If you have a certain type of cancer that affects your white blood cells, your doctor might suggest Darzalex. It’s a prescription drug used to treat multiple myeloma in adults.
It comes as a liquid solution that’s given by intravenous (IV) infusion (an injection into your vein) over several hours.
The active ingredient in Darzalex is daratumumab. This is the ingredient that makes Darzalex work. Darzalex belongs to a group of drugs called monoclonal antibodies, which work with your immune system. It is not a chemotherapy drug.
There is another version of Darzalex called Darzalex Faspro, but this article will focus on Darzalex.
This article describes the dosages of Darzalex, as well as its form, strengths, and how to use it. To learn more about Darzalex, see this in-depth article.
Note: This article covers Darzalex’s typical dosages, which are provided by the drug manufacturer. But your doctor will prescribe the Darzalex dosage that’s right for you.
The dose and dosing schedule for Darzalex for multiple myeloma are described below.
What form does Darzalex come in?
Darzalex comes as a liquid solution in a single-dose vial. It’s mixed with another liquid solution by a healthcare professional before it’s injected into your vein as an intravenous (IV) infusion.
What strengths does Darzalex come in?
Darzalex comes in single-dose vials with the following strengths:
- 100 milligrams (mg) per 5 milliliters (mL)
- 400 mg/20 mL
What are the typical dosages of Darzalex?
The recommended dose of Darzalex for treating multiple myeloma is 16 mg per kilogram (kg)* of body weight. In other words, your doctor will calculate your dose by multiplying 16 mg for every kilogram you weigh. For example, the Darzalex dose for a person who weighs 50 kg (about 110 pounds) would be 800 mg.
Darzalex may be prescribed with other types of cancer medications or by itself. Your dosing schedule and how long you take Darzalex will depend on:
- your diagnosis
- your treatment history
- any other medications you take with it
A healthcare professional will mix Darzalex with 0.9% sodium chloride (a type of saltwater solution). They’ll then give it to you as an intravenous (IV) infusion (injection into your vein over a period of time). An infusion of Darzalex typically lasts several hours.
The dosing guides below show the recommended schedules for Darzalex infusions. Your doctor will determine the best dosage and dosing schedule to fit your needs.
* One kilogram is equal to about 2.2 pounds (lbs.).
Dosage for certain adults who can’t receive a stem cell transplant or whose previous treatments didn’t work well
Darzalex is given with other drugs or on its own for adults:
- who can’t receive a stem cell transplant using their own stem cells
- whose previous treatments with certain other drugs didn’t work well
Darzalex with lenalidomide and dexamethasone
The dosing guide chart below describes the dose and schedule for adults receiving Darzalex together with Revlimid (lenalidomide) and dexamethasone. This drug combination and dosing schedule are used for adults who:
- are newly diagnosed with multiple myeloma, and
- can’t receive a stem cell transplant using their own stem cells
It’s also used in adults whose:
- cancer has relapsed (come back), or
- condition didn’t improve with prior treatments
| Darzalex dose: 16 mg/kg body weight | |
| Timeline | Dosing schedule |
| weeks 1 to 8 | once per week (total of 8 doses) |
| weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| weeks 25 and beyond | once every 4 weeks |
Darzalex with pomalidomide and dexamethasone
The same dose and schedule are used for adults who will use Darzalex together with Pomalyst (pomalidomide) and dexamethasone. These people also have had two or more previous treatments, including:
- lenalidomide, and
- a proteasome inhibitor
| Darzalex dose: 16 mg/kg body weight | |
| Timeline | Dosing schedule |
| weeks 1 to 8 | once per week (total of 8 doses) |
| weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| weeks 25 and beyond | once every 4 weeks |
Darzalex by itself following other treatments
The following dosing guide can be used for adults who:
- had three or more previous treatments, including:
- a proteasome inhibitor, and
- an immunomodulatory drug, or
- have multiple myeloma that didn’t respond to previous treatments, including:
- a proteasome inhibitor, and
- immunomodulatory drug
| Darzalex dose: 16 mg/kg body weight | |
| Timeline | Dosing schedule |
| weeks 1 to 8 | once per week (total of 8 doses) |
| weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| weeks 25 and beyond | once every 4 weeks |
Darzalex together with Velcade (bortezomib), melphalan, and prednisone
The dosing guide below explains the dose and schedule for adults who will receive Darzalex in combination with Velcade (bortezomib), melphalan, and prednisone. This drug combination and dosing schedule are used for adults who are newly diagnosed with multiple myeloma and can’t receive a stem cell transplant using their own stem cells.
| Darzalex dose: 16 mg/kg body weight | |
| Timeline | Dosing schedule |
| weeks 1 to 6 | once per week (total of 6 doses) |
| weeks 7 to 54 | once every 3 weeks (total of 16 doses) |
| weeks 55 and beyond | once every 4 weeks |
Dosage for certain adults with newly diagnosed multiple myeloma
Darzalex is given together with bortezomib, thalidomide, and dexamethasone for adults:
- with newly diagnosed multiple myeloma, and
- who can receive a stem cell transplant using their own stem cells
The dosing schedule has multiple parts:
- The first 16 weeks of dosing (called induction) aim to help induce (cause) your cancer to go into remission.
