Tepezza (teprotumumab-trbw)

Medically Reviewed By Purva Singla, PharmD

About Tepezza

Tepezza is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat thyroid eye disease (TED) in adults.

TED happens when your immune system mistakenly attacks healthy tissues behind your eyes. It causes bulging eyes, eye irritation, and double vision.

TED often occurs in people with Graves’ disease. For this reason, TED is also known as Graves’ eye disease, Graves’ ophthalmopathy, and Graves’ orbitopathy. However, TED can also develop in people who don’t have Graves’ disease. 

For details about TED and how Tepezza treats it, see the “Tepezza: Use for thyroid eye disease” section below.

Key points

The following table provides key facts about Tepezza.

Active drug teprotumumab-trbw*
Drug class insulin-like growth factor-1 receptor (IGF-1R) inhibitor
Form powder that’s made into a solution and given by IV infusion
FDA approval January 2020

* The reason “-trbw” appears at the end of the drug’s name is to distinguish it from a current or future biosimilar version. To learn about biosimilar drugs, see the “Tepezza: Generic or biosimilar” section below.

Finding a healthcare professional

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Tepezza: Generic or biosimilar

Tepezza contains the active drug teprotumumab-trbw, which is a biologic. Biosimilar forms of Tepezza aren’t available at this time.

Biologics are drugs made from living cells. It’s not possible to copy these drugs exactly. Generics, on the other hand, refer to drugs made from chemicals. Generics are exact copies of the active drug in brand-name medications. Biosimilar medications are drugs that are similar to brand-name biologic drugs (parent drugs).

Biosimilars are considered just as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

Tepezza: Questions you may have

Here are some common questions about Tepezza and brief answers to them. If you’d like to know more about these topics, ask your doctor.

What can I expect before and after treatment with Tepezza?

Before you start treatment with Tepezza, your doctor may do some or all of the following:

  • discuss your health history and how Tepezza could affect your other conditions, such as inflammatory bowel disease or diabetes
  • check your blood sugar level so they will be able to tell whether Tepezza increases it
  • talk with you about where you’ll receive Tepezza infusions and help schedule your appointments for infusions
  • perform an eye exam so they can monitor how Tepezza affects your eye disease

After treatment with Tepezza, your thyroid eye disease (TED) symptoms may improve. For example, in clinical studies, treatment with Tepezza reduced:

Improvement in these symptoms may make you feel better about your appearance. It can also improve your ability to do daily activities that rely on eyesight, such as reading, walking, or driving.

Keep in mind that not everyone receiving Tepezza may have the same experience. The benefits of treatment, as well as the side effects of it, depend on your personal situation. Talk with your doctor about what you can expect with Tepezza.

Are before and after pictures available from people who’ve taken Tepezza?

Yes, pictures showing people’s eyes before and after treatment with Tepezza are available on the drug manufacturer’s website.

Different people may have unique results with Tepezza. Before starting treatment, be sure to talk with your doctor about Tepezza for your condition. And during Tepezza treatment, talk with your doctor regularly about your results.

Will Tepezza cure my condition?

No, Tepezza won’t cure thyroid eye disease (TED). However, it may reduce certain symptoms of TED, such as bulging eyes and double vision.

It’s not known how long the effects of Tepezza treatment will last. However, in clinical studies, most people maintained reduced symptoms for at least 1 year after finishing treatment with Tepezza.

Tepezza: Cost

Like other medications, prices for Tepezza may vary. The infusion’s cost will depend on factors such as:

  • the facility where you receive doses of the drug
  • your insurance coverage

The drug’s cost per year and cost with insurance will vary among people.

Cost considerations for Tepezza

Here’s a list of things to consider when looking into the cost of Tepezza.

  • Need for prior authorization. Before insurance coverage for Tepezza is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Tepezza. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Tepezza, contact your insurance company.
  • Possible cost assistance options. Financial assistance to help lower the cost of Tepezza is available. The Horizon By Your Side program for Tepezza may help reduce its cost. To learn more and see if you’re eligible for support, call 833-583-7399 or visit the manufacturer’s website. Also, check out this article to learn about ways to save on prescription drugs.
  • Availability of a biosimilar form. Tepezza is a biologic drug that is not available in biosimilar form. Biologics are drugs made from living cells. It’s not possible to copy these drugs exactly. Biosimilar drugs are not exact copies of brand-name biologics, but they are similar. On the other hand, generic drugs are exact copies of the active drug in brand-name medications. Both biosimilar forms and generics often cost less than brand-name drugs.

