Tepezza Infusion: Treatment for Thyroid Eye Disease

What is Tepezza?

If you have thyroid eye disease (TED), your doctor may recommend Tepezza to help reduce your symptoms.

Tepezza is a prescription medication that’s used in adults who have TED. With TED, your immune system attacks the muscle and fat tissue behind your eyes. This can cause bulging eyes, eye pain and redness, and double vision. TED may also be called Graves’ eye disease, Graves’ ophthalmopathy, and Graves’ orbitopathy.

Tepezza basics

You’ll receive Tepezza as an intravenous (IV) infusion, which is an injection into a vein (usually in your arm) over a period of time. You’ll receive Tepezza infusions every 3 weeks. Tepezza treatment usually lasts about 5 months. Your infusions may be given at a hospital, an infusion clinic, or your doctor’s office. In some cases, you may receive Tepezza infusions at home.

Tepezza contains the drug teprotumumab, which is a biologic medication. A biologic is made from parts of living organisms. Tepezza 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, teprotumumab comes only as the brand-name drug Tepezza.

Read on to learn more about Tepezza’s side effects, cost, and more.

What does Tepezza cost?

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. Tepezza’s cost per year may vary depending on your location. To learn about Tepezza’s cost with insurance, talk with your insurance company.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Tepezza manufacturer’s website to see if they have support options.

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

What are Tepezza’s side effects?

Like most drugs, Tepezza may cause mild or serious side effects. The lists below describe some of the more common side effects that Tepezza 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 or pharmacist can tell you more about the potential side effects of Tepezza. They can also suggest ways to help reduce side effects.

Mild side effects

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

Mild side effects of Tepezza that have been reported include:

• muscle spasms*
• nausea
• diarrhea
• fatigue (lack of energy)
• hair loss or thinning hair
• change in the way things taste
• headache
• dry skin

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 or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Tepezza can occur, but they aren’t common. If you have serious side effects from Tepezza, 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 Tepezza that have been reported include:

• high blood sugar
• hearing loss*
• infusion-related side effects, such as fast heart rate and high blood pressure*
• allergic reaction*

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Tepezza may cause.

Hearing loss

In some people, Tepezza may cause hearing problems, such as hearing loss or deafness. Other hearing problems have also been reported with this drug. These include increased sensitivity to noise. For example, your own voice or breathing may seem louder to you than usual.

In studies, hearing problems such as hearing loss were common with Tepezza. Hearing loss was generally mild or moderate and got better after treatment with Tepezza was stopped. But there have also been a few reports of more severe or long-lasting hearing loss with this drug.

What might help

If you notice any changes in your hearing during your treatment, be sure to tell your doctor. They can assess if it’s safe for you to continue using this drug.

Your doctor may also want to check your hearing before, during, and after your Tepezza treatment.

If you have questions about your risk of hearing loss with Tepezza, talk with your doctor.

Infusion-related side effects

You’ll receive Tepezza as an intravenous (IV) infusion, which is an injection into a vein (usually in your arm) over a period of time.

Tepezza can sometimes cause infusion-related side effects (also called infusion reactions). These are side effects that happen either during or shortly after your infusion.

Symptoms of infusion-related side effects may include:

• feeling hot
• fast heart rate
• high blood pressure
• shortness of breath
• headache
• muscle pain

In studies, infusion-related side effects weren’t common with Tepezza. And most people who experienced them had mild or moderate symptoms.

What might help

You’ll be monitored for side effects during your infusion and for 90 minutes after the infusion has ended. Be sure to tell your doctor if you experience any symptoms.

If you have infusion-related side effects, your infusion may need to be slowed down or paused until your symptoms improve. Your doctor may also give you medications such as corticosteroids or antihistamines to treat the reaction. And before your next infusion, your doctor may give you medications (called pre-medications) to help prevent a reaction from happening again. They may also administer your next infusion more slowly.

Muscle spasms

Some people may experience muscle spasms with Tepezza. Muscle spasms are sudden twitches or cramps that happen in one or more of your muscles. They can cause pain or weakness.

In studies, muscle spasms were the most common side effect reported with Tepezza.

What might help

If you have mild muscle cramps, these may be eased by stretching or massaging the affected muscle.

