Tepezza is given as an intravenous (IV) infusion, meaning it’s delivered directly into a vein through an IV line. A full course of treatment consists of 8 infusions spaced 3 weeks apart, taking roughly 21 weeks from start to finish. Each infusion session lasts 60 to 90 minutes, though you should expect to spend around 3 hours total at the infusion center once check-in, IV setup, and post-infusion monitoring are factored in.
Dosing Schedule and Timeline
The first infusion uses a lower dose of 10 mg/kg of body weight. This serves as an introductory dose. Every infusion after that, infusions 2 through 8, uses a higher dose of 20 mg/kg. Your dose is calculated based on your weight, so two patients may receive different total amounts of medication.
Infusions are scheduled every 3 weeks. That means you’ll visit the infusion center roughly once every three weeks for about five months. Missing or delaying appointments can interrupt the treatment timeline, so most clinics work with patients to build a consistent schedule upfront.
What to Expect at the Infusion Center
Tepezza infusions are administered at specialized infusion centers, not at home. When you arrive, a nurse will check you in, take vitals, and insert an IV line. The medication itself flows through the IV over 60 to 90 minutes. After the infusion finishes, you’ll stay for at least 30 minutes of observation so staff can watch for any signs of a reaction.
Infusion reactions occur in about 4% of patients. These reactions can happen during any of the 8 infusions or within 1.5 hours afterward, which is why the observation window matters. Reactions may include symptoms like flushing, nausea, or changes in blood pressure. Staff at the infusion center are trained to manage these if they occur.
Pre-Treatment Screening
Before your first infusion, your care team will run several screenings. Women of childbearing age need a pregnancy test before starting treatment, and effective contraception is required during treatment and for 6 months after the final dose. Tepezza can harm a developing fetus, so this step is non-negotiable.
Blood sugar screening is also standard. Tepezza can raise blood glucose levels, sometimes significantly. All patients should have their blood sugar assessed before the first infusion. If you have diabetes or prediabetes, your care team will want your blood sugar well-controlled before treatment begins. Experts recommend that patients with pre-existing diabetes have an HbA1c below 7% before starting, and treatment should be delayed if HbA1c exceeds 9%.
Blood Sugar Monitoring During Treatment
Elevated blood sugar is one of the more notable side effects of Tepezza, and it deserves its own attention. Most cases of treatment-related hyperglycemia develop within the first 12 weeks, so monitoring is especially important during that window.
Your blood glucose will be checked before each infusion. If you have diabetes, you’ll likely be asked to monitor your levels daily at home using a standard glucose meter or a continuous glucose monitor. A follow-up HbA1c test is recommended around the 12-week mark to catch any significant changes early. Even if you don’t have a history of diabetes, your team should educate you on the warning signs of high blood sugar: increased thirst, frequent urination, blurred vision, and fatigue.
Because Tepezza sits at the intersection of eye disease and metabolic health, patients ideally work with both an ophthalmologist and an endocrinologist during treatment. This kind of coordinated care helps catch and manage blood sugar issues before they become serious.
How the Medication Is Prepared
You won’t need to handle any of this yourself, but understanding the process can help set expectations. Tepezza comes as a powder in a vial. The pharmacy or infusion center staff reconstitute it with sterile water, then dilute the solution in a saline bag before it’s connected to your IV line. The size of the saline bag depends on your dose: smaller bags for doses under 1,800 mg, larger bags for doses at or above that threshold. This preparation takes some time, which is part of why your total visit runs longer than the infusion itself.
The Full Treatment Arc
From the first infusion to the last, a complete course of Tepezza spans about 21 weeks. That’s 8 visits to the infusion center, each requiring roughly half a day when you account for travel, check-in, the infusion, and the observation period. Many patients begin noticing improvements in eye bulging and double vision partway through the course, though results vary. The treatment is designed to be completed as a full 8-infusion course, so sticking with the schedule matters for the best outcome.