Tecvayli (teclistamab-cqyv) is a prescription drug that’s used to treat multiple myeloma in certain adults. Tecvayli comes as a solution that’s injected under your skin.

Tecvayli basics

You may be prescribed Tecvayli if past treatments didn’t work for your multiple myeloma, or if the cancer came back after past treatments. For more information on the drug’s uses, see the “What is Tecvayli used for?” section below.

Tecvayli contains the active ingredient teclistamab-cqyv,* which is a biologic medication. A biologic is made from parts of living organisms. Tecvayli is not available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, teclistamab-cqyv comes only as the brand-name drug Tecvayli.

* The reason “-cqyv” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.

Whether you have health insurance or not, cost may be a factor when you’re considering Tecvayli. What you’ll pay for Tecvayli may depend on several things, such as your treatment plan.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks* to get price estimates of what you’d pay for Tecvayli when using coupons from the site.
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or insurance provider. A program called Janssen Compass may also be available.

You can also check out this article to learn more about saving money on prescriptions.

* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with any insurance copays or benefits.

Like most drugs, Tecvayli may cause mild or serious side effects. The lists below describe some of the more common side effects that Tecvayli may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor can tell you more about the potential side effects of Tecvayli. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Tecvayli can cause. To learn about other mild side effects, talk with your doctor, or read Tecvayli’s prescribing information.

Mild side effects of Tecvayli that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Tecvayli can occur, but they aren’t common. If you have serious side effects from Tecvayli, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Tecvayli that have been reported include:

* For more information, see the “What should be considered before receiving Tecvayli?” section.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

Some people may have an allergic reaction to Tecvayli.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Tecvayli. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Tecvayli that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Forms and strengths

Tecvayli is available as a solution that’s given as an injection under your skin. It comes in a vial in two strengths:

  • 30 milligrams of Tecvayli in 3 milliliters (mg/mL) of solution
  • 153 mg/1.7 mL of solution

Recommended dosage

You’ll start your Tecvayli treatment with a step-up dosing schedule. This means you’ll get two lower doses of Tecvayli before getting your first treatment dose of the drug. This is done to see how your body reacts to the drug. Your doctor will follow a step-up dosing schedule when you first start Tecvayli and if you stop and restart treatment.

The typical dosing schedule for Tecvayli is as follows:

  • Day 1: receive first step-up dose
  • Day 4: receive a higher step-up dose
  • Day 7: receive first treatment dose
  • Day 14 and after: receive one dose per week

To learn more about Tecvayli’s dosage, see this article.

How it’s given

You’ll receive Tecvayli injections from your doctor or another healthcare professional in a special facility that’s been approved by the Risk Evaluation and Mitigation Strategy (REMS) program. You’ll likely stay in the hospital for at least 48 hours after each of your first three doses of Tecvayli.

Your doctor will explain how Tecvayli will be given to you. They’ll also explain how much you’ll be given and how often.

Questions about using Tecvayli

Below are some common questions about using Tecvayli.

  • Is there a best time of day to take Tecvayli? No, there’s no best time of day to take Tecvayli. After your step-up doses, you’ll receive injections once weekly. Your doctor may recommend scheduling your doses of Tecvayli on the same day each week, such as Wednesdays.
  • What if I miss a dose of Tecvayli? If you miss an appointment to receive a Tecvayli injection, call your doctor’s office as soon as possible to reschedule.
  • Will I need to use Tecvayli long term? Yes, if Tecvayli is working for you, your treatment will likely be long term.

Overdose

Do not take more Tecvayli than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Tecvayli

Call your doctor if you think you’ve taken too much Tecvayli. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Tecvayli can be used in adults with multiple myeloma. This is a type of cancer that occurs in certain white blood cells called plasma cells.

You may be prescribed Tecvayli if past treatments didn’t work for your multiple myeloma, or if the cancer came back after past treatments. Specifically, Tecvayli is only approved for use in adults who’ve already tried at least four other medications that haven’t worked to treat their condition.

Tecvayli works by attaching to multiple myeloma cells and causing an immune response. This means your immune system attacks and destroys the multiple myeloma cells.

Note: Tecvayli received accelerated FDA approval in 2022. This means the FDA approved the drug based on initial data because there aren’t many other treatment options available for multiple myeloma. The FDA will decide whether to give Tecvayli full approval after all its studies have been completed.

Below is important information you should consider before starting Tecvayli treatment.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

It’s possible that Tecvayli may interact with other medications, herbs, supplements, foods, or alcohol. However, the manufacturer of Tecvayli did not check for interactions in studies of the drug.

Before starting Tecvayli treatment, talk with your doctor. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor.

Pregnancy and breastfeeding

It’s not known whether Tecvayli may be safe to receive during pregnancy. But based on the way that Tecvayli works, the drug may cause harm to a fetus.

