Talvey (talquetamab-tgvs) is a prescription drug that’s used to treat certain types of multiple myeloma. Talvey comes as an injection that a healthcare professional will give you.
Talvey is prescribed to adults to treat multiple myeloma that has come back or hasn’t responded to medications in the past. Your doctor may prescribe Talvey if you’ve taken at least four other medications before it, including:
- proteasome inhibitors
- immunomodulatory agents
- anti-CD38 monoclonal antibodies
To learn more about Talvey’s uses, see the “What is Talvey used for?” section below.
Talvey basics
Talvey contains the active ingredient talquetamab-tgvs. (An active ingredient is what makes a drug work.)
Talvey is a biologic medication. A biologic is made from parts of living organisms. Talvey is available only as a brand-name drug. It isn’t available in a biosimilar form.
Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
Biosimilars will have the same active ingredient core name as the brand-name drug. But they’ll have unique four-letter suffixes at the end of the name of their active ingredient. This helps distinguish them from biosimilars that may be created in the future.
Talvey is prescribed to treat multiple myeloma that has come back or hasn’t responded to medications in the past. Adults should have taken at least four other medications before starting Talvey, including:
- proteasome inhibitors
- immunomodulatory agents
- anti-CD38 monoclonal antibodies
Blood cells (red, white, and platelets) are made in your bone marrow. The white blood cells help fight infection as part of your immune system response.
Plasma cells and T cells are types of white blood cells. But with multiple myeloma, which is a blood cancer, plasma cells that are cancerous multiply in the marrow. These cancerous cells build up and crowd out noncancerous blood cells.
Multiple myeloma can cause symptoms such as bone pain, weight loss, and infection.
Talvey is a type of immunotherapy. This means that the drug helps activate your immune system to fight cancer. Talvey works to treat multiple myeloma by allowing the T cells to destroy the cancerous cells.
Note: The FDA granted Talvey
Like most drugs, Talvey may cause mild or serious side effects. The lists below describe some of the more common side effects that Talvey may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Talvey. They also can suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Talvey can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Talvey’s prescribing information.
Mild side effects of Talvey that have been reported include:
- fever and chills
- change in taste
- skin or nail problems, such as dry skin and discoloration or deepened color
- dry mouth
- weight loss
- tiredness
- pain in your bones, muscles, ligaments, or nerves
- low blood pressure
- headache
- diarrhea
- upper respiratory infection, such as the common cold
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Talvey can occur. If you have serious side effects from Talvey, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Talvey that have been reported include:
- oral problems, such as altered taste, dry mouth, reduced appetite, and difficulty swallowing, which may contribute to significant weight loss
- infection, such as from bacteria, sepsis, and COVID-19
- low levels of certain blood cells, such as neutrophils, platelets, or red blood cells
- skin damage, such as rash and deepening of color
- liver problems, including increased blood levels of certain liver enzymes
- high fever
- extreme tiredness, pain, or headache
- extremely low blood pressure
- high heart rate
- lower amounts of oxygen circulating through the body, which may cause shortness of breath, confusion, or coordination problems
- boxed warnings: risk of cytokine release syndrome and serious neurologic damage*
- severe allergic reaction†
* For more information, see the “What should be considered before using Talvey?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.
Allergic reactionAlthough allergic reaction wasn’t reported in studies of Talvey, it can still occur.
Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause difficulty breathing.
Call your doctor right away if you have an allergic reaction to Talvey. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Talvey that’s right for you. Below are commonly prescribed dosages. Your doctor will determine the right dosage for your condition.
Form and strengths
Talvey comes as a liquid solution that you receive as an injection under your skin. It’s available in two strengths:
- 3 milligrams in 1.5 milliliters of liquid solution (2 mg/mL)
- 40 mg/mL
Recommended dosages
Your Talvey dose is based on your weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb). So your actual dose will be in mg/kg. Depending on your prescribed dose, you may receive multiple injections.
A healthcare professional will inject your Talvey dose under your skin.
When you first start Talvey treatment, your doctor likely will prescribe a low dosage. Then they’ll gradually increase the dose and give it more frequently. This is called “step-up” dosing. Step-up dosing helps reduce your risk of developing side effects, such as cytokine release syndrome.*
After you finish step-up dosing, you’ll receive an injection of Talvey once every 1 or 2 weeks. These are called your treatment doses.
* Talvey has boxed warnings about the risks of cytokine release syndrome and serious neurologic damage. A boxed warning is the most serious warning from the FDA. For more information, see the “What should be considered before using Talvey?” section below.
Step-up doses followed by treatment doses every week
The following table shows recommended dosages beginning with step-up dosing and followed by treatment doses every week.
| Day | Dose type | Dose |
|---|---|---|
| 1 | step-up dose 1 | 0.01 mg/kg |
| 4 | step-up dose 2 | 0.06 mg/kg |
| 7 | first treatment dose | 0.4 mg/kg |
| 14† | second treatment dose and all following treatment doses | 0.4 mg/kg once per week‡ |
† Your doctor will determine the actual day for your second treatment dose. Day 14 is only an example, so your actual day may differ. Studies recommend receiving the second treatment dose 1 week after the first.
