Teprotumumab at a glance
Medicine class
IGF-1R inhibitor and monoclonal antibody
Licensed use
Moderate to severe thyroid eye disease in adults
Administration
Intravenous infusion given by a healthcare professional in a suitably equipped clinical setting
Important monitoring
Hearing, blood glucose and symptoms of inflammatory bowel disease
What is Teprotumumab used for?
Teprotumumab is licensed for:
Treatment of moderate to severe thyroid eye disease in adults.
How does Teprotumumab work?
Abnormal immune activity involving IGF-1R contributes to inflammation and expansion of tissues around the eyes. Teprotumumab binds to IGF-1R and blocks its activation and signalling, although its full clinical mechanism is not completely characterised.
Teprotumumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 500 mg
How to take Teprotumumab
A healthcare professional prepares teprotumumab and gives it into a vein using an infusion pump. Patients are observed during and after administration for infusion reactions.
Tell the team about diabetes or raised blood glucose, hearing problems, inflammatory bowel disease, pregnancy or plans for pregnancy.
Immediately report feeling hot, breathlessness, headache, muscle pain, a racing heartbeat or other new symptoms during the infusion.
Do not drive or operate machinery if fatigue or headache affects you.
Teprotumumab side effects
Common or expected effects
- Muscle spasms
- Diarrhoea or nausea
- Headache or fatigue
- Raised blood glucose
- Hair loss
- Hearing changes, tinnitus or ear discomfort
- Dry skin or altered taste
- Nail changes
- Changes in menstrual bleeding
Get urgent medical advice
- Severe infusion or allergic reaction
- Severe or potentially permanent hearing impairment
- Diabetic ketoacidosis or a hyperosmolar hyperglycaemic state
- New or worsening inflammatory bowel disease, particularly severe or bloody diarrhoea
Teprotumumab in pregnancy
Teprotumumab is contraindicated during pregnancy because fetal harm is possible. People who could become pregnant should use highly effective contraception while receiving it and for six months afterwards. If pregnancy occurs, contact the specialist team promptly; treatment should be stopped and fetal risks discussed.
Teprotumumab while breastfeeding
It is unknown whether teprotumumab enters human milk, and risk to a breastfed child cannot be excluded. The specialist and patient should decide between avoiding teprotumumab and stopping breastfeeding, considering the benefits of treatment and breastfeeding.
Teprotumumab interactions
Formal interaction studies have not been performed. Metabolic interactions are not expected, but medicines that can damage hearing require particular caution.
Aminoglycoside antibiotics
May add to the risk of hearing impairment.
Vancomycin
Concurrent use may increase the risk of hearing toxicity.
Platinum-containing chemotherapy
Potential additive hearing damage warrants specialist assessment.
Loop diuretics
Common questions about Teprotumumab
Answers are fully visible for fast scanning and source review.
Can teprotumumab cause hearing loss?
Yes. Hearing changes can be severe and may sometimes be permanent. Report new tinnitus, muffled hearing or hearing loss promptly.
Can teprotumumab raise blood glucose?
Yes, particularly in people with diabetes or impaired glucose tolerance. Blood glucose should be assessed and monitored.
Can teprotumumab worsen inflammatory bowel disease?
It may worsen pre-existing inflammatory bowel disease. Increased diarrhoea, abdominal cramps or blood in the stool requires prompt specialist assessment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.