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Tepezza (teprotumumab-trbw)
teprotumumab
Adult Dosing .
Dosage forms: INJ
Special Note
- [drug name clarification]
- Info: nonproprietary name = teprotumumab-trbw
thyroid eye disease
- [10 mg/kg/dose IV x1, then 20 mg/kg/dose IV q3wk x7 doses]
- Info: consider premed with antihistamine, antipyretic, or corticosteroid if first 2 doses not tolerated
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy
- caution: patients of childbearing potential
- caution: hyperglycemia
- caution: diabetes mellitus
- caution: inflammatory bowel disease
Drug Interactions .
Overview
teprotumumab
IGF-1R antagonist
- hyperglycemic effects
- ototoxicity
Avoid/Use Alternative
- amikacin
- amikacin inhaled
- ethacrynic acid
- gentamicin
- neomycin
- plazomicin
- streptomycin
- tobramycin
- tobramycin inhaled
Monitor/Modify Tx
- acarbose
- alogliptin
- amphotericin
- avanafil
- bexagliflozin
- bromocriptine
- bumetanide
- canagliflozin
- carboplatin
- chloroquine
- cisplatin
- colesevelam
- dapagliflozin
- deferasirox
- deferoxamine
- docetaxel
- dulaglutide
- eflornithine
- empagliflozin
- ertugliflozin
- exenatide
- fenoprofen
- fludarabine
- furosemide
- glimepiride
- glipizide
- glyburide
- insulin
- isotretinoin
- itraconazole
- linagliptin
- liraglutide
- lixisenatide
- metformin
- miglitol
- naproxen
- nateglinide
- neomycin otic
- oxaliplatin
- paromomycin
- pioglitazone
- pramlintide
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- repaglinide
- rosiglitazone
- salsalate
- saxagliptin
- semaglutide
- sildenafil
- sitagliptin
- tadalafil
- tirzepatide
- torsemide
- vancomycin
- vardenafil
- vinblastine
- vincristine
- vinorelbine
Adverse Reactions .
Serious Reactions
- inflammatory bowel disease exacerbation
- GI perforation
- ototoxicity, auditory
- hyperglycemia
- diabetic ketoacidosis
- hyperosmolar hyperglycemic state
Common Reactions
- muscle spasm
- ototoxicity, auditory
- hyperglycemia
- nausea
- diarrhea
- alopecia
- fatigue
- headache
- dry skin
- dysgeusia
- weight decr.
- nail disorder
- menstrual disorder
- infusion reaction
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; blood glucose before each infusion and periodically during tx; audiometry at baseline, during tx, and after D/C
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use during pregnancy; no human data available; risk of fetal harm, including decr. fetal wt and skeletal abnormalities, based on animal data at 2.8x MRHD and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception before tx start, during tx and x6mo after D/C in patients of childbearing potential
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: for teprotumumab: unknown; CYP450: unknown
Excretion: for teprotumumab: unknown; Half-life: 20 days
Subclass: IGF-1R Antagonists ; Thyroid Disorders: Thyroid Eye Disease
Mechanism of Action
for teprotumumab: exact mechanism of action unknown; antagonizes insulin-like growth factor-1 receptor (IGF-1R), preventing orbital fibroblast stimulation
Formulary .
No Formulary Selected
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