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Tepezza (teprotumumab-trbw) is an FDA-approved treatment for Thyroid Eye Disease, also called Graves' orbitopathy. TED is a serious autoimmune condition that causes eye pain, redness, swollen eyelids and double vision. Tepezza treats the cause of TED, reducing symptoms and lessening the appearance of bulging eyes.

Last Modified: September 14, 2023
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What Is Tepezza Used For?

Tepezza is the only U.S. Food and Drug Administration-approved medication or drug used to treat thyroid eye disease, or TED. It is also known as Graves’ orbitopathy, Graves’ eye disease or thyroid-associated ophthalmopathy. The FDA approved Tepezza in 2020.

TED is an autoimmune inflammatory disorder of the soft tissues in the eye socket associated with thyroid dysfunction. 

The condition causes antibodies to attack the muscles associated with eye and eyelid movement. This leads to symptoms of pain, inflammation (swelling and redness), bulging eyes, double vision, retraction of the eyelids and, in severe cases, loss of sight.

How Does Tepezza Work?

Tepezza treats the cause of TED, not just the symptoms. The tissue behind the eye has cells with receptors on their surface that act like switches. When a person has TED, the body’s immune system attacks this tissue. The reaction activates molecules, called autoantibodies, to turn on the switches.

This action causes swelling of the muscles, fat and tissue in the eye socket, which are the symptoms of Graves’ eye disease. Tepezza is designed to bind the switch and block it from turning on. Although it does not cure thyroid eye disease, it relieves specific symptoms, including inflammation, bulging eyes and double vision.

A doctor or nurse slowly infuses the drug intravenously in the arm over the course of 90 minutes per Tepezza treatment. The treatments are given every three weeks and include up to eight infusions. In clinical studies, symptoms continued to get better during the entire course of treatments.

Tepezza Side Effects

Tepezza side effects include hearing loss, hearing changes, muscle spasms and hyperglycemia (high blood sugar). It can also cause infusion-related reactions such as headaches, trouble breathing or feeling hot. The active ingredient in Tepezza, teprotumumab, has been associated with minimal side effects in clinical trials.

The manufacturer indicates other common Tepezza side effects such as muscle cramps or spasms, nausea, hair loss, diarrhea, fatigue, high blood sugar, taste changes, dry skin and menstrual changes. 

How Much Does Tepezza Cost?

The manufacturer has priced Tepezza at $14,900 to $16,301.09 per vial in the United States. Treatment requires up to eight infusions. Total Tepezza cost will depend on your treatment plan.

Coverage for Tepezza varies depending on health insurance plans. Additional support may be available for people with government insurance, including Medicare, Medicare Part D, Medicaid, Medigap, VA, CHAMPUS, Department of Defense, TRICARE or any state patient, foundation or other pharmaceutical program.

Tepezza Lawsuits

People across the nation have filed several lawsuits against Tepezza, claiming the drug caused hearing loss.

Plaintiffs allege the manufacturer failed to warn them or their doctors that the medication could cause hearing loss or tinnitus.

Lawsuit Information
People who developed hearing loss or tinnitus after taking Tepezza are filing lawsuits.
View Lawsuits

Tepezza Interactions and Warnings

No studies have evaluated the drug interaction potential of Tepezza or its active ingredient, teprotumumab. 

Warnings for Tepezza (teprotumumab) include: 
  • Avoid During Pregnancy: Tepezza should not be used during pregnancy. Contraception methods should be used before taking the drug, during treatment and for six months following the last dose of the medication.
  • Hearing Impairment: The frequency, magnitude, reversibility and mechanism of hearing impairment associated with the use of Tepezza remains unclear in existing studies.
  • Hyperglycemia: Diabetes patients and those with preexisting impaired glucose require close monitoring while being treated with Tepezza because it has been shown to cause hyperglycemia in patients with a history of diabetes or prediabetes.
  • Inflammatory Bowel Disease: Tepezza may reactivate the condition in patients with a history of the disease.
  • Infusion Reactions: Adverse reactions, such as increased blood pressure, feeling hot, tachycardia and muscular pain, have occurred in around 4% of patients.
  • Muscle Spasm: Clinical studies show spasms, which may present in the lower limbs during Tepezza use, may be mild or moderate in severity.

Side effects were similar in men and women and did not change much for patients above and below age 65. The side effects may disappear during treatment as the body adjusts to the medicine. People who experience any infusion reaction symptoms after treatment should consult their doctor.

In July 2023, Horizon added the following warning to the drug’s label:

“Hearing Impairment Including Hearing Loss: Tepezza may cause severe hearing impairment including hearing loss, which in some cases may be permanent. Assess patients’ hearing before, during, and after treatment with Tepezza and consider the benefit-risk of treatment with patients.”

Please seek the advice of a medical professional before making health care decisions.