Tepezza: Side effects

As with most drugs, it’s possible to have side effects with Tepezza. These can include some mild side effects, but also some serious ones.

To learn more about Tepezza’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Tepezza, you can do so through MedWatch.

Mild and serious side effects

Mild and serious side effects of Tepezza are listed below. These lists do not include all of Tepezza’s possible side effects.

Mild side effects

Mild side effects* of Tepezza may include:

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

* This is not a complete list of Tepezza’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For more information about this side effect, see “Tepezza’s side effects explained” below.

Serious side effects

Serious side effects from Tepezza aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Serious side effects of Tepezza may include:

* For more information about this side effect, see “Tepezza’s side effects explained” below.
† An allergic reaction is possible after taking Tepezza. However, it’s not clear whether this side effect occurred in clinical studies.

Tepezza’s side effects explained

Below, you can find detailed information about some of Tepezza’s side effects. To learn more about other side effects of this medication, talk with your doctor. 

Hearing loss

You may have hearing loss with Tepezza. You may also have other hearing problems, such as increased sensitivity to noise. For instance, sounds made by your body may seem louder than usual to you. This could include sounds with breathing, for example.

In clinical studies, hearing problems were common with Tepezza. Hearing loss was typically mild or moderate, but some people had more severe hearing loss or deafness.

For most people taking Tepezza, hearing problems get better after treatment is stopped. However, a few reports note long-lasting hearing loss after stopping treatment with this drug.

What to do

Your doctor may check your hearing before you start Tepezza treatment. Let them know if you have any hearing problems.

If you notice any changes in your hearing during treatment with Tepezza, tell your doctor. A hearing specialist, such as an audiologist or otolaryngologist, can check your hearing and determine whether it’s safe for you to continue treatment with Tepezza.

Infusion side effects

Tepezza is given by IV infusion. Some people may have certain side effects during or shortly after a Tepezza infusion. These are called infusion side effects or infusion reactions.

In clinical studies, infusion side effects weren’t common with Tepezza. These side effects generally were mild or moderate. However, more severe reactions are possible.

Symptoms of infusion side effects may include:

What to do

Your healthcare professional will monitor you for infusion side effects during your infusion and for 90 minutes after. If you have any of the symptoms listed above, tell your doctor right away.

If you have infusion side effects, your doctor may give you a combination of medications such as acetaminophen (Tylenol), antihistamines, or corticosteroids to help ease symptoms. Your doctor may ask you to take these medications before your next infusion to prevent a reaction from happening again. If you are having a reaction, your doctor may also slow down or pause your infusion until your symptoms get better.

If you have a serious reaction to Tepezza, your doctor may recommend stopping this treatment completely.

Hair loss

You may have some hair loss or hair thinning during treatment with Tepezza. In clinical studies, hair loss was one of the more common side effects of the drug.

Hair loss or hair thinning may affect only the hair on your scalp. However, it often affects body hair as well. Hair loss is typically mild and gets better after treatment is finished.

What to do

If you have bothersome hair loss during treatment with Tepezza, talk with your doctor. They can suggest ways to help manage this side effect.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Tepezza. A more severe allergic reaction is rare but possible.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids
rash • swelling in your throat or mouth
• itching trouble breathing

If you have an allergic reaction to Tepezza, call your doctor right away. This is important to do because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Tepezza: Use for thyroid eye disease

Prescription drugs, such as Tepezza, are approved by the Food and Drug Administration (FDA) to treat certain conditions. A drug’s approved uses are also called its indications.

Using Tepezza for thyroid eye disease

Tepezza is FDA-approved to treat thyroid eye disease (TED) in adults.

TED is an autoimmune condition. That means your immune system mistakenly attacks healthy tissues in your body. With TED, your immune system attacks the muscle and fatty tissue behind your eyes. This causes inflammation behind your eyes that makes them bulge forward.

TED often occurs in people with Graves’ disease, which is another autoimmune condition. With Graves’ disease your immune system attacks your thyroid gland, causing hyperthyroidism (overactive thyroid function).  

Because it affects people with Graves’ disease, TED is also known as Graves’ eye disease, Graves’ ophthalmopathy, and Graves’ orbitopathy. But TED can also develop in people who don’t have Graves’ disease. 

Symptoms of TED can include:

  • proptosis (bulging eyes)
  • eye irritation
  • eye redness
  • eye pain, including pain behind the eyes or when moving them
  • dry, itchy, or gritty eyes
  • swelling of your eyelids
  • sensitivity to light
  • double vision

In severe cases, the inflammation behind your eyes can press on your optic nerve. This may cause loss of vision.