It’s also not known whether Tecvayli is safe to receive while breastfeeding. But because of the possible risks, doctors will usually recommend that you do not breastfeed during your Tecvayli treatment and for at least 5 months after your last dose.

If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor before starting Tecvayli treatment.

Birth control

Tecvayli may cause harm to a fetus. If you can become pregnant, your doctor will recommend that you take a pregnancy test before receiving this drug. In addition,you should use birth control, such as condoms, during your Tecvayli treatment and for at least 5 months after your last dose.

Boxed warnings

Tecvayli has boxed warnings about the risk of neurologic toxicity and cytokine release syndrome. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Because of these risks, Tecvayli is only available at facilities certified through a Risk Evaluation and Mitigation Strategy (REMS) program. The purpose of a REMS program is to help decrease the risk of serious side effects from a drug.

If you’re prescribed Tecvayli, your doctor will also give you a wallet card that you should carry with you at all times during your treatment. This tells other doctors or healthcare professionals that you’re receiving Tecvayli and what symptoms of neurologic toxicity or cytokine release syndrome to watch for.

See below for details on Tecvayli’s boxed warnings.

Risk of neurologic toxicity. Tecvayli may cause neurologic toxicity. This condition can occur if the drug damages your nervous system. Symptoms of neurologic toxicity may include:

  • headache
  • difficulty moving or speaking
  • restlessness
  • numbness or tingling
  • confusion

Neurologic toxicity was commonly reported in studies. In some cases, it can be severe or even life threatening.

Due to this risk, you’ll likely stay in the hospital for at least 48 hours after each of your first three doses of Tecvayli. In addition, you should not drive or operate machinery between the first three doses or for at least 48 hours after receiving your third dose. This is because the drug may cause neurological issues, such as with coordination or memory.

If you develop any symptoms of neurologic toxicity, tell your doctor right away. They may pause or stop your Tecvayli treatment. They can help determine the best treatment plan for you.

Risk of cytokine release syndrome (CRS). Tecvayli may cause CRS in some people. With this condition, your immune system becomes overactive and causes inflammation (swelling) throughout your body. CRS was commonly reported in studies of people taking Tecvayli. In some cases, this condition may be severe or life threatening.

Your doctor will give you certain medications before your dose of Tecvayli to help prevent CRS.

Symptoms of CRS to watch for during your Tecvayli treatment include:

See a doctor right away if you develop any of these symptoms.

If you develop CRS from Tecvayli, your doctor may recommend going to the hospital for monitoring. They may also pause or stop your Tecvayli treatment.

Other warnings

Tecvayli can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Tecvayli is a good treatment option for you.

Talk with your doctor about your health history before you take Tecvayli. Be sure to tell them if any of the following factors apply to you:

Find answers to some commonly asked questions about Tecvayli.

Can Tecvayli cause long-term side effects?

Yes, Tecvayli may cause long-term side effects in some people. Examples include:

If you’re concerned about long-term side effects from Tecvayli, talk with your doctor.

* Tecvayli has a boxed warning for this side effect. To learn more, see the “What should be considered before receiving Tecvayli?” section above.

How does Tecvayli work?

Tecvayli attaches to immune cells called T-cells and to multiple myeloma cells, which causes an immune response. This means your immune system attacks and destroys the multiple myeloma cells.

If you have other questions about how Tecvayli works, talk with your doctor.

Is Tecvayli safe for older adults?

Yes, Tecvayli is likely safe for older adults (ages 65 years and older). In studies, no differences in safety or effectiveness were reported in adults ages 65–74 years compared with younger adults. However, there were not enough people ages 75 years and older in the studies to make comparisons for that age range.

In general, older adults may experience more severe side effects from taking any drug, including Tecvayli. This may be because of other medical conditions that may affect how the drug works. For example, older adults have a higher risk of liver or kidney problems. This could raise the risk of side effects from a drug.

If you have concerns about receiving Tecvayli because of your age or health factors, talk with your doctor.

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Tecvayli, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to Tecvayli:

  • proteasome blockers, such as carfilzomib (Kyprolis)
  • monoclonal antibodies, such as daratumumab (Darzalex)
  • immunomodulatory drugs, such as thalidomide (Thalomid)
  • chimeric antigen receptor (CAR) T-cell treatments, such as ciltacabtagene (Carvykti)
  • selinexor (Xpovio)

If you have questions about taking Tecvayli, talk with your doctor. Questions you may want to ask include:

  • Can my dose of Tecvayli be increased if the drug isn’t working for me?
  • How long do I need to stay in the hospital after receiving my dose of Tecvayli?
  • How can I manage side effects that I experience from Tecvayli?

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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.