From the Guidelines
The most common side effects of Tepezza (Teprotumumab) include hyperglycemia, muscle spasms, nausea, alopecia, diarrhea, tinnitus and hearing impairment, dysgeusia, headache, weight loss, nail disorders, and menstrual disorders. These side effects are associated with the use of Teprotumumab, a human monoclonal antibody inhibitor of IGF-IR, as reported in the 2024 study published in Ophthalmology 1. The study highlights that Teprotumumab treatment is not suitable for everyone, particularly those with inflammatory bowel disease, pregnancy, or pre-existing hearing loss.
- Key side effects to monitor include:
- Hyperglycemia, which is crucial for diabetic patients to closely monitor their glucose levels during treatment
- Muscle spasms, which may affect the legs and back
- Hearing impairment, including tinnitus, which can persist after treatment ends
- Gastrointestinal symptoms like nausea and diarrhea
- Dermatological effects such as alopecia and nail disorders It is essential for patients to report any persistent or severe side effects to their healthcare provider, as dose adjustments or supportive treatments may be necessary to manage these effects while continuing therapy 1.
From the FDA Drug Label
The most common adverse reactions (≥5%) that occurred at greater incidence in the TEPEZZA group than in the control group during the treatment period of Studies 1 and 2 are summarized in Table 1
Adverse ReactionsTEPEZZAN=84N (%)PlaceboN=86N (%)
- Fatigue includes asthenia † Hyperglycemia includes blood glucose increase ‡ Hearing impairment including hearing loss (deafness, including sensorineural deafness, eustachian tube dysfunction, hyperacusis, hypoacusis, autophony and tinnitus) § Nail disorder (includes nail discoloration, nail disorder and onychoclasis) Muscle spasms21 (25%)6 (7%) Nausea14 (17%)8 (9%) Alopecia11 (13%)7 (8%) Diarrhea10 (12%)7 (9%) Fatigue*10 (12%)6 (7%) Hyperglycemia†8 (10%)1 (1%) Hearing impairment‡8 (10%)0 Dysgeusia7 (8%)0 Headache7 (8%)6 (7%) Dry skin7 (8%)0 Weight decreased5 (6%)0 Nail disorder§4 (5%)0
The most common side effects of Tepezza (Teprotumumab) are:
- Muscle spasms (25%)
- Nausea (17%)
- Alopecia (13%)
- Diarrhea (12%)
- Fatigue (12%)
- Hyperglycemia (10%)
- Hearing impairment (10%)
- Dysgeusia (8%)
- Headache (8%)
- Dry skin (8%)
- Weight decreased (6%)
- Nail disorder (5%) 2
From the Research
Common Side Effects of Tepezza (Teprotumumab)
The most common side effects of Tepezza (Teprotumumab) include:
- Nausea
- Diarrhoea
- Muscle spasms
- Hearing impairment
- Dysgeusia
- Headaches
- Dry skin
- Infusion reactions
- Hyperglycaemia 3
- Fatigue 4
- Hair loss 4
- Weight loss 4
- Gastrointestinal disturbances 4
- Menstrual changes 4
Serious Side Effects
Some patients may experience serious side effects, such as:
Management of Side Effects
It is essential to monitor patients for these side effects and manage them accordingly. For example, hyperglycemia can be managed by monitoring blood sugar levels and adjusting treatment as needed 4. Hearing changes can be monitored, and possible upcoming therapies can be reviewed 4.
Dose Adjustment
In some cases, dose adjustment may be necessary to minimize side effects. For example, a lower dose of teprotumumab (10 mg/kg) has been shown to be effective in reducing the severity of adverse events, including sensorineural hearing loss 5.