Tepezza helps protect the tissue behind your eyes, keeping your immune system from mistakenly attacking it. Doctors prescribe Tepezza to help reduce the symptoms of TED.

Using Tepezza with other therapies

Your doctor may recommend using Tepezza with certain other drugs. Examples of these include:

  • corticosteroids, to help reduce inflammation behind your eyes
  • immunosuppressants, to help stop your immune system from attacking the tissue behind your eyes
  • lubricant eye drops, to help ease dryness, irritation, and pain in your eyes

Your doctor also may recommend therapies other than drugs, such as:

  • applying cold compresses to your eyes
  • wearing sunglasses or special eyeglasses
  • sleeping with your head raised on pillows

Using Tepezza in children

Tepezza hasn’t been studied in children. It’s approved only to treat TED in adults.

Finding a healthcare professional for Tepezza

If you’re interested in taking Tepezza, you can find a doctor who may prescribe it by searching here. To prepare for your appointment, you may find it helpful to visit Healthgrades’ appointment guide for thyroid eye disease.

Tepezza: How it works

Tepezza is used to treat thyroid eye disease (TED).

With TED, your immune system mistakenly attacks the muscle and fatty tissue behind your eyes. When this happens, your immune system activates a protein found in the tissue behind your eyes. This protein is called insulin-like growth factor-1 receptor (IGF-1R).

When your immune system activates IGF-1R, it causes inflammation in the tissue behind your eyes. This makes your eyes bulge forward. It also causes eye pain, swelling, redness, and double vision.

Tepezza is a type of drug called an IGF-1R inhibitor. It attaches to IGF-1R and blocks it from being activated by your immune system. This reduces the inflammation behind your eyes. In turn, it helps ease the symptoms of TED.

How long does Tepezza take to start working?

Tepezza starts working soon after your first infusion. However, it may take several weeks before your symptoms improve. For some people, symptoms may start to improve after 6 weeks or so.

However, most people will need the full course of treatment before their symptoms improve. A full course of treatment usually takes about 5 months.

Tepezza: Dosage

Below you’ll find dosages that are commonly recommended for Tepezza. However, you should follow the treatment plan your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Tepezza’s forms and strengths

Tepezza is available as follows.

  • Form: powder that’s made into a solution and given by IV infusion
  • Strength: 500 milligrams (mg)

You’ll be given Tepezza infusions by a healthcare professional in an infusion center or your doctor’s clinic. In some cases, you may be able to receive this treatment at home.

Tepezza’s recommended dosage

To treat thyroid eye disease (TED), Tepezza typically is given once every 3 weeks for a total of eight infusions.

The dosage your doctor prescribes will depend on your body weight. For your first infusion, your dosage will be lower than the dosage for your following infusions. Recommended doses for Tepezza in adults are described below.

Adult dosage

The recommended dosage for Tepezza in adults is as follows.

Infusions, which are given once every 3 weeks Dose
first infusion 10 milligrams/kilogram (mg/kg)
second and following infusions 20 mg/kg

Here’s an example dosage calculation. For an adult weighing 60 kg (about 132 pounds), the recommended dose for their first infusion is 600 mg. For their next 7 infusions, the recommended dose is 1,200 mg.

Dosage considerations

Below are some things to consider about Tepezza’s dosage.

  • Missing a dose. If you miss an appointment to have a dose of Tepezza, call your doctor’s office right away to reschedule. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Length of treatment. Doctors typically don’t prescribe Tepezza as a long-term treatment. Instead, they typically prescribe a course of eight doses to treat TED. This course takes about 5 months to complete.

Tepezza: How it’s administered

A healthcare professional will administer Tepezza by IV infusion in an infusion center or your doctor’s clinic. In some cases, you may be able to receive Tepezza infusions at home. Check with your doctor and insurance company to learn whether home infusions are an option for you.

Your first two Tepezza infusions are usually given over 90 minutes or so. After the infusion has ended, your healthcare professional will monitor you for side effects for another 90 minutes.

If you don’t have infusion side effects with your first two infusions, the rest of your infusions may be given over 60 minutes or so.

Questions about receiving Tepezza

Here’s a list of common questions related to receiving Tepezza.