‡ All treatment doses following the second treatment dose should be at least 6 days apart.
As an example for this dosage, assume a person weighs 70 kg, which is about 154 lb. Their doctor would prescribe:
- step-up dose 1: 0.7 mg
- step-up dose 2: 4.2 mg
- all doses thereafter: 28 mg
Step-up doses followed by treatment doses every 2 weeks
The following table shows recommended dosages beginning with step-up dosing and followed by treatment doses every 2 weeks.
| Day | Dose type | Dose |
|---|---|---|
| 1 | step-up dose 1 | 0.01 mg/kg |
| 4 | step-up dose 2 | 0.06 mg/kg |
| 7 | step-up dose 3 | 0.4 mg/kg |
| 10 | first treatment dose | 0.8 mg/kg |
| 24§ | second treatment dose and all following treatment doses | 0.8 mg/kg once every 2 weeks¶ |
§ Your doctor will determine the actual day for your second treatment dose.Day 24 is only an example, so your actual day may differ. Studies recommend receiving the second treatment dose 2 weeks after the first.
¶ All treatment doses following the second treatment dose should be at least 12 days apart.
As an example for this dosage, assume a person weighs 80 kg, which is about 176 lb. Their doctor would prescribe:
- step-up dose 1: 0.8 mg
- step-up dose 2: 4.8 mg
- step-up dose 3: 32 mg
- all doses thereafter: 64 mg
How to use
Your doctor will explain how you’ll receive Talvey. They’ll also explain your dose and how often you’ll receive it.
Talvey is available as a liquid solution that you receive as an injection under your skin. You’ll receive these injections from a healthcare professional.
A healthcare professional injects the Talvey dose under your skin. Usually, they’ll inject it into your abdomen, but they might use your thigh or another area.
Between 1–3 hours before certain doses, you’ll likely be given medications to reduce your risk of cytokine release syndrome*. You may swallow the medications or receive them by intravenous (IV) infusion. (An IV infusion is an injection given into your vein over a period of time). The medications are:
- a corticosteroid, such as dexamethasone
- an antihistamine, such as diphenhydramine
- a pain and fever reducer, such as acetaminophen
After a step-up dose or if you experience certain side effects, you may need to be hospitalized for up to 48 hours. This is so that you can be monitored for possible serious side effects.
* Talvey has boxed warnings about the risks of cytokine release syndrome and serious neurologic damage. A boxed warning is the most serious warning from the FDA. For more information, see the “What should be considered before using Talvey?” section below.
Questions about using Talvey
Below are some common questions about Talvey administration.
- What if I miss a dose of Talvey? If you miss an appointment to receive an injection of Talvey, call your doctor’s office as soon as possible to reschedule. Depending on your prescribed dosage and how long it’s been since your last dose, you may need to return to step-up dosing. (This is explained above in the “Recommended dosages” section above.) Your doctor will determine the best way to handle a missed dose for you.
- Will I need to receive Talvey long term? Talvey is usually prescribed as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely receive it long term.
- How long does Talvey take to work? Talvey begins to work after you receive your first dose. In studies, cancerous cells started to respond to Talvey in just over 1 month. Your doctor will order tests throughout your treatment to check whether Talvey is working for your condition.
Below is important information you should consider before starting Talvey.
Interactions
Using a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Talvey can interact with several other medications.
Before starting Talvey treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Drug interactions
Drugs that are broken down by cytochrome P450 can interact with Talvey. Cytochrome P450 is an enzyme in the liver. Numerous drugs are broken down by cytochrome P450.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Talvey and alcohol
Alcohol isn’t known to interact with Talvey. However, drinking alcohol may increase your risk of liver problems. Talvey may also cause liver problems. So drinking alcohol while receiving Talvey may increase your risk of liver problems.
Because of this, your doctor may recommend that you limit the amount of alcohol you drink during Talvey treatment.
Pregnancy and breastfeeding
Your doctor will likely recommend that you do not receive Talvey while you’re pregnant due to a risk of fetal harm. They may have you take a pregnancy test before you start treatment.
If you’re planning to become pregnant, talk with your doctor before starting Talvey treatment.
You should not breastfeed during Talvey treatment and for 3 months after your last dose.
Birth control
If you’re able to become pregnant, you should use effective birth control throughout your Talvey treatment. And you should continue using it for 3 months after your last dose.
Boxed warnings
Talvey has boxed warnings about the risks of cytokine release syndrome and serious neurologic damage. A boxed warning is the most serious warning from the FDA about drug effects that may be dangerous.
The boxed warnings are described below.
