Dosing and administration

Dosing and
TZIELD is administered over the course of a single 2-week period
Recommended dosing schedule1:
Day 1
65 mcg/m2
Day 2
125 mcg/m2
Day 3
250 mcg/m2
Day 4
500 mcg/m2
Days 5-14
1030 mcg/m2
Dosing and administration instructions1:
30 minutes
TZIELD is administered by intravenous infusion (over a minimum of 30 minutes), using body surface area–based dosing, once daily for 14 consecutive days.
A single-dose vial
Dosage form and strength:
2 mg per 2 mL (1 mg/mL), clear and colorless solution in a single-dose vial.
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Do not administer 2 doses on the same day.
A calendar with a date crossed out
If an infusion is missed:
Resume by administering all remaining doses on consecutive days to complete the 14-day course.
Explore more details on dosing and administering TZIELD
Labs and premedication
Labs prior to initiation
Prior to initiating TZIELD, obtain a complete blood count and liver enzyme tests. Use of TZIELD is not recommended in patients with certain laboratory abnormalities1:
  • Lymphocyte count less than 1000 lymphocytes/mcL
  • Hemoglobin less than 10 g/dL
  • Platelet count less than 150,000 platelets/mcL
  • Absolute neutrophil count less than 1500 neutrophils/mcL
  • Elevated ALT or AST greater than 2 times the upper limit of normal (ULN) or bilirubin greater than 1.5 times ULN
  • Laboratory or clinical evidence of acute infection with Epstein-Barr virus (EBV) or cytomegalovirus (CMV)
  • Active serious infection or chronic active infection other than localized skin infections
Administer all age-appropriate vaccinations prior to starting TZIELD:
  • Administer live-attenuated (live) vaccines at least 8 weeks prior to treatment
  • Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment
Premedicate prior to TZIELD infusion for the first 5 days of dosing with: (1) a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen, (2) an antihistamine, and/or (3) an antiemetic. Administer additional doses of premedication if needed.1
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Step-by-step TZIELD dosing instructions:
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Important Safety Information
TZIELD is a CD3-directed monoclonal antibody indicated to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients aged 8 years and older with Stage 2 T1D.
  • Cytokine Release Syndrome (CRS): CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration. Prior to TZIELD treatment, premedicate with antipyretics, antihistamines and/or antiemetics, and treat similarly if symptoms occur during treatment. If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.
  • Serious Infections: Use of TZIELD is not recommended in patients with active serious infection or chronic infection other than localized skin infections. Monitor patients for signs and symptoms of infection during and after TZIELD administration. If serious infection develops, treat appropriately, and discontinue TZIELD.
  • Lymphopenia: Lymphopenia occurred in most TZIELD-treated patients. For most patients, lymphocyte levels began to recover after the fifth day of treatment and returned to pretreatment values within two weeks after treatment completion and without dose interruption. Monitor white blood cell counts during the treatment period. If prolonged severe lymphopenia develops (<500 cells per mcL lasting 1 week or longer), discontinue TZIELD.
  • Hypersensitivity Reactions: Acute hypersensitivity reactions including serum sickness, angioedema, urticaria, rash, vomiting and bronchospasm occurred in TZIELD-treated patients. If severe hypersensitivity reactions occur, discontinue TZIELD and treat promptly.
  • Vaccinations: The safety of immunization with live-attenuated (live) vaccines with TZIELD-treated patients has not been studied. TZIELD may interfere with immune response to vaccination and decrease vaccine efficacy. Administer all age-appropriate vaccinations prior to starting TZIELD.
    • Administer live vaccines at least 8 weeks prior to treatment. Live vaccines are not recommended during treatment, or up to 52 weeks after treatment.
    • Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment. Inactivated vaccines are not recommended during treatment or 6 weeks after completion of treatment.
Most common adverse reactions (>10%) were lymphopenia, rash, leukopenia, and headache.
  • Pregnancy: May cause fetal harm.
  • Lactation: A lactating woman may consider pumping and discarding breast milk during and for 20 days after TZIELD administration.
Please see full Prescribing Information, including patient selection criteria, and Medication Guide. View Important Safety Information page.
Reference: 1. TZIELD Prescribing Information. Provention Bio, Inc; 2023.