Daratumumab Treatment: Uses, Dosage, and Side Effects Explained

Summary or Key Points

Daratumumab is a prescription medication used to treat various blood cancers, including multiple myeloma and amyloidosis. It works by targeting specific proteins on cancer cells, allowing the immune system to recognize and destroy them. Daratumumab is typically administered as an infusion or as an injection under the skin. Always consult your healthcare provider before starting or adjusting treatment. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Darzalex

Generic Name: Daratumumab

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Daratumumab is the generic name, and Darzalex is the brand name.

Pharmacologic Category

Monoclonal Antibody

Anti-CD38 Agent

Daratumumab Dosage

Daratumumab is approved for treating several conditions in adults. The dosage and frequency depend on the specific condition being treated. Always consult your doctor before making any changes to your dose. You can also speak with one of our telemedicine providers for guidance.

Daratumumab for Multiple Myeloma

Initial Dose: 16 mg/kg via intravenous (IV) infusion once weekly for the first 8 weeks.

Maintenance Dose: After the initial 8 weeks, the dose is administered every 2 weeks for 16 weeks, then every 4 weeks thereafter.

Daratumumab for Amyloidosis

Initial Dose: 16 mg/kg via IV infusion once weekly for the first 6 weeks.

Maintenance Dose: After the first 6 weeks, the dose is administered every 2 weeks for 6 months, then every 4 weeks thereafter.

Waldenström’s Macroglobulinemia

Initial Dose: 16 mg/kg via IV infusion once weekly for the first 8 weeks.

Maintenance Dose: After the initial 8 weeks, the dose is administered every 2 weeks for 16 weeks, then every 4 weeks thereafter.

Daratumumab for Chronic Lymphocytic Leukemia

Initial Dose: 16 mg/kg via IV infusion once weekly for 6 weeks.

Maintenance Dose: After the first 6 weeks, the dose is administered every 2 weeks for 6 months, then every 4 weeks thereafter.

Daratumumab for Non-Hodgkin Lymphoma

Initial Dose: 16 mg/kg via IV infusion once weekly for the first 8 weeks.

Maintenance Dose: After the initial 8 weeks, the dose is administered every 2 weeks for 16 weeks, then every 4 weeks thereafter.

Daratumumab for Acute Lymphoblastic Leukemia

Initial Dose: 16 mg/kg via IV infusion once weekly for 6 weeks.

Maintenance Dose: After the first 6 weeks, the dose is administered every 2 weeks for 6 months, then every 4 weeks thereafter.

Lymphoplasmacytic Lymphoma

Initial Dose: 16 mg/kg via IV infusion once weekly for the first 8 weeks.

Maintenance Dose: After the initial 8 weeks, the dose is administered every 2 weeks for 16 weeks, then every 4 weeks thereafter.

Daratumumab for Plasma Cell Leukemia

Initial Dose: 16 mg/kg via IV infusion once weekly for 6 weeks.

Maintenance Dose: After the first 6 weeks, the dose is administered every 2 weeks for 6 months, then every 4 weeks thereafter.

Myeloma Cast Nephropathy

Initial Dose: 16 mg/kg via IV infusion once weekly for the first 8 weeks.

Maintenance Dose: After the initial 8 weeks, the dose is administered every 2 weeks for 16 weeks, then every 4 weeks thereafter.

Dosage Forms and Strengths

Daratumumab is available in the following forms:

1. Injection, solution: 100 mg/5 mL (20 mg/mL)
2. Injection, solution: 400 mg/20 mL (20 mg/mL)
3. Subcutaneous injection: 1,800 mg/15 mL

Daratumumab Administration Guidelines

Daratumumab is administered either as an intravenous (IV) infusion or a subcutaneous injection. The IV infusion is given slowly over several hours, especially during the first dose, to monitor for any reactions. Subcutaneous injections are typically quicker and may be more convenient for some patients. Your healthcare provider will determine the best method for you. It’s important to follow all instructions from your healthcare team and report any side effects immediately. If you have any questions or concerns, you can consult one of our telemedicine providers for further guidance.

Contraindications for Daratumumab

A contraindication is a specific condition where a medication should not be used due to potential harm. For Daratumumab, certain conditions may make its use unsafe.

Severe allergic reactions (hypersensitivity): If you have had a severe allergic reaction to Daratumumab or any of its ingredients, you should not take this medication. Allergic reactions may include difficulty breathing, swelling of the face or throat, or severe skin rashes.

Active infections: Daratumumab can weaken your immune system, making it harder to fight infections. If you have an active infection, taking Daratumumab could worsen your condition.