But if you have cramps that are bothersome or severe, talk with your doctor. They may recommend medication to help relieve this side effect, such as muscle relaxers.

Allergic reaction

Some people may have an allergic reaction to Tepezza. Although allergic reaction wasn’t reported in studies of Tepezza, it can still happen.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically 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 Tepezza. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What is Tepezza used for?

Tepezza is only approved for one indication (use). It’s prescribed to treat thyroid eye disease (TED) in adults.

TED is an autoimmune condition. This means it’s caused by your immune system mistakenly attacking healthy tissues in your body.

With TED, your immune system attacks the muscle and fat tissue behind your eyes. This causes inflammation (swelling) in these tissues. The swelling can cause bulging eyes, which may lead to eye irritation and double vision. In rare cases, the swelling can press on your optic nerve, causing vision loss.

TED most commonly develops in people who have another autoimmune disease called Graves’ disease. With this condition, your immune system attacks your thyroid gland, causing hyperthyroidism (overactive thyroid). But it can also attack the tissue behind your eyes, causing TED.

Because TED mainly occurs in people with Graves’ disease, it’s also called Graves’ eye disease, Graves’ ophthalmopathy, and Graves’ orbitopathy. But TED can also develop in people who don’t have Graves’ disease. It’s important to note that Tepezza is not approved to treat Graves’ disease.

Symptoms of TED may include:

• bulging eyes
• eye pain, including pain behind your eyes or when moving your eyes
• redness and swelling of your eyes and eyelids
• double vision

Tepezza helps reduce these symptoms of TED.

What are some frequently asked questions about Tepezza?

Find answers to some commonly asked questions about Tepezza.

Can I view before and after pictures of people who’ve used Tepezza?

Yes, you can. You can find pictures of people with TED who’ve used Tepezza on the manufacturer’s website.

Keep in mind that your results with Tepezza may differ. Talk with your doctor to find out more about what you can expect from your treatment.

How does Tepezza work?

Tepezza is used to treat thyroid eye disease (TED). This condition occurs when your immune system mistakenly attacks the muscle and fat tissue behind your eyes.

Tepezza’s mechanism of action (how it works) for treating TED isn’t fully understood. The drug attaches to certain proteins found on the surface of your cells. By doing this, Tepezza keeps your immune system from activating the proteins. This helps protect the muscle and fat tissue behind your eyes from your immune system.

Is it safe to use eye drops during Tepezza treatment?

Yes, it’s usually safe to use eye drops during your Tepezza treatment. In fact, your doctor may recommend using certain eye drops to help reduce your symptoms until Tepezza starts working.

For example, your doctor may recommend lubricant eye drops if your eyes are dry, itchy, gritty, or irritated. And they may prescribe steroid eye drops to help reduce eye inflammation (swelling).

Eye drops aren’t known to interact with Tepezza. But be sure to talk with your doctor about any medications that you use during your Tepezza treatment. They can make sure the drugs are safe to use with Tepezza.

What is Tepezza’s dosage?

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

Form

Tepezza comes as a powder inside single-dose vials. Your doctor will use the powder to make a liquid solution of Tepezza. You’ll be given the Tepezza solution by intravenous (IV) infusion. With an IV infusion, the drug is injected into a vein (usually in your arm) over a period of time.

Recommended dosage

To treat thyroid eye disease (TED), you’ll usually receive a Tepezza infusion every 3 weeks. You’ll receive eight infusions in total over the course of about 5 months.

For your first infusion, the recommended dose of Tepezza is 10 milligrams per kilogram of body weight (mg/kg). For the next seven infusions, the recommended dose is 20 mg/kg.

For example, if you weigh 60 kg (about 132 pounds), for your first infusion you’ll receive a dose of 600 mg. For your next seven infusions you’ll receive a dose of 1,200 mg.

Questions about Tepezza’s dosage

• What if I miss a dose of Tepezza? It’s important that you don’t miss any doses of Tepezza. If you miss an appointment for your Tepezza infusion, call your doctor’s office right away to reschedule.
• Will I need to use Tepezza long term? No, you’ll only receive eight infusions of Tepezza. Your treatment will usually last about 5 months.
• How long does Tepezza take to work? After starting Tepezza treatment, it may take at least 6 weeks before your symptoms are relieved. If you have questions about what to expect during your treatment, talk with your doctor.

