Targeted Therapy / Oncology — Hematologic

Darzalex (daratumumab)

Janssen Oncology · Anti-CD38 Monoclonal Antibody

FDA Approved 2015 Intravenous (IV) infusion or subcutaneous injection Specialty Medication
Darzalex daratumumab vials, Janssen Oncology, anti-CD38 for multiple myeloma

What is Darzalex? Darzalex (daratumumab) is an anti-CD38 monoclonal antibody by Janssen approved for multiple myeloma in multiple treatment lines — both as monotherapy and in numerous combination regimens. Darzalex Faspro is the subcutaneous formulation.

About Darzalex

Brand NameDarzalex
Generic / INNdaratumumab
Drug ClassAnti-CD38 Monoclonal Antibody
ManufacturerJanssen Oncology
AdministrationIntravenous (IV) infusion or subcutaneous injection
FDA Approval2015
📦 Darzalex IV: 100 mg/5 mL and 400 mg/20 mL (20 mg/mL) vials. Darzalex Faspro SC: 1800 mg/15 mL prefilled cartridge with co-formulated hyaluronidase-fihj.

FDA-Approved Uses for Darzalex

Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.

  • Multiple myeloma — newly diagnosed, transplant-eligible (VTd, VRd, D-VMP)
  • Multiple myeloma — newly diagnosed, transplant-ineligible (D-Rd, D-VMP)
  • Multiple myeloma — relapsed/refractory (multiple combinations: D-Pd, D-Kd, D-Vd, D-Rd, monotherapy)
  • Light chain (AL) amyloidosis — with bortezomib, cyclophosphamide, dexamethasone (daratumumab SC)
Biomarker Note: CD38 expression is universally high in multiple myeloma. No specific biomarker testing is required for approved indications.

How Does Darzalex Work?

Daratumumab targets CD38 — a transmembrane glycoprotein highly expressed on myeloma cells. It kills myeloma cells through multiple mechanisms: complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cellular phagocytosis (ADCP), and induction of apoptosis.

Dosage & Administration

IV regimen: complex schedule (weekly × 8, every 2 weeks × 16, then every 4 weeks). SC (Darzalex Faspro): 1800 mg fixed dose, approximately 3–5 minutes — dramatically faster than IV. Specific dosing schedules depend on the combination regimen.

⚠️ Important

Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.

Warnings, Precautions & Side Effects

General Warning

Infusion-related reactions — very common with IV (pre-medication required); significantly less with SC. Neutropenia, thrombocytopenia. Infections (hepatitis B reactivation screening required). Embryo-fetal toxicity. Interference with serologic testing (cross-reacts with blood typing assays).

⛔ Serious Warnings & Precautions
  • Infusion-related reactions
  • Neutropenia
  • Thrombocytopenia
  • Hepatitis B reactivation
  • Blood typing interference
  • Embryo-fetal toxicity

Common Side Effects

  • Infusion-related reactions (IV)
  • Upper respiratory infections
  • Fatigue
  • Nausea
  • Anemia
  • Neutropenia
  • Thrombocytopenia
  • Diarrhea

This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.

Storage & Handling

Refrigerate at 2°C to 8°C (36°F to 46°F). Do not freeze.

BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.

Insurance Coverage, Prior Authorization & Patient Assistance

🛡️ Commercial Insurance

Darzalex is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.

✅ Prior Authorization

Prior authorization is required by virtually all insurance plans for Darzalex. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.

🏥 Medicare Coverage

Medicare Part B covers this IV medication when administered in a clinical setting. Medicaid coverage varies by state.

🆓 Patient Assistance

Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.

Prior Authorization Patient Assistance Insurance & Savings Medication Costs

Frequently Asked Questions — Darzalex

Darzalex is an anti-CD38 antibody approved for multiple myeloma across nearly every treatment line. It kills myeloma cells through multiple immune mechanisms and has become a backbone of most modern myeloma regimens.

Darzalex Faspro (daratumumab and hyaluronidase-fihj) is the subcutaneous formulation — given as a 3–5 minute injection rather than the 3–7 hour IV infusion, with significantly fewer infusion reactions.

Yes — daratumumab binds CD38 on red blood cells used in lab tests, causing false-positive results in indirect antiglobulin tests (blood typing). Patients must inform transfusion services they are receiving daratumumab.

Darzalex IV is covered by Medicare Part B; Darzalex Faspro (SC) coverage may be Part B or Part D depending on where administered. Prior authorization required.

Related Medications

Sarclisa (isatuximab)  ·  Velcade (bortezomib)  ·  Revlimid (lenalidomide)  ·  Kyprolis (carfilzomib)  ·  Abecma (idecabtagene vicleucel)

Related Conditions

Multiple myeloma  ·  AL amyloidosis  ·  Relapsed/refractory myeloma

Comparisons

Abecma Bortezomib

Authoritative References

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your oncologist, hematologist, or licensed healthcare professional before making any treatment decisions. Last reviewed: August 2026 by the BiologicHealthPlus Clinical Team.