Hepatitis B infection: Daratumumab can reactivate hepatitis B in patients with a history of the infection, potentially leading to severe liver damage. If you have a history of hepatitis B, your doctor may monitor you closely or suggest an alternative treatment.

Drug to Drug Interactions

It’s essential to inform your healthcare provider about all the medications you are currently taking, as Daratumumab can interact with other drugs. Some medications that may interact with Daratumumab include:

1. Immunosuppressants: Medications like tacrolimus (Prograf) and cyclosporine (Neoral) can further suppress your immune system when taken with Daratumumab, increasing your risk of infections.
2. Live vaccines: Vaccines such as MMR (measles, mumps, and rubella) or yellow fever should not be administered while you are on Daratumumab. Your immune system may not respond effectively, potentially leading to the illness the vaccine is designed to prevent.
3. Anticoagulants: Blood thinners like warfarin (Coumadin) or apixaban (Eliquis) may increase the risk of bleeding when taken alongside Daratumumab.

Daratumumab in Pregnancy

Is it Safe to Take Daratumumab During Pregnancy?

Daratumumab is generally not recommended during pregnancy unless absolutely necessary, as it may pose risks to an unborn baby by affecting the immune system. If you are pregnant or planning to become pregnant, it’s important to discuss this with your healthcare provider. They will carefully weigh the benefits and risks of continuing Daratumumab treatment and may suggest alternative options if needed.

Daratumumab while Breastfeeding

Is it Safe to Take Daratumumab While Breastfeeding?

It is currently unknown whether Daratumumab passes into breast milk. Due to the potential for serious side effects in a nursing infant, breastfeeding is not recommended while taking Daratumumab. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to determine the best course of action for both you and your baby.

Estimated Cost of Daratumumab

The cost of Daratumumab can be significant, especially without insurance coverage. A 30-day supply, using a GoodRx coupon, can range from $10,000 to $15,000. Prices may vary depending on your location and the pharmacy you use. It’s important to check with your insurance provider and explore patient assistance programs that may help reduce the cost of Daratumumab treatment.

Possible Alternatives to Daratumumab

If Daratumumab is not suitable for you, there are other treatment options available for the conditions it treats. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these alternatives in more detail.

1. Multiple Myeloma: Alternatives include bortezomib (Velcade), lenalidomide (Revlimid), and autologous stem cell transplantation. Lifestyle changes, such as maintaining a healthy diet and engaging in regular exercise, can also help manage symptoms.
2. Amyloidosis: Treatment options include chemotherapy drugs like cyclophosphamide and melphalan, along with supportive care to manage symptoms. Dietary adjustments and regular monitoring of organ function are also important.
3. Waldenström’s Macroglobulinemia: Rituximab (Rituxan) and ibrutinib (Imbruvica) are common alternatives. Regular monitoring and managing symptoms like anemia through diet and supplements may also be beneficial.
4. Chronic Lymphocytic Leukemia (CLL): Alternatives include ibrutinib (Imbruvica), venetoclax (Venclexta), and fludarabine. Staying active and eating a balanced diet can support your overall health during treatment.
5. Non-Hodgkin Lymphoma: Rituximab (Rituxan) and chemotherapy regimens like CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) are commonly used. Lifestyle changes, such as stress management and regular physical activity, may also be helpful.
6. Acute Lymphoblastic Leukemia (ALL): Common treatments include chemotherapy, radiation therapy, and stem cell transplants. Maintaining a healthy lifestyle and following your doctor’s recommendations for supportive care can improve outcomes.
7. Lymphoplasmacytic Lymphoma: Rituximab (Rituxan) and ibrutinib (Imbruvica) are often used. Regular monitoring and symptom management are key to living well with this condition.
8. Plasma Cell Leukemia: Treatment options include chemotherapy and stem cell transplantation. Supportive care, including pain management and nutritional support, can also improve quality of life.
9. Myeloma Cast Nephropathy: Treatment often involves managing the underlying multiple myeloma with medications like bortezomib (Velcade) or lenalidomide (Revlimid). Staying hydrated and following a kidney-friendly diet can help protect kidney function.

Recent Updates on Daratumumab Research

Recent studies have shown that Daratumumab, when combined with other medications, can significantly improve outcomes for patients with multiple myeloma. Ongoing research is also exploring its use in other blood cancers, such as amyloidosis and chronic lymphocytic leukemia. Additionally, new formulations, such as subcutaneous injections, are being developed to make Daratumumab administration more convenient for patients.

If you are interested in learning more about the latest research or exploring whether Daratumumab is right for you, schedule a telemedicine consultation with one of our providers today.

James Kingsley

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