  • When should I receive Tepezza? You’ll typically receive Tepezza once every 3 weeks. You’ll have a total of eight infusions. Be sure to note your infusion schedule on your calendar. You could also set an alarm, use a timer, or download a reminder app on your phone. Also, ask whether you can schedule your next infusion in advance while you’re at the infusion center or your doctor’s office.
  • Do I need to receive Tepezza doses with food? No, you can receive Tepezza infusions on a full or empty stomach.
  • Can Tepezza be taken by mouth? No, Tepezza is given only by IV infusion. The drug wouldn’t work if it were taken by mouth because it would be broken down by your digestive system.

Tepezza: Consuming alcohol during treatment

Tepezza doesn’t interact with alcohol. However, consuming alcohol during treatment could increase certain Tepezza side effects, such as nausea, headache, or diarrhea.

Consuming alcohol during Tepezza treatment could also raise your risk for hyperglycemia (high blood sugar level).

If you drink alcohol, talk with your doctor about how much is safe to consume while you’re receiving treatment with Tepezza.

Tepezza: Interactions

Tepezza isn’t known to interact with other medications, supplements, or foods. However, this doesn’t mean interactions can’t happen with Tepezza.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

Before you start Tepezza, be sure to tell your doctor about any medications, herbs, vitamins, or supplements you take. They can check for any possible interactions between these products and Tepezza.

Tepezza: Using while pregnant

Tepezza is not safe to use in pregnancy. It could harm a developing fetus. Your doctor may want you to have a pregnancy test before you start receiving Tepezza to make sure you’re not pregnant.

If you’re pregnant or planning to become pregnant, talk with your doctor about alternative treatment options for your thyroid eye disease.

If you become pregnant during treatment with Tepezza, tell your doctor right away.

Tepezza: Birth control needs

Tepezza is not safe to use in pregnancy. Talk with your doctor about your birth control needs with Tepezza if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

If you’d like to learn more about taking Tepezza during pregnancy, see the “Tepezza: Using while pregnant” section above.

Note: Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

For females using Tepezza

If you’re a female able to become pregnant, you should use birth control during treatment with Tepezza. You should also continue to use it for 6 months after your last dose.

For males using Tepezza

The manufacturer of Tepezza hasn’t given birth control recommendations for males using the drug. If you’re a male using Tepezza and you’re sexually active with a female who’s able to become pregnant, talk with your doctor about your birth control needs.

Tepezza: Using while breastfeeding

Doctors don’t know whether Tepezza passes into breast milk or if it’s safe to use the drug while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor before receiving Tepezza.

Tepezza: Precautions

Tell your doctor about your health history before starting treatment with Tepezza. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

  • Allergic reaction. Your doctor will likely not prescribe Tepezza if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
  • Inflammatory bowel disease (IBD). If you have IBD, such as Crohn’s disease or ulcerative colitis, taking Tepezza could make your symptoms flare up or get worse. Talk with your doctor about whether Tepezza is right for you. If your doctor prescribes Tepezza, tell them if you have new or worsening IBD symptoms, such as diarrhea, bloody stools, rectal bleeding, or abdominal cramps. If Tepezza makes your IBD worse, your doctor may decide to stop giving you Tepezza.
  • Diabetes or prediabetes. Tepezza can increase your blood sugar level and may cause hyperglycemia (high blood sugar level). If you have diabetes or prediabetes, you may have a higher risk for this side effect. Before starting Tepezza, your doctor will likely check your blood sugar and may adjust your diabetes medication if needed. Talk with your doctor about how often your blood sugar should be checked during treatment with Tepezza. Your doctor will advise if any changes are needed to your diabetes treatment plan.
  • Pregnancy. Tepezza isn’t safe to use during pregnancy. If you’d like more information about taking Tepezza while pregnant, view the “Tepezza: Using while pregnant” section above.
  • Breastfeeding. It’s not known whether Tepezza passes into breast milk. If you’d like more information about taking Tepezza while breastfeeding, view the “Tepezza: Using while breastfeeding” section above.

To learn more about effects of Tepezza that could be harmful, see the “Tepezza: Side effects” section above.

Tepezza: Questions for your doctor

If you have questions about Tepezza, talk with your doctor. They can help advise you on whether Tepezza could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

  • Can Tepezza worsen irritable bowel syndrome (IBS)?
  • Can I receive Tepezza infusions at home?
  • If my eye symptoms come back after stopping Tepezza, can I have another course of treatment?
  • What are my other treatment options?

Your doctor may also tell you about other treatment options for your condition. You may find this series of videos helpful in learning about eye health. And check out our selection of videos on thyroid disease.

Disclaimer: Healthgrades 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.

Medical Reviewer: Purva Singla, PharmD
Last Review Date: 2022 May 22
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.