How is Tepezza administered?

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

Receiving Tepezza

You’ll receive Tepezza as an intravenous (IV) infusion, which is an injection into a vein (usually in your arm) over a period of time. You’ll receive infusions in a hospital or infusion center.

You’ll receive a Tepezza infusion every 3 weeks, for a total of eight doses.

Your first two infusions will usually take about 90 minutes. You’ll be monitored for side effects during your infusion and for 90 minutes after the infusion has ended. Be sure to tell your doctor if you experience any symptoms.

If you don’t have side effects with your first two infusions, your following infusions will be given over a period of about 60 minutes.

If you have side effects with your first two infusions, your doctor may slow down or pause your infusion until your symptoms are relieved. And in this case, your following infusions will continue to be given over a period of about 90 minutes.

To read more about infusion-related side effects with Tepezza, see “What are Tepezza’s side effects?” above.

Receiving Tepezza with other drugs

If you have infusion-related side effects with Tepezza, you may be given medications to treat your symptoms. These medications may include corticosteroids or antihistamines.

Your doctor may also give you medications (called pre-medications) before your next Tepezza infusion to help prevent these side effects from happening again. These medications may include acetaminophen (Tylenol), corticosteroids, and antihistamines.

Questions about receiving Tepezza

• Can Tepezza be taken by mouth? No, Tepezza is only given by IV infusion.
• Should I take Tepezza with food? It doesn’t matter. You can receive your Tepezza infusions on a full or empty stomach.

Questions for your doctor

You may have questions about Tepezza and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions such as:
  • How will Tepezza affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

What should be considered before taking Tepezza?

Before taking Tepezza, it’s important to consider your overall health, any medical conditions you have, and any medications you take. Talk with your doctor about how Tepezza could affect you.

Interactions

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

There are no known interactions between Tepezza and other drugs or supplements. But before taking Tepezza, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Tepezza.

Warnings

Tepezza may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Tepezza. Factors to consider include those in the list below.

• Allergic reaction. If you’ve had an allergic reaction to Tepezza or any of its ingredients, your doctor will likely not prescribe Tepezza. Ask your doctor what other medications are better options for you.
• Diabetes or prediabetes. Tepezza may raise your blood sugar levels. Your risk for this side effect is higher if you have diabetes or prediabetes. If you have one of these conditions, your doctor will make sure your blood sugar is well managed before you start treatment with Tepezza. They’ll also monitor your blood sugar level more closely during your treatment. If needed, they may adjust your diabetes treatment plan to help manage your blood sugar.
• Inflammatory bowel disease. If you have inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, Tepezza could make your symptoms worse. Tell your doctor if you have new or worsening diarrhea, rectal bleeding, belly pain, or other symptoms. Your doctor may decide to stop your Tepezza treatment.

Tepezza and alcohol

Tepezza isn’t known to interact with alcohol. But drinking alcohol may worsen certain side effects of Tepezza, such as nausea, headache, or diarrhea.

If you drink alcohol, talk with your doctor about whether it’s safe to drink during your Tepezza treatment.

Pregnancy and breastfeeding

It’s not safe to receive Tepezza during pregnancy. This medication could harm a fetus. If you’re pregnant or planning to become pregnant, talk with your doctor about other treatment options.

If you’re a female* who could get pregnant, you should use birth control before and during your treatment. And you’ll need to keep using birth control for at least 6 months after your last dose of Tepezza. Before starting treatment with Tepezza, talk with your doctor about your birth control needs.

It’s not known if it’s safe to receive Tepezza infusions while breastfeeding. If you’re currently breastfeeding or planning to breastfeed, talk with your doctor before starting treatment.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

What to ask your doctor

If you have questions about taking Tepezza to treat your thyroid eye disease (TED), talk with your doctor. They can discuss possible treatment options with you and help you decide if Tepezza is right for you.

You may find this Healthline article helpful:

• Your FAQs answered: How is thyroid eye disease treated?

Here are some examples of questions you might want to ask your doctor:

• Will Tepezza cure TED?
• Can I receive Tepezza infusions at home?
• Are there other treatments for TED?
• If my Graves’ disease is treated, will this reduce my TED symptoms?
• Can Tepezza affect irritable bowel syndrome (IBS)?