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Generic name: teplizumab-mzwv
Dosage form:  injection, for intravenous use
Drug class: Miscellaneous antidiabetic agents

Medically reviewed by Melisa Puckey, BPharm. Last updated on Jun 8, 2023.

What is Tzield?

Tzield (teplizumab-mzwv) is used to help slow down the progression from stage 2 to stage 3 type 1 diabetes. Type 1 diabetes is an autoimmune disorder where your own immune system attacks and destroys insulin-making cells (beta cells) in the pancreas. Tzield helps to prevent the immune system from attacking the beta cells,  which may help slow down the progression of type 1 diabetes. Tzield can help patients stay at stage 2 for longer meaning that patients can spend more time symptom free without the complication of needing insulin injections, checking blood glucose levels regularly and the risk of diabetic ketoacidosis, which can be life threatening.

In type 1 diabetes, the body's immune system, which normally fights harmful bacteria, mistakenly attacks and destroys the insulin-producing cells (beta cells) in the pancreas. This leads to reduced insulin production and increased blood sugar levels. Stage 2 of type 1 diabetes occurs before any diabetic symptoms appear, but there is some damage to the beta cells, causing slightly elevated blood sugar levels. Tests also reveal the presence of at least two types of antibodies against the pancreatic cells. In stage 3 of type 1 diabetes, there is further damage to the beta cells, resulting in minimal insulin production. Stage 3 patients experience common diabetic symptoms such as increased thirst, frequent urination, weight loss, fatigue, and diabetic ketoacidosis. Tests also confirm the presence of antibodies against the pancreatic cells in stage 3 patients.

Tzield (teplizumab-mzwv) is an  anti-CD3-directed antibody that binds to a protein (antigen) on the surface of T lymphocytes (white blood cell) which slows the immune system attacking the beta cells. Tzield is usually given as an infusion once a day for 14 days.

Who can use Tzield?

Tzield became FDA approved November 17, 2022 to be used to delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years of age and older with stage 2 type 1 diabetes. Patients should not fit the clinical history for type 2 diabetes. Patients must also be diagnosed as stage 2 type one diabetes by having:


Serious side effects can occur with Tzield

Cytokine Release Syndrome is a serious side effect that may occur during the first 5 days of treatment. Tell your healthcare provider right away if, during treatment, you develop any of these signs and symptoms, feeling unusually tired, fever, headache, nausea, or muscle and joint pain.

Decrease in white blood cells. This medicine may decrease the number of a type of white blood cells (lymphocytes)  that can affect your body's ability to fight infections.

Liver and complete blood counts.Your healthcare provider will do blood tests to check your liver and your complete blood counts before you start treatment and during treatment with this medicine. 

During and after your treatment, your healthcare provider will check for serious side effects, as well as other side effects, and treat you as needed. Your healthcare provider may temporarily or completely stop your treatment with this medicine if you develop liver problems, have a serious infection, or if your blood counts stay too low.

Before taking this medicine

Tell your doctor if you have:


Tzield may harm an unborn baby. Do not use if you are pregnant and for at least 30 days before a planned pregnancy. Tell your doctor if you become pregnant.

If you become pregnant while taking Tzield, you are encouraged to report your pregnancy to the Provention Bio’s Adverse Event reporting line at 1-844-778-2246.


Do not breastfeed while using this medicine. If you are considering breastfeeding, use a breast pump and throw out any milk you collect during treatment with this drug and for at least 20 days after your last dose.

How will I receive Tzield?

Teplizumab is a solution  injected into a vein (intravenous infusion) over approximately 30 minutes. You will receive this medicine once a day for 14 days.

Before starting this medicine you will have a complete blood count and liver enzyme tests.

You will be given other medications to help reduce side effects of fever, headache, muscle and joint pain, or nausea. Medicines may include ibuprofen, naproxen or other pain relievers such as acetaminophen, and an antihistamine, and an anti-nausea medicine. 

You should receive all appropriate vaccines before you start using this medicine. Live-attenuated (live) vaccines should be given at least 8 weeks before Tzield  treatment. Inactivated (killed) vaccines or mRNA vaccines should be given at least 2 weeks prior to treatment.

You will need regular blood tests before and during treatment with Tzield.

Your treatment may be temporarily or permanently discontinued if you have certain side effects.

Dosing information

Usual Adult and Pediatric Dose for Delay of Onset of Stage 3 Type 1 Diabetes:

Tzield is given by intravenous infusion (over a minimum of 30 minutes), using a body surface area-based dosing, once daily for 14 consecutive days as follows:

Do not administer two doses on the same day. 


Use: to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients aged 8 years and older with Stage 2 type 1 diabetes.

What should I avoid while receiving Tzield?

Avoid receiving an inactivated, mRNA, and "live" vaccine. The vaccine may not work as well while you are using teplizumab.

 Tzield side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your medical caregivers if you have signs of cytokine release syndrome (CRS), a serious side effect: fever, chills, trouble breathing, confusion, severe vomiting or diarrhea, fast or irregular heartbeats, feeling light-headed or very tired.

Tzield may cause serious side effects. Call your doctor at once if you have:

Common side effects of Tzield may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Tzield?

Other drugs may affect Tzield, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use. To check for interactions with Tzield click on the link below.

What are the ingredients in Tzield?

Active ingredient: teplizumab-mzwv.
Inactive ingredients: dibasic sodium phosphate, monobasic sodium phosphate, polysorbate 80, sodium chloride, and water for injection.



Provention Bio, Inc., 55 Broad Street, Red Bank, NJ 07701.

Popular FAQ

Tzield (teplizumab-mzwv) is an injectable medicine that is used to delay the onset of stage 3 Type 1 diabetes in people whose immune system has begun attacking their insulin-producing cells. Continue reading

Tzield is thought to work by binding to CD3 (a cell surface antigen present on T lymphocytes) to delay the onset of stage 3 type 1 diabetes in adults and children 8 and older with stage 2 type 1 diabetes. Tzield may also deactivate the immune cells that attack insulin-producing cells while increasing the proportion of cells that help moderate the immune response. Tzield is classified as an anti-CD3 monoclonal antibody. Continue reading

Tzield has been shown to delay the progression of Stage 2 type 1 diabetes to Stage 3 type 1 diabetes by 25 months (approximately 2 years) in a phase 3, randomized, double-blind clinical trial. In an extended follow-up of this trial (duration 923 days), the average time to diagnosis of stage 3 type 1 diabetes was 59.6 months for Tzield-treated patients compared with 27.1 months for patients given a placebo (a difference of 32.5 months). Continue reading

Tzield is given by intravenous infusion over a minimum of 30 minutes once daily for 14 consecutive days. Dosage is based on body surface area and increases. Continue reading

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.