Daily Medication Pearl: Tocilizumab (Actemra)

Tocilizumab (Actemra) is indicated for treatment of rheumatoid arthritis, giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, and cytokine release syndrome.

Medication Pearl of the Day: Tocilizumab (Actemra)

Indication: Tocilizumab (Actemra) is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of rheumatoid arthritis, giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, and cytokine release syndrome.

Insight:

  • Dosing: Dosage is based on weight, from 8 mg/kg to 12 mg/kg.
  • Dosage forms: Intravenous infusion injection 80 mg/4 mL (20 mg/mL), 200 mg/10 mL (20 mg/mL), 400 mg/20 mL (20 mg/mL) in single-dose vials for further dilution prior to intravenous infusion (3). Subcutaneous injection 162 mg/0.9 mL in a single-dose prefilled syringe.
  • Adverse events: Most common adverse reactions (incidence of at least 5%) include upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, and injection site reactions.
  • Mechanism of action: Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R) and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes, and fibroblasts.

Source: ACTEMRA (tocilizumab) injection (fda.gov)