teprotumumab

Contraindicated in:

OB: Pregnancy.

Use Cautiously in:

Inflammatory bowel disease (IBD) (may cause exacerbation);
Diabetes;
Lactation: Safety not established in breastfeeding;
Rep: Women of reproductive potential;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: alopecia, dry skin

EENT: hearing impairment

Endo: hyperglycemia

GI: diarrhea, nausea

MS: muscle spasms

Neuro: fatigue, dysgeusia, headache

Misc: infusion reactions

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Lyophilized powder for injection: 500 mg/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 10 mg/kg initially; then 20 mg/kg every 3 wk for 7 additional doses.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Exact mechanism in thyroid eye disease not fully characterized. Inhibits insulin-like growth factor-1 receptors.

Therapeutic effects:

Reduction in proptosis (eyeball protrusion)

Classifications ⬆ ⬇

Therapeutic Classification: none assigned

Pharmacologic Classification: insulin like growth factor 1 receptor inhibitors, monoclonal antibodies

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Minimally distributed to extravascular tissues.

Metabolism/Excretion: Metabolized via proteolytic degradation. Excretion pathway not characterized.

Half-Life: 20 days

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose of teprotumumab to patient.
Advise patient to notify health care professional if symptoms of infusion reaction occur.
Inform patient of risk of IBD. Instruct patient to notify health care professional immediately if diarrhea, with or without blood or rectal bleeding, associated with abdominal pain, or cramping/colic, urgency, tenesmus, or incontinence, occurs.
May cause hyperglycemia. If diabetic, advise patient to discuss with health care professional need to adjust glycemic control measures, including medications as appropriate. Encourage compliance with glycemic control.
Inform patient that hearing impairment may occur during therapy. Instruct patient to notify health care professional immediately if they experience any changes in hearing during therapy.
Rep: May cause fetal harm. Advise females of reproductive potential to notify health care professional immediately if pregnancy is planned or suspected; discontinue teprotumumab if pregnancy occurs. Advise females of reproductive potential to use effective contraception during therapy and for 6 mo following last dose.

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Indications ⬇

Contraind./Precautions ⬆ ⬇