Daily Medication Pearl: Tocilizumab (Actemra)

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)