[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) › Daratumumab

# Daratumumab

## Antineoplastic monoclonal antibodies?

Antineoplastic monoclonal antibodies

## High alert?

An error with this medicine can cause serious harm: double checks and protocols are used.

Human anti-CD38 antibody that marks myeloma cells for immune killing. Infusion reactions are common, and it disturbs blood-bank crossmatching for months.

Updated Nov 1, 2026

## Quick facts

**Group**
[Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/)

**Target**
CD38, a surface glycoprotein abundant on myeloma plasma cells

**Used for**
Multiple myeloma · The subcutaneous form is also used

**Key effects**
Infusion reactions · Upper respiratory infections

**Monitor**
Vital signs and breathing during · Blood count

**ATC**
L01FC01

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**CD38, a surface glycoprotein abundant on myeloma plasma cells**Daratumumab

ⓘ The crystal shows the extracellular domain of human CD38 bound to the antigen-binding fragment of daratumumab.

**Target in 3D:** CD38, a surface glycoprotein abundant on myeloma plasma cells. PDB structure 7DHA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7DHA) · Drag to rotate · pinch to zoom

Daratumumab is a human IgG1 antibody that binds CD38 on the surface of myeloma cells and other blood cells. The bound antibody recruits complement (complement-dependent cytotoxicity) and immune effector cells such as natural killer cells (antibody-dependent cellular cytotoxicity), which kill the tumour cell. Because it is given with other myeloma drugs, its effect adds to theirs.

- Daratumumab binds CD38 on myeloma cells
- Complement and NK cells are drawn to the coated cell
- The myeloma cell is destroyed

## Indications

- Multiple myeloma, newly diagnosed or relapsed, alone or with other drugs such as lenalidomide or bortezomib and dexamethasone. [Multiple myeloma →](https://durgical.com/en/conditions/multiple-myeloma/)
- The subcutaneous form is also used, with other drugs, in a type of amyloidosis in newly diagnosed adults. [Amyloidosis →](https://durgical.com/en/conditions/amyloidosis/)

## Adverse effects

### Common

- Infusion reactions: cough, wheeze, throat tightness, stuffy nose, chills
- Upper respiratory infections
- Tiredness, back and joint pain, muscle spasms
- Diarrhoea, constipation, swelling of the legs
- Tingling or burning in the hands and feet

### Serious (rare, important)

- Severe infusion reactions with bronchospasm and breathlessness
- Neutropenia and thrombocytopenia
- Reactivation of hepatitis B and of herpes zoster in people who had them

## Contraindications

- Previous severe allergy to daratumumab or its ingredients

## Key interactions

**Blood-bank compatibility tests (indirect antiglobulin test, crossmatch)**
Daratumumab can give false results for up to six months after the last dose; blood typing is done before the first dose and the blood bank is told.

**Other laboratory tests**
It can change the results of some tests, so the laboratory is told the patient receives it.

## What is monitored

- Vital signs and breathing during and after each infusion
- Blood count
- Blood type and antibody screen before the first dose
- Hepatitis B history and signs of infection or shingles

## Administration and safety

- Given by a doctor or nurse in a healthcare setting, with medicines before and after the infusion to prevent reactions.
- The intravenous and subcutaneous (with hyaluronidase) products are different preparations and are not interchanged.
- The infusion may be slowed or stopped if a reaction occurs.

## Pregnancy and breastfeeding

Contraception is used during treatment and for some months after the last dose.

## Nursing care

- Watch closely during the infusion and afterwards for cough, wheeze, throat tightness or breathlessness.
- Before any transfusion, tell the blood bank that the patient receives or received daratumumab.
- Ask about hepatitis B, shingles, asthma or COPD before starting.
- Teach the patient to report fever, bruising, bleeding or yellow skin.

## Pharmacokinetics

**Absorption**
Intravenous infusion; another form is injected under the skin together with hyaluronidase.

**Elimination**
Like other IgG antibodies, it is broken down by protein catabolism rather than by the liver or kidneys.

## Memory aid

DARA hits CD38 — and so does the blood bank: the antibody makes every crossmatch look positive, so type the blood before the first dose.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the target of daratumumab?

CD38, a glycoprotein abundant on myeloma plasma cells.

## By which two immune mechanisms does daratumumab kill myeloma cells?

Complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity.

## A patient on daratumumab needs a transfusion. What must the blood bank know?

That the patient receives daratumumab, because it interferes with compatibility testing for up to six months after the last dose.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/daratumumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

## Connections

## Related drugs 2

- [Bortezomib](https://durgical.com/en/pharmacology/bortezomib/)
- [Lenalidomide](https://durgical.com/en/pharmacology/lenalidomide/)

## Related conditions 2

- [Multiple myeloma](https://durgical.com/en/conditions/multiple-myeloma/)
- [Amyloidosis](https://durgical.com/en/conditions/amyloidosis/)

[← Back to the class: Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Daratumumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a616002.html) (MedlinePlus (U.S. National Library of Medicine), 2019); [Daratumumab and Hyaluronidase-fihj Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a620040.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [crystal structure of CD38 in complex with daratumumab](https://www.rcsb.org/structure/7DHA) (RCSB Protein Data Bank, 2021).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/daratumumab/
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