Tepezza (teprotumumab-trbw) can cause side effects that range from mild to serious. Examples include muscle spasm, infusion-related reaction, and severe hearing loss. If side effects from Tepezza become difficult to tolerate, talk with your doctor about coping tips or other treatment options.

Tepezza is used in adults to treat thyroid eye disease (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 (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 Tepezza overview.

* 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. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult for you to tolerate.

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. 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.

Tepezza may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to the drug’s prescribing information.

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.

Serious side effects have been reported with Tepezza include:

For more information about some of these side effects, see the “Side effect specifics” section.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while receiving Tepezza and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Tepezza can cause an allergic reaction. But this side effect wasn’t reported in studies.

In general, symptoms of an allergic reaction can be mild or serious.

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 and can determine whether you should continue Tepezza treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty 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.

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 the 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 of Tepezza are long term, such as:

  • hearing loss
  • hair loss
  • weight loss
  • nail disorders, such as a color change or splitting
  • menstrual cycle issues, such as irregular or no periods
  • increased blood sugar

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. For more information about some of these side effects, see “Side effect specifics.”

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

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

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:

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 you can do

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 you can do

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 difficulty 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.

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 received when you had the side effect
  • how soon you had the side effect after receiving 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.

Consider the following important information before starting Tepezza.

Warnings

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:

If you have questions about who should not take Tepezza, talk with your doctor for more information.

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.

Pregnancy

Tepezza is not safe to receive 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 due to the risk of fetal harm.

Breastfeeding

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

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.