- What is tocilizumab, and how does it work (mechanism of action)?
- What is tocilizumab used for?
- What are the side effects of tocilizumab?
- What is the dosage for tocilizumab?
- Which drugs or supplements interact with tocilizumab?
- Is tocilizumab safe to take if you are pregnant or breastfeeding?
- What else should you know about tocilizumab?
What is tocilizumab, and how does it work (mechanism of action)?
- Tocilizumab is an injectable synthetic (man-made) protein that binds to interleukin-6 (IL-6) in the body and blocks the effects of IL-6 in patients with rheumatoid arthritis. Inflammation is the body's reaction to injury and is a necessary process for the repair of injury. IL-6 is a protein that the body produces when there is inflammation. IL-6 promotes inflammation and the signs of inflammation, which, in the case of arthritis, includes fever as well as pain, tenderness, and swelling of the joints. The unchecked inflammation of rheumatoid arthritis eventually leads to destruction of the joints. Tocilizumab binds to IL-6 in the body and thereby blocks the effects of IL-6. As a result, inflammation and its consequences in the joints are reduced, and the progressive destruction of the joints is slowed or prevented.
- The FDA approved tocilizumab in January 2010.
- The brand name for tocilizumab is Actemra.
- Tocilizumab is not available in generic form. You need to obtain a prescription for tocilizumab.
What is tocilizumab used for?
Tocilizumab is prescribed to treat:
- Moderately to severe active arthritis in adults.
- Giant cell arthritis.
- Polyarticular juvenile idiopathic arthritis in patients 2 years of age and older with active disease.
- Systemic juvenile idiopathic arthritis in patients 2 years of age and older with active disease.
- Cytokine release syndrome in patients 2 years of age and older with active disease.
What are the side effects of tocilizumab?
The most common adverse effects of tocilizumab in clinical studies were:
- respiratory tract infections,
- hypertension (high blood pressure), and
- elevations in liver tests suggesting liver injury.
Injection site reactions (rash, redness, swelling, itching) may also occur. Use of tocilizumab has been associated with serious infections such as:
- sepsis (bacteria in the blood) and
- fungal infections.
Individuals with active infections should not be treated with tocilizumab. Tocilizumab may worsen or cause new diseases of the nervous system. In studies, some patients who used tocilizumab developed cancer. Other side effects include:
- reduced levels of white blood cells or platelets,
- reactivation of herpes zoster infection (shingles), and
- hypersensitivity (allergic) reactions.
In studies, gastrointestinal perforation was observed in patients with diverticulitis.
What is the dosage for tocilizumab?
The recommended dose of tocilizumab is 4-8 mg/kg administered as a single 60 minute intravenous infusion every 4 weeks.
Which drugs or supplements interact with tocilizumab?
Tocilizumab has not been studied in combination with other similar drugs that block other chemicals that promote inflammation, for example, drugs that block TNF (for example, adalimumab [Humira]). Combining anakinra (Kineret), abatacept (Orencia), rituximab (Rituxan) with other antirheumatic drugs similar to tocilizumab resulted in a reduction in white blood cells in the blood (neutropenia), serious infections and no additional benefit. Tocilizumab may interfere with the effectiveness of vaccines. Live vaccines, including attenuated vaccines, should not be given to patients receiving tocilizumab.
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Is tocilizumab safe to take if you are pregnant or breastfeeding?
- There are no adequate studies of tocilizumab in pregnant women.
- It is not known whether tocilizumab is excreted in breast milk.
Tocilizumab (Actemra) is a man-made synthetic protein (injectable) prescribed for the treatment of rheumatoid arthritis. Side effects, drug interactions, patient safety and pregnancy information should be reviewed prior to taking any medication.
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Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Early RA signs and symptoms include anemia, both sides of the body affected (symmetric), depression, fatigue, fever, joint deformity, joint pain, joint redness, joint stiffness, joint swelling, joint tenderness, joint warmth, limping, loss of joint function, loss of joint range of motion, and polyarthritis.
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Still's disease is a disorder characterized by inflammation with high fever spikes, fatigue, salmon-colored rash, and/or arthritis. Though there have been several theories regarding the cause(s) of Still's disease, the cause is not yet known. Many symptoms of Still's disease are often treatable with anti-inflammatory drugs.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA prescribing information for Actemra.