by GlaxoSmithKline, contains the active ingredient mepolizumab. It is typically prescribed to be injected under the skin (subcutaneously) once every four weeks. Nucala works by targeting and blocking a specific protein in the body called interleukin-5. As an IL-5 antagonist, Nucala helps reduce the number of eosinophils that can cause airway inflammation and worsen asthma symptoms.

Dupixent is manufactured by Regeneron and contains the active ingredient dupilumab. It is generally given subcutaneously once every two weeks, although some people may be able to use it once every four weeks. Dupixent works by blocking two proteins, interleukin-4 and interleukin-13, which play key roles in inflammation, helping reduce symptoms of asthma and other allergic conditions. 

Both Nucala and Dupixent should be stored in the refrigerator until ready for use. Nucala can be kept unrefrigerated at temperatures up to 86°F (30°C) for a maximum of seven days. If it’s not used within eight hours after being taken out of its carton, it needs to be thrown away. Dupixent, on the other hand, can be stored at room temperature up to 77°F (25°C) for up to 14 days. Once it’s out of the fridge, it needs to be used within 14 days.

Compare Nucala vs. Dupixent key differences
	Nucala	Dupixent
Drug class	Monoclonal antibody, interleukin-5 antagonist	Monoclonal antibody, interleukin-4 receptor alpha antagonist
Brand/generic status	Brand	Brand
What is the generic name?	Mepolizumab	Dupilumab
What form(s) does the drug come in?	Subcutaneous injection	Subcutaneous injection
What is the standard dosage?	40 mg, 100 mg, or 300 mg every 4 weeks, depending on the condition being treated	600 mg followed by 300 mg every 2 weeks Dosage varies depending on the condition being treated
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults and children 6 years and older, depending on the indication	Adults and children 6 months and older, depending on the indication

Nucala vs. Dupixent: Conditions treated

Nucala and Dupixent are used to manage various medical conditions, primarily related to the treatment of asthma and skin disorders. Both medications are approved by the Food and Drug Administration to treat eosinophilic asthma, but Dupixent may be able to treat a broader group of people with this type of asthma. Although Nucala is approved to treat severe eosinophilic asthma, Dupixent is approved to treat people with moderate-to-severe eosinophilic asthma or asthma in people who need oral corticosteroids to manage their condition.

Nucala and Dupixent are also used to treat chronic rhinosinusitis with nasal polyps. In this condition, the sinuses become inflamed and swollen, leading to the growth of soft, noncancerous lumps called polyps. This can cause symptoms like nasal congestion, difficulty breathing, and loss of smell.

Nucala is also approved to treat eosinophilic granulomatosis with polyangiitis, a rare condition that causes inflammation in blood vessels and can affect various organs. Additionally, it is used for hypereosinophilic syndrome, where high levels of eosinophils in the blood can damage different body tissues.

In addition to asthma and chronic rhinosinusitis, Dupixent is approved for treating atopic dermatitis (eczema), eosinophilic esophagitis (EoE), and prurigo nodularis. Atopic dermatitis causes itchy, red skin patches, while EoE involves a buildup of eosinophils in the esophagus, leading to swallowing problems. Prurigo nodularis features hard, itchy lumps on the skin due to scratching or irritation.

Compare Nucala vs. Dupixent conditions treated
Condition	Nucala	Dupixent
Atopic dermatitis	No	Yes
Asthma	Yes	Yes
Chronic rhinosinusitis with nasal polyposis	Yes	Yes
Eosinophilic granulomatosis with polyangiitis	Yes	No
Hypereosinophilic syndrome	Yes	No
Eosinophilic esophagitis	No	Yes
Prurigo nodularis	No	Yes

Is Dupixent better than Nucala?

In one meta-analysis, researchers reviewed data from eight clinical trials involving over 6,400 patients to compare the safety and effectiveness of three asthma medications: mepolizumab, benralizumab, and dupilumab. They found that dupilumab reduced asthma exacerbations by 68% compared to a placebo, while mepolizumab and benralizumab reduced attacks by 63% and 51%, respectively. The study concluded that there were only small differences in how well these medications worked and their safety.

A systematic review analyzed 37 research papers to compare the effectiveness of three treatments—omalizumab, dupilumab, and mepolizumab—for chronic rhinosinusitis with nasal polyps. It found that all three medications improved symptoms and reduced polyp size, but dupilumab was the most effective. However, the evidence was limited, indicating a need for more thorough research.

While Dupixent may be considered more effective than Nucala for asthma control, the better option will depend on different factors. A healthcare provider may evaluate a person’s overall condition and medical history to determine the best option. 

Nucala vs. Dupixent: Insurance coverage and cost comparison

Nucala and Dupixent are considered specialty drugs, which are distributed by select pharmacies. In addition, they’re not available in generic versions. Therefore, they are more limited and expensive than brand-name alternatives. However, many commercial insurance and Medicare plans may help cover the cost of these medications, especially if they’re administered in a clinical setting. 

RELATED: Is Dupixent covered by Medicare? │Is Nucala covered by Medicare?

