Johnson & Johnson rode growing sales of the cancer treatment Darzalex and other key drugs to a better-than-expected second quarter, but foreign exchange rates again cut into the health care giant’s 2022 forecast.

After trimming its forecast in April citing exchange rates, the company did so again Tuesday to a range that is below analyst expectations. Johnson & Johnson, which brings in nearly half of its sales from outside the United States, now expects earnings of $10 to $10.10 per share, down from the $10.15 to $10.35 it forecast in the spring.

Wall Street had been expecting earnings of $10.19 per share, according to FactSet.

The strong U.S. dollar is nearing parity with the euro for the first time in decades, and that can affect sales for companies that do a lot of international business. A stronger dollar makes U.S.-made products more expensive in overseas markets, while giving foreign products a price edge in the United States.

J&J drew more than $6 billion in sales from Europe in the second quarter and $12 billion from the U.S.

In the quarter for J&J, sales of the blood cancer treatment Darzalex jumped 39% to nearly $2 billion. Revenue from Stelara, which is used for psoriasis and other inflammatory disorders, climbed 14% to $2.6 billion.

Sales of J&J’s one-shot COVID-19 vaccine, which debuted last year, totaled $544 million, with only $45 million coming from the United States.

U.S. regulators in May strictly limited who can receive Johnson & Johnson’s COVID-19 vaccine due to the ongoing risk of rare but serious blood clots. That came a month after J&J said it was suspending sales projections for the vaccine, from which it doesn’t intend to profit.

Outside pharmaceuticals, which make up J&J’s biggest business, sales slipped for the company’s medical device and consumer health segments but grew slightly when not counting exchange rates.

J&J said last fall it will split off its consumer health business, which sells Band Aids and beauty products, into a separate, publicly traded company. That will allow the world’s largest maker of health care products to focus on pharmaceuticals and medical devices.

J&J’s quarterly profit plunged 23% to $4.81 billion compared with last year, when earnings jumped as hospitals and the rest of the health care industry recovered from the initial impact of the pandemic.

Adjusted earnings per share totaled $2.59 and sales grew 3% to $24.02 billion.

Industry analysts expected earnings of $2.54 per share on $23.77 billion in revenue.

Shares of the New Brunswick, New Jersey, company edged up less than 1% to $175.63 before the opening bell.

The stock has climbed about 2% so far this year while the Dow Jones industrial average, of which J&J is a member, has dropped about 14%.