Tepezza (teprotumumab-trbw) is a prescription drug used to treat thyroid eye disease (TED). Tepezza can cause side effects that range from mild to serious. Examples include muscle spasm, infusion-related reaction, and severe hearing loss.

Tepezza is used in adults to treat TED, sometimes called Graves’ ophthalmopathy, since it commonly occurs in people with Graves’ disease.

The active ingredient in Tepezza is the biologic drug teprotumumab-trbw.* (An active ingredient is what makes a drug work.) The drug comes as a powder that your doctor will prepare as an intravenous (IV) infusion. (This is an injection into a vein given over time.)

Keep reading to learn about the common, mild, and serious side effects Tepezza can cause. For a general overview of the drug, including details about its uses, see this article.

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

Some people may experience mild to serious side effects during Tepezza treatment. Examples of the drug’s commonly reported side effects include:

Mild side effects have been reported with Tepezza. These include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop Tepezza treatment unless your doctor recommends it.

Tepezza may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* An allergic reaction is possible after using Tepezza, but this side effect wasn’t reported in studies.

Serious side effects have been reported with Tepezza. These include:

If you develop serious side effects from Tepezza, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Tepezza, but this side effect wasn’t reported in studies.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Tepezza, visit MedWatch.

Get answers to some frequently asked questions about Tepezza’s side effects.

How long does Tepezza stay in your system?

Tepezza has a half-life of about 20 days. (Half-life is the amount of time it takes for a substance to be reduced to half the original amount.) After you take your last dose of Tepezza, it will take about 20 days for your body to clear half the amount of the drug from your body. Every 20 days the amount of drug is reduced by half again. Altogether, it will take about 100 days for your body to remove the drug completely from your system.

Talk with your doctor if you have questions about how long Tepezza stays in your system. They can tell you how that may affect any benefits or side effects you experience from this medication.

How long do side effects of Tepezza typically last?

It depends on the side effect. Certain side effects are long-term* such as:

  • hearing loss
  • hair loss
  • weight loss
  • nail disorders
  • menstrual cycle disorders
  • increased blood sugar

Other side effects may only last for a short time after starting Tepezza or after each infusion. These may include:

  • infusion-related reaction
  • muscle spasm
  • nausea
  • diarrhea
  • fatigue
  • dry skin
  • headache
  • altered taste

If you’re concerned about how long side effects from Tepezza may last, talk with your doctor or pharmacist.

* Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. It also includes side effects that may not go away, even after you stop taking the drug.

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

Hearing loss

Hearing problems, including hearing loss, were a common side effect reported in studies of Tepezza. With hearing loss, people may become deaf.

Different types of deafness occurred with Tepezza:

  • With sensorineural deafness, the inner ear becomes damaged and cannot send sound information to the brain.
  • With eustachian tube dysfunction, a different part of the ear loses function and can cause:
    • muffled hearing
    • tinnitus (ringing in the ears)
    • pain
    • reduced hearing
    • a full feeling in the ear

Hearing loss may cause other symptoms such as:

  • a perception of your voice as too loud or echoing
  • low tolerance to sound
  • loss of hearing at specific frequencies of sound

What might help

Before prescribing Tepezza, your doctor will evaluate your hearing to make sure the benefits of treatment outweigh the risks. They’ll also check your hearing frequently throughout your treatment with this drug.

If you have any changes in your hearing during Tepezza treatment, talk with your doctor immediately. Hearing loss with this drug may become permanent. Your doctor may have you stop Tepezza treatment, but do not stop without speaking with them first.

High blood sugar

An increase in blood sugar may occur in people receiving Tepezza. In studies, the majority of people with high blood sugar during Tepezza treatment had diabetes or problems with blood sugar.

What might help

Before you receive your infusions of Tepezza, your doctor will check your blood sugar and ask about any symptoms of high blood sugar. If you have diabetes or trouble managing your blood sugar, tell your doctor before starting Tepezza. They’ll make sure you’re taking the appropriate blood sugar medications.

If you think your blood sugar is rising during treatment with Tepezza, talk with your doctor. If your blood sugar is too high, they may prescribe medication to help manage it.

Allergic reaction

Like most drugs, Tepezza can cause an allergic reaction in some people. But this side effect wasn’t reported in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Tepezza, they’ll decide if you should continue treatment.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Tepezza, they may have you switch to a different treatment.

Keeping track of side effects

During your Tepezza treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Tepezza affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before starting treatment with Tepezza.


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

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

Alcohol and Tepezza

There are no known interactions between alcohol and Tepezza. If you have questions about consuming alcohol during Tepezza treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Tepezza

Before starting Tepezza treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning to be either.


Tepezza is not safe during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options.

If you’re able to become pregnant, your doctor may recommend using an effective form of birth control during your Tepezza treatment. They’ll likely recommend that you use contraception before, during, and for 6 months after treatment with Tepezza.

If you become pregnant while using this medication, tell your doctor immediately. They’ll have you stop your Tepezza treatment because of the risks to your fetus.


It isn’t known whether Tepezza is safe to use while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

Like most drugs, Tepezza can cause a number of side effects that range from mild to serious. But most are temporary and go away after a few days to weeks. If you have questions about side effects Tepezza can cause, talk with your doctor. Examples of questions to help get you started include:

  • If Tepezza causes too many long-term side effects, what other drug can I take for thyroid eye disease?
  • Will eating before or after my Tepezza infusion reduce nausea?
  • What can I do to prevent hair loss while receiving Tepezza treatment?

To learn more about Tepezza, see these articles:

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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.