Without insurance, the cost of these medications can vary widely. In some cases, a SingleCare prescription discount card may be able to help reduce the cost of these drugs. Always consult your healthcare provider, insurance company, or pharmacy to determine what price you might pay. 

RELATED: How to save on Dupixent │Nucala savings tips

Compare Nucala vs. Dupixent cost & coverage
	Nucala	Dupixent
Typically covered by insurance?	Varies	Varies
Typically covered by Medicare Part D?	Varies	Varies
Quantity	1 injection	1 injection
SingleCare cost	N/A*	$3,606ᐩ

*Nucala is a limited-distribution drug that may only be available at certain specialty pharmacies. ᐩDrug prices vary. This is the SingleCare price at the time of publication at one of many national pharmacies SingleCare partners with.

Nucala vs. Dupixent side effects

As injectable medications, Nucala and Dupixent may cause injection site reactions, which may include redness, itching, and swelling around the area of injection. Other common side effects of both medications may include dizziness, diarrhea, mouth or throat pain, and joint pain. 

Nucala may cause headaches, back pain, and fatigue. On the other hand, Dupixent is more likely to cause upper respiratory tract infections than Nucala. Some people also report experiencing dry eyes and insomnia with Dupixent. 

RELATED: Dupixent eye side effects

Serious side effects are possible and may include allergic reactions, with symptoms like hives, swelling of the face or throat, and breathing problems. 

Compare Nucala vs. Dupixent side effects
	Nucala		Dupixent
Side effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	19%	No	–
Upper respiratory tract infections	No	–	Yes	18%
Dry eye	No	–	Yes	2%
Injection site reactions	Yes	8%	Yes	10%
Back pain	Yes	5%	No	–
Fatigue	Yes	5%	No	–
Dizziness	Yes	>3%	Yes	3%
Diarrhea	Yes	3%	Yes	3%
Insomnia	No	–	Yes	1%
Mouth or throat pain	Yes	8%	Yes	2%
Herpes infection	Yes	N/A	Yes	3%
Joint pain	Yes	6%	Yes	3%

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Nucala), DailyMed (Dupixent)

Nucala and Dupixent drug interactions

Nucala and Dupixent work without causing many interactions with other medications. In other words, they are generally safe to use with most other drugs. However, it’s always important to let healthcare providers know about all the medications being taken to ensure there are no unexpected interactions. 

So far, no formal studies have been done to check how Nucala interacts with other medications. Nucala is not known to interact with many other drugs, so it may be a flexible option for patients who are taking multiple medications.

Dupixent is also unlikely to interact with other medications. Studies have shown that Dupixent does not affect how other drugs work in the body. However, it is important to complete all recommended vaccinations before starting Dupixent treatment. Avoid using live vaccines while on Dupixent, as it is not known if they will be safe or effective during treatment.

RELATED: Important information about Dupixent and vaccines

Compare Nucala vs. Dupixent drug interactions
Drug	Drug Class	Nucala	Dupixent
MMR (Measles, Mumps, Rubella), Varivax (Varicella), Rotarix (Rotavirus)	Live vaccines	No	Yes

Consult a healthcare professional for other possible drug interactions.

Nucala and Dupixent Drug warnings

Both Nucala and Dupixent can cause serious allergic reactions, including anaphylaxis, angioedema (swelling), rashes, and breathing problems. If any of these occur, it’s important to stop the medication and seek medical help. 

RELATED: Dupixent face rash and redness: Causes and treatment

Both biologic therapies should not be used to treat sudden asthma symptoms or asthma attacks. If asthma symptoms worsen or remain uncontrolled, seek medical advice. 

Additionally, both drugs may affect the body’s response to parasitic infections (helminth infections). Patients with known parasitic infections should be treated before starting these medications, and if a new infection occurs during treatment, the medication should be stopped until the infection is treated.

Warnings for Nucala

Nucala has specific warnings about the risk of shingles (herpes zoster) infections. Patients may need to consider vaccination before starting Nucala. Corticosteroid medications should not be abruptly stopped when starting Nucala; instead, any reduction in corticosteroid dosage should be done gradually under a healthcare provider’s supervision to avoid withdrawal symptoms or the return of suppressed conditions. 

Warnings for Dupixent

Dupixent has additional warnings about eye-related side effects, such as conjunctivitis (pink eye) and keratitis (inflammation of the cornea). Patients should report any new or worsening eye symptoms to their healthcare provider. 

Dupixent may also cause joint pain (arthralgia), which can, in some cases, affect mobility. Patients experiencing joint pain should consult their healthcare provider. Another warning for Dupixent involves its potential impact on patients with eosinophilic conditions, which can lead to serious lung or blood vessel problems. If such symptoms occur, patients should seek medical advice.

Always consult with a healthcare provider if any adverse effects occur while taking these medications.

RELATED: Can you take Dupixent while pregnant?

Can you take Nucala and Dupixent together?

Taking Nucala and Dupixent together is not typically recommended. Both medications are used to treat severe uncontrolled asthma and other allergic conditions, but they work through different mechanisms of action. Instead of using them together, treatment may be switched from one to the other depending on how well a patient responds to the initial treatment.