Alternatives to Dupixent If You Can't Fill Your Prescription

Dupixent (dupilumab) is a highly effective biologic — but it's not always accessible. Prior authorization denials, high cost, insurance gaps, and the specialty pharmacy process can leave patients without their medication. If you're in that situation, knowing your alternatives is essential.

The right alternative depends on which condition Dupixent was prescribed for. Below we break down the best alternatives by indication, with key differences to discuss with your doctor.

Alternatives for Atopic Dermatitis (Eczema)

Atopic dermatitis is Dupixent's most well-known indication. Fortunately, several newer biologics and oral medications are now available.

Adbry (Tralokinumab) — Best Biologic Alternative

Adbry (tralokinumab-ldrm) is an injectable biologic approved for moderate-to-severe atopic dermatitis in patients 12 years and older. Like Dupixent, it targets the IL-13 inflammatory pathway (though Dupixent also blocks IL-4). It's given as a subcutaneous injection every 2 weeks, with the possibility of reducing to monthly dosing if your skin clears well at 16 weeks.

Some patients who experience significant eye problems (conjunctivitis, keratitis) on Dupixent have been successfully switched to Adbry, since IL-13 selective blockers appear to cause fewer ocular side effects in some patients.

Ebglyss (Lebrikizumab) — Another IL-13 Biologic Option

Ebglyss (lebrikizumab-lbkz) is another biologic approved for moderate-to-severe eczema in patients 12 and older (weighing at least 40 kg). It also selectively targets IL-13. After a loading dose, the maintenance schedule may reduce to once every 4 weeks for patients who respond well — less frequent than Dupixent's typical every-2-weeks dosing. Indirect comparison studies suggest lebrikizumab may offer equal or superior long-term efficacy to dupilumab for some patients.

Rinvoq (Upadacitinib) — Oral Option With Broader Coverage

Rinvoq (upadacitinib) is an oral once-daily JAK-1 inhibitor approved for moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older. Head-to-head clinical data have shown upadacitinib 30 mg may achieve higher rates of skin clearance compared to dupilumab in some patients. However, it carries a boxed warning for serious infections, blood clots, and malignancy that Dupixent does not have.

Rinvoq is a pill — which may be preferable for patients who are uncomfortable with injections. Many insurance plans have different formulary tiers for Rinvoq versus Dupixent, so it may be more accessible for some patients.

Cibinqo (Abrocitinib) — Oral JAK Inhibitor for Adults

Cibinqo (abrocitinib) is another oral once-daily JAK-1 inhibitor approved for adults with moderate-to-severe AD that isn't controlled by other therapies. It comes in 100 mg and 200 mg doses. Like Rinvoq, it carries a boxed warning. It is not approved for patients under 18.

Alternatives for Asthma

For patients on Dupixent for moderate-to-severe eosinophilic asthma, several other biologics target similar inflammatory pathways:

Nucala (mepolizumab) — targets IL-5, reduces eosinophil count; monthly injection

Fasenra (benralizumab) — targets IL-5 receptor; given every 4 weeks initially, then every 8 weeks

Tezspire (tezepelumab) — targets TSLP, a broader upstream cytokine; works across multiple asthma phenotypes

Xolair (omalizumab) — targets IgE; best for allergic asthma with high IgE levels

Alternatives for Chronic Rhinosinusitis With Nasal Polyps (CRSwNP)

For patients using Dupixent for nasal polyps, alternatives include:

Xolair (omalizumab) — FDA-approved for CRSwNP; targets IgE signaling

Nucala (mepolizumab) — FDA-approved for CRSwNP in adults; reduces polyp burden

Intranasal corticosteroids + surgery — remains an option for patients who cannot access biologics

How to Have the Alternative Conversation With Your Doctor

When discussing alternatives, be direct with your provider:

Tell them the specific barrier: "My insurance denied Dupixent" or "I can't afford the specialty pharmacy copay."

Ask which alternatives are on your specific insurance plan's formulary at a lower tier.

Ask whether any alternatives have better patient assistance programs for your situation.

Don't Give Up on Dupixent Yet

Before switching, it's worth exhausting your Dupixent options. Many patients who are denied coverage get approved on appeal. The DUPIXENT MyWay Patient Assistance Program can provide free medication to qualifying uninsured patients. See our guide to saving money on Dupixent for more options. And if you're just struggling to find a pharmacy that carries it, medfinder can help you locate a specialty pharmacy that can fill your Dupixent prescription.