Risk of cytokine release syndrome (CRS)
Talvey helps activate your immune system to fight cancer. Your immune system makes cytokine, which is a type of protein. Cytokines help your immune system respond to infections. But if you receive Talvey for multiple myeloma, it may cause your body to make too many cytokines.
Too many cytokines put your immune system into overdrive, known as CRS. CRS may cause a range of symptoms. These may include inflammation, fever, low blood pressure, and the need to have supplemental oxygen. CRS could lead to death in extreme cases or if it is left untreated.
To reduce the risk of CRS, doctors will usually start Talvey with step-up dosing. This means that Talvey is started at a low dose and increased gradually over time. Doctors also may give you certain medications before you receive a dose of Talvey. This may help reduce the risk of certain side effects.
Risk of serious neurologic damage
Talvey may increase the risk of developing serious problems in your brain, spinal cord, or nerves. This includes a condition called immune effector cell-associated neurotoxicity syndrome (ICANS). Symptoms of ICANS may include memory problems, headache, and seizure. In extreme cases or if left untreated, ICANS can lead to death.
If you develop CRS or neurologic damage while receiving Talvey, your doctor may stop your treatment until symptoms resolve. But in severe cases, your doctor may stop your Talvey treatment permanently.
Because of the risks of CRS and neurologic damage, only trained healthcare professionals will inject your Talvey doses. And after certain doses, you may be admitted to the hospital for 48 hours to be monitored.
Talvey is available only through a risk evaluation and mitigation strategy (REMS) program. REMS programs are required by the FDA for certain drugs to help make sure they’re given safely.
Your doctor will monitor you for these risks throughout your treatment. To learn more about these boxed warnings, talk with your doctor.
Other warnings
Talvey can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Talvey is a good treatment option for you.
Talk with your doctor about your health history before you receive Talvey. Be sure to tell them if any of the following factors apply to you:
- active infection or skin rash
- low blood levels of platelets or neutrophils
- mouth ulcers or other oral problems that make swallowing difficult
- liver problems
- past allergic reaction to Talvey
- pregnancy
- breastfeeding
Find answers to some commonly asked questions about Talvey.
Does Talvey cause long-term side effects?
It’s not known whether Talvey causes long-term side effects. These side effects include those that may start at any time during treatment with a drug, even if you’ve been receiving treatment with it for a long time. It also includes side effects that may not go away, even after you stop treatment with the drug.
The FDA granted Talvey
If you’re concerned about possible long-term side effects from Talvey, talk with your doctor or pharmacist.
How does Talvey compare with Tecvayli?
Both Talvey and Tecvayli are prescribed to treat specific multiple myeloma. The condition either must have come back or not responded to at least four other medications.
Each drug contains different active ingredients. Talvey contains the active ingredient talquetamab-tgvs, and Tecvayli contains the active ingredient teclistamab-cqyv. (An active ingredient is what makes a drug work.)
Both drugs come as injections you receive under your skin by a healthcare professional. Treatment with both drugs starts with step-up dosing* to reduce the risk of serious side effects. But after step-up dosing, you might receive Talvey once every 1 or 2 weeks, while you might receive Tecvayli once per week. The dose you’ll receive for either drug depends on your body weight.
Talvey and Tecvayli belong to different groups of drugs.
If you have other questions about how Talvey and Tecvayli compare, talk with your doctor. They can help you find the best treatment option for you.
* Step-up dosing helps reduce your risk of developing certain side effects. It means your doctor will prescribe a low dose and then gradually increase it and give it more frequently. After that, you’ll receive a treatment dose routinely. See the “What is Talvey’s dosage?” section above for more information.
Is Talvey prescribed for other types of cancer?
No, it’s not at this time. But studies are still ongoing to learn more about Talvey’s safety and effectiveness.
To learn more about treatment options for other types of cancer, including Talvey, talk with your doctor.
Whether you have health insurance or not, cost may be a factor when you’re considering Talvey. What you’ll pay for Talvey may depend on several things, such as your treatment plan and the pharmacy you use.
Here are a few things to consider regarding cost:
- Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Talvey when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
- Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Janssen Compass may be available to you.
You can also check out this article to learn more about saving money on prescriptions.
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Other drugs are available that can treat your condition. If you’d like to explore an alternative to Talvey, talk with your doctor. They can tell you about other medications that might work for you.
The following drugs also treat multiple myeloma that either has returned or hasn’t responded to at least four other medications:
- Tecvayli (teclistamab-cqyv)
- Carvykti (ciltacabtagene autoleucel)
- Elrexfio (elranatamab-bcmm)
- Abecma (idecabtagene vicleucel)
If you have questions about receiving Talvey, talk with your doctor or pharmacist. Questions you may want to ask include:
- How will you decide whether I should receive a dose of Talvey once per week or once every 2 weeks?
- Do any of the medications I’m taking interact with Talvey?
- Are there specific times I should plan to be in the hospital for treatment?
To learn more about Talvey, see these articles:
To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.