Actemra is an interleukin inhibitor that’s frequently prescribed to treat arthritis. It’s also effective in auto-immune conditions such as giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, scleroderma, systemic sclerosis-associated interstitial lung disease, and severe cytokine release syndrome. Additionally, Actemra is approved to treat some adult COVID-19 patients. Patients ages 2-18 can also be treated with Actemra for COVID-19 under an emergency use authorization.

Tocilizumab is the active ingredient in Actemra. This medicine is available either as an intravenous (IV) solution or as a subcutaneous injection.

How Does Actemra Work?

Actemra is an interleukin inhibitor, which keeps the interleukin-6 protein from being activated in your body. Interleukin-6 is part of the immune system. Cells produce interleukin-6 when they’re injured or infected. This protein signals the immune system to respond to the problem. Ideally, interleukin-6 prompts an immune response that helps heal the injury.

However, overactive interleukin-6 is associated with auto-immune disorders such as arthritis. The protein attracts unnecessary immune responses that attack healthy parts of the body. This causes inflammation, pain, damage, loss of function, and more.

Actemra blocks the receptors where interleukin-6 would typically communicate with other cells. The tocilizumab particles connect with the receptors, so interleukin-6 cannot. This suppresses the overactive immune response that interleukin-6 would otherwise initiate.

Actemra Precautions and Warnings

Actemra changes how your immune system works,, so serious warnings should be considered before beginning this medicine. Actemra patients are more likely to experience significant infections such as tuberculosis, viral, and fungal infections. Actemra prevents your immune system from responding generally to illness, so these infections can lead to hospitalization or death.

You shouldn’t receive live vaccines while using Actemra. Live vaccines contain living, though weakened, versions of the disease they protect against. Since Actemra reduces your immune responses, you could get sick from these vaccines. You should also avoid people who have recently received live vaccines. Inactive vaccines are still safe to use.

It’s unclear whether Actemra is safe to use during pregnancy or breastfeeding. Tell your doctor if you’re pregnant, hope to become pregnant, or are nursing a baby before starting Actemra.

You should be free from infections before starting Actemra. Your doctor may test you for latent infections, which occur when infectious particles are in your body but you’re not experiencing any symptoms. Your doctor will also need to know about your complete medical history, including:

  • Repeat or chronic infections
  • Tuberculosis
  • Hepatitis B
  • Liver problems
  • Stomach or intestinal ulcers
  • Nervous system conditions like multiple sclerosis

Side Effects of Actemra

Actemra’s side effects include very mild symptoms and more serious issues.

Common Side Effects

The most common Actemra side effects are:

  • Runny nose
  • Sore throat
  • Sinus pain
  • Headache
  • Increase blood pressure
  • Abnormal liver levels
  • Irritation at the injection site

Serious Side Effects

Seek help immediately if you have signs of an allergic reaction, which include trouble breathing or swallowing, swollen face/tongue/throat, rash, itching, or hives. Don’t use Actemra if you’re allergic to tocilizumab or other ingredients.

Contact your doctor if you have any of these more serious symptoms:

  • Severe stomach upset such as cramps, diarrhea, constipation, or bloating
  • Unusual bleeding anywhere in the body
  • Blood in the stools or ruin
  • Coughing up blood
  • Vomit that looks like coffee grounds
  • Loss of appetite
  • Yellow eyes or skin
  • Vomiting
  • Confusion
  • Dark urine
  • Clay-colored bowel movements
  • Stomach pain on the right side of the body
  • Fever or chills
  • Body aches
  • Skin sores
  • Burning sensation during urination
  • Cough
  • Difficulty breathing
  • Night sweats
  • Weight loss
  • Fatigue
  • Ongoing stomach pain

Drug Interactions With Actemra

Actemra can interfere with other medicines you take, including over-the-counter drugs, vitamins, herbs, cannabis, alcohol, and more. Tell your doctor about all the medications you take. The following arthritis drugs are likely to interact with Actemra:

  • Abatacept
  • Etanercept (found in Enbrel)
  • Anakinra
  • Adalimumab (found in Humira)
  • Certolizumab
  • Golimumab
  • Infliximab
  • Rituximab

Strengths and Dosages of Actemra

Actemra dosages are based on the condition being treated and the patient’s age and size.

