What is the minimum time to wait before administering the next dose of Dupixent (dupilumab) if the last dose was given late?

Dupixent Dosing After a Late Dose

If you miss a Dupixent dose, the timing of your next injection depends entirely on your prescribed dosing schedule: for weekly dosing, give the missed dose immediately and restart the weekly schedule from that point; for every-2-week dosing, give the missed dose within 7 days and continue the original schedule, but if more than 7 days have passed, give it immediately and restart a new every-2-week schedule from that point; for every-4-week dosing, the same 7-day rule applies. 1

Dosing Schedule-Specific Guidelines

Weekly Dosing Schedule

• Give the missed Dupixent injection as soon as you remember 1
• Start a new weekly dose schedule from the time you remember to take your injection 1
• There is no minimum waiting period—administer immediately upon remembering 1

Every 2 Weeks (Q2W) Dosing Schedule

• If within 7 days of the missed dose: Give the injection and continue with your original schedule 1
• If more than 7 days have passed: Give the injection immediately and start a new every-2-week schedule from that point 1
• This is the FDA-approved standard maintenance regimen for most indications 1, 2

Every 4 Weeks (Q4W) Dosing Schedule

• If within 7 days of the missed dose: Give the injection and continue with your original schedule 1
• If more than 7 days have passed: Give the injection immediately and start a new every-4-week schedule from that point 1

General Principle for Biologics

• For delays less than 7 days with most biologics, take the missed dose immediately upon remembering and continue with the original dosing schedule without shifting future dates 3
• This aligns with the FDA labeling for Dupixent, which uses the 7-day threshold as the decision point for whether to maintain or reset the dosing schedule 1

Clinical Context on Extended Dosing Intervals

• The approved regimen of 300 mg every 2 weeks is recommended for long-term treatment and maintains optimal efficacy with negligible change in disease control 2
• While some patients with well-controlled disease may extend to every 3 or 4 weeks in clinical practice, this is off-label and should only be considered after at least 52 weeks of treatment with sustained disease control 4
• Extended dosing intervals (Q3W or Q4W) show comparable efficacy to standard Q2W dosing in well-controlled patients, but this is not FDA-approved 5

Important Safety Considerations

• Do not double up on doses—if you miss a dose, follow the schedule-specific guidelines above rather than taking two doses close together 1
• Contact your healthcare provider if you have questions about your specific situation, particularly if you've missed multiple doses 1
• Continuing response over time is most consistently maintained with more frequent dosing (weekly or every 2 weeks) compared to longer intervals 2