Formulary
Daratumumab: Indications, Dosing, Side Effects and Interactions
Daratumumab is a monoclonal antibody that binds to CD38, a cell-surface protein, resulting in tumour cell death by immune-mediated actions and apoptosis.
MedNext Academy | 3 min read
Daratumumab: Indications, Dosing, Side Effects and Interactions
Daratumumab is a monoclonal antibody that binds to CD38, a cell-surface protein, resulting in tumour cell death by immune-mediated actions and apoptosis.
Drug action
Daratumumab is a monoclonal antibody that binds to CD38, a cell-surface protein, resulting in tumour cell death by immune-mediated actions and apoptosis.
Indications and dose
**Multiple myeloma (specialist use only)**
- **Adult** (By Intravenous Infusion, Or By Subcutaneous Injection): Specialist indication - access specialist resources for dosing information.
**Light-chain (AL) amyloidosis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): (consult product literature or local protocols).
Cautions
History of obstructive pulmonary disorder (consider additional post-medication-consult product literature); patients may need pre-medication to minimise adverse reactions; risk of herpes zoster reactivation (consider antiviral prophylaxis) Cautions, further information Infusion-related reactions Serious infusion-related reactions can occur following either intravenous or subcutaneous injection, and daratumumab should only be administered by appropriately trained staff where resuscitation facilities are available; manufacturer advises pre-medication with a corticosteroid, an antihistamine and an anti-pyretic and post-medication with oral corticosteroids-consult product literature. Manufacturer advises patients should be closely monitored for signs of infusion-related reactions during and after administration; in the event of a hypersensitivity reaction, treatment should be stopped immediately and appropriate management initiated.
Side effects
Common or very common With parenteral use Anaemia; appetite decreased; arthralgia; asthenia; atrial fibrillation; chills; constipation; cough; decreased leucocytes; dehydration; diarrhoea; dizziness; dyspnoea; fever; headache; hyperglycaemia; hypertension; hypocalcaemia; hypogammaglobulinaemia; increased risk of infection; infusion related reaction; insomnia; muscle spasms; nausea; neutropenia; pain; pancreatitis; paraesthesia; peripheral neuropathy; peripheral oedema; pulmonary oedema; sepsis; skin reactions; syncope; thrombocytopenia; vomiting Uncommon With parenteral use Hepatitis B reactivation Rare or very rare With parenteral use Anaphylactic reaction Side-effects, further information Manufacturer advises treatment should be immediately interrupted if an infusion-related reaction of any grade or severity occurs-consult product literature for specific management recommendations.
Interactions
**Other interactions (6):**
- Due to the high affinity to a unique epitope on CD38, daratumumab is not anticipated to alter drugmetabolising enzymes.
- Clinical pharmacokinetic assessments with daratumumab intravenous or subcutaneous formulations and lenalidomide, pomalidomide, thalidomide, bortezomib, melphalan, prednisone, carfilzomib,...
- Interference with indirect antiglobulin test (indirect Coombs test) Daratumumab binds to CD38 on RBCs and interferes with compatibility testing, including antibody screening and cross matching (see...
- Daratumumab interference mitigation methods include treating reagent RBCs with dithiothreitol (DTT) to disrupt daratumumab binding or other locally validated methods.
- Interference with serum protein electrophoresis and immunofixation tests Daratumumab may be detected on serum protein electrophoresis (SPE) and immunofixation (IFE) assays used for monitoring...
- In patients with persistent very good partial response, where daratumumab interference is suspected, consider using a validated daratumumabspecific IFE assay to distinguish daratumumab from any...
Pregnancy
Avoid-no information available. M See also Pregnancy and reproductive function in Cytotoxic drugs .
Breast feeding
Manufacturer advises avoid-no information available.
Medicinal forms
Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Daratumumab in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

