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SUMMARY
- The recommended dose of DARZALEX is 16mg/kg actual body weight administered as an intravenous infusion according to the schedules listed in Section 2.2 Recommended Dosage of the DARZALEX Prescribing Information.1
- The recommended dose of 16 mg/kg to be administered on Day 1 when DARZALEX is administered as monotherapy or in combination may be split over two consecutive days, such that an 8 mg/kg dose is administered on Day 1 and Day 2, respectively.1
- Following the dilution with 0.9% Sodium Chloride Injection, USP as outlined in Section 2.5 Preparation for Administration in the DARZALEX Prescribing Information, administer DARZALEX infusion intravenously at the appropriate infusion rate, as outlined in Table: Infusion Rates for DARZALEX (16 mg/kg) Administration. Consider incremental escalation of the infusion rate only in the absence of infusion-related reactions (IRRs).1
- For the week 2 infusion, use a dilution volume of 500 mL only if there were no IRRs the previous week. Otherwise, continue to use a dilution volume of 1000 mL.
- Use a modified initial rate for subsequent infusions (i.e. week 3 onwards) only if there were no IRRs during the previous infusion. Otherwise, continue to use instructions for the week 2 infusion.
- For dosing instructions of combination agents administered with DARZALEX, see Section 14 Clinical Studies in the DARZALEX Prescribing Information and manufacturer's prescribing information for the combination agent.1
- For IRRs of any grade/severity, immediately interrupt the DARZALEX infusion and manage symptoms. Management of IRRs may further require reduction in the rate of infusion, or treatment discontinuation of DARZALEX.1
PRODUCT LABELING
Please note the following as stated in the DOSAGE AND ADMINISTRATION Section of the DARZALEX Prescribing Information:
2.2 Recommended Dosage
Infusion Rates for DARZALEX (16 mg/kg) Administration1
|
|
|
|
|
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Week 1 infusion
|
Option 1 (Single dose infusion)
|
Week 1 Day 1 (16 mg/kg)
| 1000 mL
| 50 mL/hour
| 50 mL/hour every hour
| 200 mL/hour
|
Option 2 (Split dose infusion)
|
Week 1 Day 1 (8 mg/kg)
| 500 mL
| 50 mL/hour
| 50 mL/hour every hour
| 200 mL/hour
|
Week 1 Day 2 (8 mg/kg)
| 500 mL
| 50 mL/hour
| 50 mL/hour every hour
| 200 mL/hour
|
| 500 mL
| 50 mL/hour
| 50 mL/hour every hour
| 200 mL/hour
|
| 500 mL
| 100 mL/hour
| 50 mL/hour every hour
| 200 mL/hour
|
aConsider incremental escalation of the infusion rate only in the absence of infusion-related reactions. bUse a dilution volume of 500 mL for the 16 mg/kg dose only if there were no infusion-related reactions the previous week. Otherwise, use a dilution volume of 1000 mL. cUse a modified initial rate (100 mL/hour) for subsequent infusions (i.e. Week 3 onwards) only if there were no infusion-related reactions during the previous infusion. Otherwise, continue to use instructions indicated in the table for the Week 2 infusion rate.
|
2.4 Dosage Modifications for Adverse Reactions
- No dose reductions of DARZALEX are recommended. Consider withholding DARZALEX to allow recovery of blood cell counts in the event of myelosuppression, per Sections 5.3 and 5.4 of the DARZALEX Prescribing Information.1
- For IRRs of any grade/severity, immediately interrupt the DARZALEX infusion and manage symptoms. Management of IRRs may further require reduction in the rate of infusion, or treatment discontinuation of DARZALEX as outlined1:
- Grade 1-2 (mild to moderate): Once reaction symptoms resolve, resume the infusion at no more than half the rate at which the reaction occurred. If the patient does not experience any further reaction symptoms, infusion rate escalation may resume at increments and intervals as clinically appropriate up to the maximum rate of 200 mL/ hour (Table: Infusion Rates for DARZALEX (16 mg/kg) Administration).
- Grade 3 (severe): Once reaction symptoms resolve, consider restarting the infusion at no more than half the rate at which the reaction occurred. If the patient does not experience additional symptoms, resume infusion rate escalation at increments and intervals as outlined in Table: Infusion Rates for DARZALEX (16 mg/kg) Administration. Repeat the procedure above in the event of recurrence of grade 3 symptoms. Permanently discontinue DARZALEX upon the third occurrence of a grade 3 or greater IRR.
- Grade 4 (life threatening): Permanently discontinue DARZALEX.
Literature Search
A literature search of MEDLINE®, Embase®, BIOSIS Previews®, and Derwent Drug File (and/or other resources, including internal/external databases) was conducted on 09 October 2025.