Tepezza
Tepezza (teprotumumab-trbw or teprotumumab) treats a rare condition called thyroid eye disease (TED), sometimes known as Graves’ orbitopathy. It's the only medication FDA-approved for the treatment of TED and works well to reduce eye bulging, pain, and redness. Tepezza (teprotumumab) is given as an infusion into the veins by a healthcare provider. The full treatment only requires 8 doses, each dose given 3 weeks apart. Tepezza (teprotumumab) can cause common side effects such as nausea and muscle spasms. It also can cause infusion-related reactions such as feeling hot, headache, or trouble breathing.
What is Tepezza (teprotumumab)?
What is Tepezza (teprotumumab) used for?
Thyroid eye disease
How Tepezza (teprotumumab) works
People with TED have an overly active immune system that attacks the tissues behind their eyes by mistake. This causes swelling of the muscle and fat tissues behind the eyes.
Tepezza (teprotumumab) is a monoclonal antibody that treats TED. The exact way it works isn’t known, but it’s thought to block your immune system from attacking the tissues behind your eyes. This improves swelling and lowers the amount of eye bulging, redness, and pain.
Drug Facts
What are the side effects of Tepezza (teprotumumab)?
Common Side Effects
- Muscle spasms (25%)
- Nausea (17%)
- Hair loss (13%)
- Diarrhea (12%)
- Tiredness (12%)
- Higher blood sugar levels (10%)
- Trouble hearing (10%)
Other Side Effects
- Change in how things taste
- Headache
- Dry skin
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dry skin
- Hair loss
- Hearing loss
- Heavy periods
- Irregular menstrual cycles or spotting
- Menstrual cramps
- Nausea
Pros and cons of Tepezza (teprotumumab)
Pros
The only medication FDA-approved for people with TED
Can reduce how much your eye bulges out and improve your double vision
Only need 8 total infusions for a full treatment course
Cons
Can cause infusion-related reaction (e.g., feeling hot, headache, or trouble breathing)
Given IV, so it’s not as convenient as taking a pill
Only available as a brand name medication, so it can be expensive
Pharmacist tips for Tepezza (teprotumumab)
Each Tepezza (teprotumumab) infusion will typically take 60 to 90 minutes, depending on how many infusions you’ve already received and whether or not you had any reactions to the infusions. If you tolerate the infusions well, you might be able to receive your remaining infusions at home. Talk to your provider to see if this is an option for you.
Each infusion appointment can take a few hours because it includes the time it takes to check in, get the infusion, and monitor for side effects, so make sure you have what you need to be comfortable during that time. Wear sleeves that are easy to roll up, bring a water bottle to help you stay hydrated, and bring a snack. You also might need to arrange for rides home or childcare ahead of time, so go through this checklist a few days before each appointment to help you stay organized.
Stay on track with your infusions, even if your eye symptoms start to improve. Make sure to complete all 8 infusions to experience the full benefits of this medication. If you miss a dose, let your provider know so they can help you decide what to do.
Tepezza (teprotumumab) can cause infusion-related symptoms, such as feeling hot, headache, or trouble breathing. Tell your provider if you’re not feeling well during your infusion. They might give you medications, like corticosteroids or diphenhydramine (Benadryl), to help relieve these symptoms before your infusions in the future.
Infusion-related reactions can occur up to 90 minutes after the Tepezza (teprotumumab) infusion ends. When you go home after your infusion, continue to watch for symptoms like feeling hot, headache, or trouble breathing. Let your provider know immediately if you begin to experience these symptoms so they can decide how to help relieve them.
Frequently asked questions about Tepezza (teprotumumab)
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What are the risks and warnings for Tepezza (teprotumumab)?
Tepezza (teprotumumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infusion-related reactions
You can experience infusion-related reactions, such as feeling hot, headache, or trouble breathing, during your Tepezza (teprotumumab) infusions. This can happen even if you’ve tolerated previous infusions well. If you experience any reactions, let your provider know. They can give the infusion to you more slowly, temporarily stop the infusion, or give you medications to manage your symptoms. Your provider can give you medications, such as diphenhydramine (Benadryl), acetaminophen (Tylenol), or corticosteroids, before future infusions to ease these symptoms. Infusion-related reactions can appear up to 90 minutes after the infusion has finished, so continue to monitor yourself even after you go home. If you’ve previously had an infusion-related reaction, your provider probably will want to observe you for a little while to see how you respond to the infusion in case they need to give you appropriate treatment.
Inflammation of the gastrointestinal tract
Risk factors: Ulcerative colitis or Crohn's disease
If you have inflammatory bowel disease (i.e., ulcerative colitis or Crohn’s disease), Tepezza (teprotumumab) can make it worse. Let your provider know immediately if you experience symptoms, such as diarrhea with stomach pain, trouble controlling when you go to the bathroom, or rectal bleeding. If your symptoms get worse, your provider will decide if you should continue your Tepezza (teprotumumab) infusions.
High blood sugars
Risk factors: Diabetes (high blood sugar)
Using Tepezza (teprotumumab) can raise your blood sugar levels, since the medication can affect how well your body processes sugar. Your risk is higher if you already have diabetes. Your provider might ask you to check your blood sugar levels regularly to make sure they don’t get too high. If you’re taking blood sugar medications, your provider might need to make dose changes to your medications. If you experience extreme thirst, hunger, or urinate more often while taking the medication, let your provider know, since this might mean your blood sugar levels are too high.
Tepezza (teprotumumab) dosage forms
Typical dosing for Tepezza (teprotumumab)
Tepezza (teprotumumab) is only available as an intravenous (IV) infusion given into your veins by a healthcare provider. Your provider will determine your dose based on your body weight.
You'll receive 8 total infusions. Each infusion is given once every 3 weeks. This means the full treatment course will take about 5 months. For your first infusion, the typical dose is 10 mg/kg. But for all other infusions, the typical dose is 20 mg/kg.
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