• Hepatitis B virus reactivation: Daratumumab-based therapy may be associated with hepatitis B virus (HBV) reactivation. You have reached the maximum limit. Notify blood transfusion centers and blood banks that a patient has received daratumumab/hyaluronidase. SubQ: Administer into the subcutaneous tissue of the abdomen ~3 inches (7.5 cm) to the right or left of the navel over ~3 to 5 minutes.

In a large pooled safety population of patients who received daratumumab/hyaluronidase as monotherapy or in combination, 11% of patients experienced a systemic administration-related reaction; grade 2 and 3 events were observed. Weeks 55 and beyond: Daratumumab 1,800 mg/hyaluronidase 30,000 units once every 4 weeks until disease progression or unacceptable toxicity. Multiple myeloma (relapsed/refractory): SubQ: As monotherapy; in patients who have received at least 3 prior lines of therapy (Mateos 2020): In combination with lenalidomide and dexamethasone (Dh-Rd); in patients who have received at least 1 prior therapy: In combination with bortezomib and dexamethasone (Dh-Vd); in patients who have received at least 1 prior therapy: Weeks 1 to 9: Daratumumab 1,800 mg/hyaluronidase 30,000 units once weekly for a total of 9 doses. Combination therapy: IV or Oral: Dexamethasone 20 mg (or equivalent) prior to each daratumumab/hyaluronidase dose. Daratumumab/hyaluronidase in combination with lenalidomide is contraindicated for use during pregnancy. Larger doses of hyaluronidase may be required.

Monitor therapy, Leflunomide: Immunosuppressants may enhance the adverse/toxic effect of Leflunomide. or pronounce in different accent or variation ? Refer to Dexamethasone, Lenalidomide, Bortezomib, Melphalan, and/or Prednisone monographs for dosing when used as a part of daratumumab-based combination therapy. Do not shake.

Avoid combination, Nivolumab: Immunosuppressants may diminish the therapeutic effect of Nivolumab. Each drug entry includes links to check for clinical trials listed in NCI's List of Cancer Clinical Trials. Note: Check label to ensure appropriate product is administered (daratumumab [IV] and daratumumab/hyaluronidase [SubQ] are different products and are not interchangeable). Management: Patients receiving salicylates (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. In patients with a history of chronic obstructive pulmonary disease, also consider short- and long-acting bronchodilators and inhaled corticosteroids. Avoid combination, CloZAPine: Myelosuppressive Agents may enhance the adverse/toxic effect of CloZAPine. Treatment of newly diagnosed multiple myeloma (in combination with lenalidomide and dexamethasone) in adults who are ineligible for autologous stem cell transplant.

Interference with these assays by daratumumab may affect the determination of complete response and disease progression in some patients with IgG kappa myeloma protein. Infusion bags/containers must be made of polyvinylchloride (PVC), polypropylene (PP), polyethylene (PE), or polyolefin blend (PP+PE). • Do not interchange: Daratumumab/hyaluronidase (for subcutaneous administration) and daratumumab (for IV administration) have different dosing and are NOT interchangeable. If coadministered, monitor for reduced efficacy of the immunosuppressant during concomitant use.

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