ConditionPatient AgeFormatDosage
Rheumatoid arthritisAdultIV4mg/kg IV as a single infusion once every 4 weeks, followed by 8mg/kg IV infusion every 4 weeks based on response
Rheumatoid arthritisAdult, under 100kgSubcutaneous injection162mg every other week, then every week based on response
Rheumatoid arthritisAdult, over 100kgSubcutaneous injection162mg every week
Giant cell arteritisAdultSubcutaneous injection162mg every week
Cytokine-associated toxicityAdultIV8mg/kg
Cytokine-associated toxicityPediatric, under 30kgIV12mg/kg
Cytokine-associated toxicityPediatric, over 30kgIV8mg/kg
Polyarticular juvenile idiopathic arthritisPediatric, under 30kgIV10mg/kg every 4 weeks
Polyarticular juvenile idiopathic arthritisPediatric, over 30kgIV8mg/kg every 4 weeks
Polyarticular juvenile idiopathic arthritisPediatric, under 30kgSubcutaneous injection162mg every 3 weeks
Polyarticular juvenile idiopathic arthritisPediatric, over 30kgSubcutaneous injection162mg every 2 weeks
Systemic juvenile idiopathic arthritisPediatric, under 30kgIV12mg/kg every 2 weeks
Systemic juvenile idiopathic arthritisPediatric, over 30kgIV8mg/kg every 2 weeks
Systemic juvenile idiopathic arthritisPediatric, under 30kgSubcutaneous injection162mg every 1 weeks
Systemic juvenile idiopathic arthritisPediatric, over 30kgSubcutaneous injection162mg every week

Alternatives to Actemra

Other interleukin inhibitors include the following prescriptions:

FAQs About Actemra

Why did my doctor prescribe me Actemra?

Actemra reduces your immune system’s response. People with auto-immune disorders like rheumatoid arthritis have overactive immune systems that attack healthy body parts. Actemra prevents your body from damaging itself.

Is there a generic for Actemra?

No, there is not a generic for Actemra.

What vaccines are safe for Actemra patients?

Actemra patients can receive inactive vaccines. These vaccines contain dead parts of the diseases they protect against, so there’s no risk of getting an infection from them.

What live vaccines should I avoid while using Actemra?

Actemra patients should not receive live vaccines, which include weak, living versions of the microorganisms that cause diseases. A healthy immune system can fight off the weak viral particles found in live vaccines. However, since Actemra suppresses the immune system, patients could become seriously ill from live vaccines. Live vaccines include MMR (measles, mumps, and rubella), smallpox, chickenpox, rotavirus, and yellow fever injections. Typhoid vaccine tablets and the nose spray flu vaccine are also live vaccines. Additionally, Actemra patients should avoid people who have been recently vaccinated with these vaccines.

How is Actemra delivered?

Actemra is available as an IV solution and a subcutaneous injection. Most patients will receive the IV solution in a medical facility such as a hospital or doctor’s office. Patients who are prescribed the subcutaneous injection may administer their own medicine at home.

Can I take Actemra if I’m pregnant?

It’s unclear if Actemra is safe to use while pregnant or breastfeeding. Tell your doctor if you’re pregnant, trying to get pregnant, or breastfeeding. Another medicine may be safer for you and your baby.

What is the cost of Actemra in America?

Actemra is a limited distribution drug and is typically only carried in specialty pharmacies. A 4ml dose of 20mg/ml IV solution Actemra can cost around $570. A subcutaneous injection of 162mg/0.9ml costs around $1,300. Insurance coverage or discounts may reduce these prices for covered patients.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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