Darzalex (daratumumab) is a prescription drug that’s used to help treat multiple myeloma. The drug comes as an intravenous (IV) infusion. It’s usually given every 1 to 4 weeks.
Darzalex is used in adults to treat multiple myeloma. It can be prescribed on its own or in combination with another multiple myeloma treatments.
The active ingredient in Darzalex is daratumumab.
Darzalex belongs to a group of drugs called monoclonal antibodies.
This article describes the dosages of Darzalex, as well as its strengths and how it’s given. For a detailed overview of Darzalex for multiple myeloma, check out this in-depth Darzalex article.
The dose and dosing schedule for Darzalex for multiple myeloma are described below.
What form does Darzalex come in?
Darzalex comes as a liquid solution in a single-dose vial. A healthcare professional will mix this with another liquid solution before it’s injected into your vein as an IV infusion.
What strengths does Darzalex come in?
Darzalex comes in single-dose vials with the following strengths:
- 100 milligrams (mg) per 5 milliliters (mL)
- 400 mg/20 mL
What are the typical dosages of Darzalex?
The recommended dosage of Darzalex for treating multiple myeloma is 16 mg per kilogram (kg) of body weight. In other words, your doctor will calculate your dose by multiplying 16 mg for every kilogram you weigh. One kg is equal to about 2.2 pounds (lb).
For example, the Darzalex dose for a person who weighs 50 kg (about 110 pounds) would be 800 mg.
Darzalex may be prescribed on its own or in combination with other medications. Your dosing schedule and how long you take Darzalex will depend on:
- your diagnosis
- your treatment history
- any other medications you take with it
The dosing guides below show the recommended schedules for Darzalex infusions. Your doctor will determine the best dosage and dosing schedule to fit your needs.
Dosage for certain adults who can’t receive a stem cell transplant or whose previous treatments weren’t effective
Darzalex is given with other drugs or on its own for adults:
- who can’t receive a stem cell transplant using their own stem cells
- whose previous treatments with certain other drugs didn’t work well
Darzalex with lenalidomide and dexamethasone
The dosing guide chart below describes the dose and schedule for adults receiving Darzalex together with Revlimid (lenalidomide) and dexamethasone. This drug combination and dosing schedule are used for adults who:
- are newly diagnosed with multiple myeloma, and
- can’t receive a stem cell transplant using their own stem cells
It’s also used in adults whose:
- cancer has relapsed (come back), or
- condition didn’t improve with prior treatments
| Dosing schedule | |
|---|---|
| Weeks 1 to 8 | once per week (total of 8 doses) |
| Weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| Weeks 25 and beyond | once every 4 weeks |
Darzalex with pomalidomide and dexamethasone
The same dose and schedule are used for adults who will use Darzalex together with Pomalyst (pomalidomide) and dexamethasone. These people also have had two or more previous treatments, including:
- lenalidomide, and
- a proteasome inhibitor
| Dosing schedule | |
|---|---|
| Weeks 1 to 8 | once per week (total of 8 doses) |
| Weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| Weeks 25 and beyond | once every 4 weeks |
Darzalex by itself following other treatments
The following dosing guide can be used for adults who:
- have had three or more previous treatments, including:
- a proteasome inhibitor, and
- an immunomodulatory drug, or
- have multiple myeloma that didn’t respond to previous treatments, including:
- a proteasome inhibitor, and
- immunomodulatory drug
| Dosing schedule | |
|---|---|
| Weeks 1 to 8 | once per week (total of 8 doses) |
| Weeks 9 to 24 | once every 2 weeks (total of 8 doses) |
| Weeks 25 and beyond | once every 4 weeks |
Darzalex together with Velcade (bortezomib), melphalan, and prednisone
The dosing guide below explains the dose and schedule for adults who will receive Darzalex in combination with Velcade (bortezomib), melphalan, and prednisone. This drug combination and dosing schedule are used for adults who are newly diagnosed with multiple myeloma and can’t receive a stem cell transplant using their own stem cells.
