Anti-CD38 monoclonal antibody (specialist)

Daratumumab

Brand names: Darzalex

Adult dose

Dose: IV: 16mg/kg per protocol; SC (Darzalex Faspro): 1800mg fixed dose per protocol

Route: IV / Subcutaneous

Frequency: Weekly cycles 1–2, q2w cycles 3–6, then q4w

Clinical pearls

Multiple NICE TAs (myeloma 1st line / relapsed-refractory; AL amyloidosis)
BSH myeloma guidelines
Inform transfusion lab — daratumumab interferes with antibody screen / crossmatch
HBV screen before initiation

Contraindications

Hypersensitivity
Active hepatitis B (screen before; risk of reactivation)

Side effects

Infusion reactions (especially first dose — pre-medication required)
Cytopenias
Infections (URTI, PJP)
Diarrhoea
Hepatitis B reactivation
Interferes with crossmatch (IAT positive — coombs interference)

Interactions

Live vaccines
Other immunosuppressives

Monitoring

FBC
HBV
Infusion reactions
Infections

Reference: BNF; multiple NICE TAs; BSH myeloma; SmPC; https://bnf.nice.org.uk/drugs/daratumumab/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways