Vusolimogene oderparepvec-wtpg (Tudriqev ™)

Author: Marisa Healy, BSN, RN
Content Contributor: Lauren Nakata, PharmD
Last Reviewed: October 7, 2026

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Pronounce: voo-soh-LIM-oh-jeen OH-der-pair-EP-vek

Classification: Genetically modified oncolytic viral therapy

About Vusolimogene oderparepvec-wtpg (Tudriqev ™)

Vusolimogene oderparepvec-wtpg is a genetically modified virus. It is a weakened version of the Herpes Simplex Virus Type 1, which can cause cold sores. The virus replicates (multiplies) within a tumor and expresses the proteins GM-CSF and GALV-GP-R–. This starts an immune response in your body to help with the lysis (breakdown) of cancer cells.

This medication should not be used in patients who are pregnant or have a compromised immune system from HIV, AIDS, blood or bone marrow cancer, autoimmune disease, or who are being treated with steroids. The effectiveness of vusolimogene oderparepvec-wtpg can be affected by anti-viral medications, such as acyclovir, and certain vaccines. Talk with your provider before starting any new medications and before getting any new vaccines.

Because this injection includes viral materials, accidental exposure may cause a viral infection for close contacts or your caregiver. If accidental exposure happens, clean the area with soap and water. Tell your provider if there are any signs of herpetic viral infection, like small bumps that turn into blisters or sores.

How to Take This Medication

This medication is injected directly into a tumor that can be seen or felt by your provider. It can also be injected into a deeper tumor that is found with ultrasound guidance. The dose depends on the number and size of tumors being treated. You will likely receive this medication every two weeks for 8 consecutive doses. It is given in combination with an intravenous (IV, into a vein) medication called nivolumab. This medication sheet will focus on vusolimogene oderparepvec-wtpg.

There is a risk of bleeding, infection, or injury to other organs near the injection site. You may need to stay at the treatment center and be monitored after the injection for procedure-related reactions. For patients receiving injections for liver, lung, or kidney tumors, monitoring is recommended for at least 2 to 4 hours after the injection. Call your provider right away if you have a fever or bleeding at the injection site.

The injection site should be covered for at least 48 hours after the injection. You or your caregiver should wash your hands before and after changing the dressing. Wear gloves if you need to change the dressing. Old dressings, gloves, and cleaning materials should be sealed in plastic bags before you put them in the trash. Don’t touch or scratch the injection site.

Possible Side Effects

These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.

Fatigue

Fatigue can cause exhaustion, feeling worn out and that your body is "heavy" and hard to move, or being unable to focus. It is common when you have cancer, and it is not the same as feeling tired. You may need to adjust your schedule to manage fatigue. Plan times to rest during the day and save your energy for more important activities. Exercise can help lessen fatigue. Talk to your providers about ways to deal with this side effect.

Low Red Blood Cell Count (Anemia)

Anemia is when your red blood cell count is lower than normal. Red blood cells carry oxygen to the tissues in your body. When your red cell count is low, you may feel tired or weak. Tell your providers if you have shortness of breath, trouble breathing, or pain in your chest. If your count gets too low, you may receive a blood transfusion.

Infection and Low White Blood Cell Count (Leukopenia or Neutropenia)

This medication can cause serious infections, with or without a decrease in white blood cell counts.

White blood cells (WBC) help your body fight infection. While you are having cancer treatment, your WBC count can drop, putting you at a higher risk of an infection. Tell your provider right away if you have a fever (a temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.

Tips for preventing infection:

  • Hand washing,  both yours and your visitors, is the best way to prevent the spread of infection.
  • Avoid large crowds and people who are sick (those who have a cold, fever, or cough, or if someone you live with has these symptoms).
  • When working outside, wear clothes that protect you, like long pants and gloves.
  • Do not handle pet waste.
  • Keep all cuts and scratches clean.
  • Shower or bathe daily.
  • Brush your teeth at least twice a day.
  • Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
  • Ask your providers before scheduling dental appointments or procedures.

Ask your providers before you or someone you live with has any vaccines. 

Joint or Muscle Pain

You may have joint or muscle pain:

  • Arthralgia pain is like arthritis pain. It can cause morning stiffness, and you may feel it in your joints at different times during the day. It can also cause pain in your elbows, shoulders, wrists, knees, feet, pelvic and hip bones, or back.
  • Myalgia is pain or aching in your muscles. 

Your providers can recommend medication and other ways to relieve pain.

Nausea and/or Vomiting

Talk to your providers if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty foods and spicy or acidic foods, like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.  

Call your providers if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.

Diarrhea

Diarrhea is when you pass three or more stools in a day. Your providers can suggest medications to relieve diarrhea. Do not take any medications to manage your diarrhea without talking to your provider first, as your stool may need to be tested. To manage it, try eating foods that are low in fiber and bland, like white rice and boiled or baked chicken. Try not to eat raw fruits, vegetables, whole grain breads, cereals, and seeds. Soluble fiber is a type of fiber found in some foods that helps absorb (soak up) fluid. Foods high in soluble fiber are applesauce, bananas (ripe), canned fruit, oranges, boiled potatoes, white rice, foods made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Stay hydrated by drinking 8 to 10 glasses of non-alcoholic, non-caffeinated fluid each day.

Injection Site Reaction

You may have irritation or injury where this medication was injected (put into your body). You may have pain, bruising, or bleeding. Call your provider if these symptoms do not get better or get worse as time goes on.

Electrolyte Abnormalities

This medication can affect your electrolytes (potassium, magnesium, sodium, calcium, etc.). Your electrolyte levels will be checked with blood tests. If your levels get too low, you may be given electrolytes by IV (intravenously through your vein) or by mouth. Talk to your provider before taking any supplements. 

Reproductive Concerns

There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy.

Talk with your provider about what kind of birth control is safest for you and your partner.

If you can become pregnant, you will need to use effective birth control during treatment and for 90 days after the last dose of this medication, even if your menstrual cycle has stopped or changed.

If you can get someone pregnant, you will need to use effective birth control during treatment and for 90 days after the last dose of this medication, even if you believe you are not producing sperm.

You should not breastfeed during treatment with this medication.

Important but Less Common Side Effects

Immune-Related Problems

This medication affects your immune system. It may cause kidney problems, inflamed blood vessels (vasculitis), swelling of the lungs (pneumonitis), worsening skin problems (such as psoriasis and vitiligo). Tell your provider about any immune diseases you have.

Herpes Infection

Because this medication contains the herpes virus, it can cause a herpes infection. Symptoms of a herpes infection are:

  • Pain, burning, or tingling in a blister around the mouth, genitals, fingers, or ears.
  • Eye pain, sensitivity, discharge from the eyes, and blurry vision.
  • Weakness in the arms and legs
  • Extreme fatigue and drowsiness.
  • Mental confusion.

If you or anyone in close contact with you has any of these symptoms, it is important to call your provider.