| Dosing schedule | |
|---|---|
| Weeks 1 to 6 | once per week (total of 6 doses) |
| Weeks 7 to 54 | once every 3 weeks (total of 16 doses) |
| Weeks 55 and beyond | once every 4 weeks |
Dosage for certain adults with newly diagnosed multiple myeloma
Darzalex is given together with bortezomib, thalidomide, and dexamethasone for adults:
- with newly diagnosed multiple myeloma, and
- who can receive a stem cell transplant using their own stem cells
The dosing schedule has multiple parts:
- The first 16 weeks of dosing (called induction) aim to help induce (cause) your cancer to go into remission.
- Weeks 1 to 8: One dose per week (total of eight doses)
- Weeks 9 to 16: One dose every 2 weeks (total of four doses)
- After this, your Darzalex treatment is paused while you get high dose chemotherapy and a stem cell transplant using your own stem cells.
- Finally, you’ll receive consolidation dosing (dosing to kill any cancer cells left after initial treatments). This consists of a Darzalex infusion every 2 weeks until you’ve had a total of four more doses.
Dosage for adults whose previous treatments with certain other drugs didn’t work well
Darzalex is used along with bortezomib and dexamethasone in adults previously treated for multiple myeloma with at least one medication.
| Dosing schedule | |
|---|---|
| Weeks 1 to 9 | once per week (total of 9 doses) |
| Weeks 10 to 24 | once every 3 weeks (total of 5 doses) |
| Weeks 25 and beyond | once every 4 weeks |
Darzalex is used along with Kyprolis (carfilzomib) and dexamethasone in adults previously treated for multiple myeloma with up to three medications.
| Dosing schedule | Darzalex dose | |
|---|---|---|
| Week 1 | days 1 and 2 (total of 2 doses) | 8 mg/kg |
| Weeks 2 to 8 | once every week (total of 7 doses) | 16 mg/kg |
| Weeks 9 to 24 | once every 2 weeks (total of 8 doses) | 16 mg/kg |
| Weeks 25 and beyond | once every 4 weeks | 16 mg/kg |
How is a Darzalex dose given?
Darzalex is given by a healthcare professional in an infusion center or doctor’s office. You’ll receive it as an IV infusion. This is an injection into your vein over the course of several hours.
Your doctor will start the infusion at a slow rate and then increase it to a rate that’s right for you. The first infusion may take up to 7 hours. Future infusions will take less time, usually from 3 to 4 hours.
You may be given other medications before your Darzalex dose, including:
- Benadryl (diphenhydramine) or a similar antihistamine
- corticosteroids, such as dexamethasone or Medrol (methylprednisolone)
- Tylenol (acetaminophen), to help prevent or reduce fever
These medications help prevent a reaction to the Darzalex infusion. Other cancer medications may also be infused with Darzalex. You may also be administered medications after your infusion.
What if I miss a dose?
If you miss your Darzalex infusion appointment, call your doctor as soon as you remember. It’s important to follow your treatment schedule.
If you need help remembering to go in for your Darzalex appointments, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone. Try to schedule your next infusion appointment before you leave the office after each dose.
Is Darzalex used long term?
Your Darzalex treatment schedule is based on several factors. How long you’ll take Darzalex will be affected by:
- the type of combination drug therapy you receive
- when you were diagnosed with multiple myeloma
- how your cancer responds to treatment
If you and your doctor determine that Darzalex is safe and effective for you, you’ll likely receive these infusions long term.
Below are answers to a couple of common questions about Darzalex dosing.
What is Darzalex split dosing?
Darzalex split dosing is when your doctor splits the first infusion over 2 consecutive days. Studies have shown similar results at the end of the first week, whether the first dose was split or given all at once. Split dosing can improve your first experience with Darzalex because of the shorter infusions.
If I have kidney disease, will my dosage of Darzalex need adjustment?
There haven’t been any formal studies on Darzalex renal dosing in people with kidney disease. Your Darzalex dose doesn’t need to be adjusted if you have kidney problems.
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.