- weeks 1 to 8: one dose per week (total of eight doses)
- weeks 9 to 16: one dose every 2 weeks (total of four doses)
- After this, your Darzalex treatment is paused while you get high dose chemotherapy and a stem cell transplant using your own stem cells.
- Finally, you’ll receive consolidation dosing (dosing to kill any cancer cells left after initial treatments). This consists of a Darzalex infusion every 2 weeks until you’ve had a total of four more doses.
Dosage for adults whose previous treatment(s) with certain other drugs didn’t work well
Darzalex is used along with bortezomib and dexamethasone in adults previously treated for multiple myeloma with at least one medication.
| Darzalex dose: 16 mg/kg body weight | |
| Timeline | Dosing schedule |
| weeks 1 to 9 | once per week (total of 9 doses) |
| weeks 10 to 24 | once every 3 weeks (total of 5 doses) |
| weeks 25 and beyond | once every 4 weeks |
Darzalex is used along with Kyprolis (carfilzomib) and dexamethasone in adults previously treated for multiple myeloma with up to three medications.
| Timeline | Dosing schedule | Darzalex dose |
| week 1 | days 1 and 2 (total of 2 doses) | 8 mg/kg |
| weeks 2 to 8 | once every week (total of 7 doses) | 16 mg/kg |
| weeks 9 to 24 | once every 2 weeks (total of 8 doses) | 16 mg/kg |
| weeks 25 and beyond | once every 4 weeks | 16 mg/kg |
Is Darzalex used long term?
Your Darzalex treatment schedule is based on several factors. How long you’ll take Darzalex will be affected by:
- the type of combination drug therapy you receive
- when you were diagnosed with multiple myeloma
- how your cancer responds to treatment
If you and your doctor determine that Darzalex is safe and effective for you, you’ll likely use it long term.
Darzalex is given by a healthcare professional in an infusion center or doctor’s office. You’ll receive it by intravenous (IV) infusion after it’s been mixed with 0.9% sodium chloride (a saltwater solution). The mixture is infused into your vein through a needle over several hours.
Your doctor will start the infusion at a slow rate and then increase it to a rate that’s right for you. The first infusion may take up to 7 hours. Future infusions will take less time, usually from 3 to 4 hours.
You may be given other medications before your Darzalex dose, including:
- Benadryl (diphenhydramine) or a similar antihistamine
- corticosteroids, such as dexamethasone or Medrol (methylprednisolone)
- Tylenol (acetaminophen), to help prevent or reduce fever
These medications help prevent a reaction to the Darzalex infusion. Other cancer medications may also be infused with Darzalex. You may also be administered medications after your infusion.
Below are answers to a couple of common questions about Darzalex dosing.
What is Darzalex split dosing?
Darzalex split dosing is when your doctor splits the first infusion over 2 consecutive days. Studies have shown similar results at the end of the first week, whether the first dose was split or given all at once. Split dosing can improve your first experience with Darzalex because of the shorter infusions.
If I have kidney disease, will my dosage of Darzalex need adjustment?
There haven’t been any formal studies on Darzalex renal dosing in people with kidney disease. Your Darzalex dose doesn’t need to be adjusted if you have kidney problems.
The dosage of Darzalex you’re prescribed may depend on several factors. These include:
- your weight
- when you were diagnosed with multiple myeloma
- if you’ve had previous multiple myeloma treatments with other medications
- other medications you’re given along with Darzalex
- other medical conditions you have
- how your body responds to Darzalex
If you miss your Darzalex infusion appointment, call your doctor as soon as you remember. It’s important to follow your treatment schedule.
If you need help remembering to go in for your Darzalex appointments, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone. Try to schedule your next infusion appointment before you leave the office after each dose.
The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Darzalex for you, they’ll prescribe the dosage that’s right for you. Talk with your doctor if you have questions or concerns about your dosage.
Here are some examples of questions you may want to ask your doctor:
- Will my dosage change if I’m taking other drugs with Darzalex?
- If Darzalex isn’t working well enough for me, will my dosing schedule change?
- Will my dosage be different than what’s shown here if other multiple myeloma treatments haven’t worked for me?
Q:
If I have bothersome side effects during my infusion, will my dosage of Darzalex change?
AnonymousA:
It’s possible that your doctor may change the rate of your Darzalex infusion if you have bothersome side effects while receiving it. But they likely won’t change the dose.
If you have side effects during a Darzalex infusion, your healthcare professional will immediately stop the infusion. They may use medications to treat your infusion reaction, depending on the side effects you’re having. Once the side effects go away, your healthcare professional will likely resume your Darzalex infusion but at half the previous infusion rate. If your infusion reaction doesn’t reappear, your healthcare professional will likely slowly increase the infusion rate over time back to the normal rate.
It’s also possible that your doctor will have you permanently stop treatment with Darzalex. This may happen if your infusion reaction is severe or occurs at multiple infusions. If this happens, they can discuss other treatment options for multiple myeloma with you.
Alex Brewer, PharmD, MBAAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.