Brand Names: Actemra
Generic Name: tocilizumab
- What is tocilizumab (Actemra)?
- What are the possible side effects of tocilizumab (Actemra)?
- What is the most important information I should know about tocilizumab (Actemra)?
- What should I discuss with my healthcare provider before I receive tocilizumab (Actemra)?
- How is tocilizumab given (Actemra)?
- What happens if I miss a dose (Actemra)?
- What happens if I overdose (Actemra)?
- What should I avoid while receiving tocilizumab (Actemra)?
- What other drugs will affect tocilizumab (Actemra)?
- Where can I get more information (Actemra)?
What is tocilizumab (Actemra)?
Tocilizumab is used to treat systemic juvenile idiopathic arthritis (or "Still disease") in children who are at least 2 years old. It is sometimes given together with methotrexate (Rheumatrex, Trexall).
Tocilizumab is also used in adults to treat giant cell arteritis, or inflammation of the lining of your arteries (blood vessels that carry blood from your heart to other parts of your body).
Tocilizumab is also used to treat severe or life-threatening cytokine release syndrome (CRS) caused by an overactive immune response to certain types of blood cell treatments for cancer. Tocilizumab is used for CRS in adults and children ages 2 and older.
Tocilizumab may also be used for purposes not listed in this medication guide.
What are the possible side effects of tocilizumab (Actemra)?
Call your doctor at once if you have:
- severe stomach cramps, bloating, diarrhea or constipation;
- unusual bleeding--nosebleeds, bleeding gums, abnormal vaginal bleeding, any bleeding that will not stop, blood in your urine or stools, coughing up blood or vomit that looks like coffee grounds;
- liver problems--loss of appetite, stomach pain, vomiting, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- signs of infection--fever, chills, aches, tiredness, cough, skin sores, diarrhea, weight loss, burning when you urinate; or
- signs of perforation (a hole or tear) in your stomach or intestines--fever, ongoing stomach pain, change in bowel habits.
Common side effects may include:
- runny or stuffy nose, sinus pain, sore throat;
- increased blood pressure;
- abnormal liver function tests; or
- pain, swelling, burning, or irritation where an injection was given.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about tocilizumab (Actemra)?
Tocilizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, aches, tiredness, cough, skin sores, diarrhea, weight loss, or burning when you urinate.
Tocilizumab may also cause a perforation (a hole or tear) in your stomach or intestines. Tell your doctor if you have a fever and stomach pain with a change in your bowel habits.
What should I discuss with my healthcare provider before I receive tocilizumab (Actemra)?
You should not use tocilizumab if you are allergic to it.
Tell your doctor if you have any signs of infection such as fever, chills, cough, body aches, tiredness, open sores or skin wounds, diarrhea, stomach pain, weight loss, painful urination, or coughing up blood.
Tell your doctor if you have ever had tuberculosis, if anyone in your household has tuberculosis, or if you have recently traveled to an area where tuberculosis is common (Ohio River Valley, Mississippi River Valley, and the Southwest).
Tell your doctor if you have ever had:
- an active or chronic infection;
- liver disease;
- diverticulitis, ulcers in your stomach or intestines;
- a nerve-muscle disease such as multiple sclerosis;
- HIV, or a weak immune system;
- hepatitis B (or if you are a carrier of the virus);
- cancer; or
- if you have received or are scheduled to receive any vaccines.
Tocilizumab may cause certain types of cancer. Ask your doctor about this risk.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of tocilizumab on the baby.
You should not breast-feed while using tocilizumab.
How is tocilizumab given (Actemra)?
Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using tocilizumab.
Tocilizumab is given as an infusion into a vein. A healthcare provider will give you this type of injection.
Tocilizumab is sometimes injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Do not use tocilizumab if you don't understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.
Prepare your injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Tocilizumab is usually given every 1 to 4 weeks. Follow your doctor's instructions.
Use all your medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice.
Tocilizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Your doctor will need to examine you on a regular basis.
If you need surgery, tell your surgeon you currently use this medicine. You may need to stop for a short time.
If you've ever had hepatitis B, using tocilizumab can cause this virus to become active or get worse. You may need frequent liver function tests while using this medicine and for several months after you stop.
Store the prefilled syringes in their original container in a refrigerator. Protect from moisture and light. Do not freeze. Throw away any prefilled syringes not used before the expiration date on the medicine label.
Each single-use prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.
Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.
Tocilizumab can have long-lasting effects on your body. You may need certain medical tests every 6 months after you stop using this medication.
What happens if I miss a dose (Actemra)?
Call your doctor for instructions if you miss a dose.
What happens if I overdose (Actemra)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while receiving tocilizumab (Actemra)?
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Do not receive a "live" vaccine while using tocilizumab. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).
What other drugs will affect tocilizumab (Actemra)?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your other medicines, especially other medicines to treat rheumatoid arthritis, such as:
This list is not complete and many other drugs may affect tocilizumab. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Where can I get more information (Actemra)?
Your doctor or pharmacist can provide more information about tocilizumab.
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