Actemra (Tocilizumab)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Actemra Used For?
Actemra contains tocilizumab, a monoclonal antibody that specifically recognizes and binds to proteins in your body to treat various inflammatory conditions.
Primary Uses
Actemra treats active moderate to severe rheumatoid arthritis (RA), COVID-19 in hospitalized patients receiving corticosteroids and oxygen support, severe cytokine release syndrome (CRS) in adults and children 2+ years, active systemic juvenile idiopathic arthritis (sJIA), and active moderate to severe polyarticular juvenile idiopathic arthritis (pJIA) in children over 2 years.
How It Works
Actemra works by binding and blocking the interleukin-6 receptor (IL-6R), which helps relieve signs and symptoms of these conditions. For rheumatoid arthritis, it can also prevent joint damage from occurring.
Good to know: Actemra is not addictive and is available only with a doctor’s prescription.
How to Take Actemra
Actemra is given as an infusion into your vein by a doctor or nurse, usually taking about one hour to complete.
Dosage Instructions
Your dose depends on your weight and condition. For RA and COVID-19: 8mg per kg of body weight. For pJIA: 8mg/kg if you weigh 30kg or more, or 10mg/kg if under 30kg. For sJIA and CRS: 8mg/kg if 30kg or more, or 12mg/kg if under 30kg. Treatment frequency: RA and pJIA every 4 weeks, sJIA every 2 weeks, CRS and COVID-19 as single doses with additional doses if needed.
What If You Miss a Dose?
Contact your doctor or nurse immediately to schedule another infusion as soon as possible. Don’t wait for your next scheduled appointment – your healthcare team will determine the best timing for your next dose.
Important: For pJIA, sJIA, CRS and COVID-19, Actemra must be given in a hospital setting for safety monitoring.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- High blood pressure (headache, dizziness, ringing in ears)
- Constipation
- Anxiety
- Difficulty sleeping
- Low potassium levels
Seek immediate medical attention if you experience:
- Allergic reactions (chest tightness, wheezing, difficulty breathing, severe dizziness, swelling of face/lips/tongue/throat, skin rash, itching, hives)
- Severe blisters and bleeding in lips, eyes, mouth, nose and genitals
- Signs of infection (sweating, chills, fatigue, cough, shortness of breath, muscle aches, weight loss, warm/red/painful skin, blood in phlegm, diarrhea, stomach ache, persistent headaches, burning urination)
- Stomach or intestinal tears (fever, persistent stomach pain, vomiting blood, rectal bleeding, bowel habit changes)
- Pancreatitis (upper stomach pain, abdominal pain spreading to back, feeling unwell)
- Liver problems (nausea, vomiting, loss of appetite, fever, itching, yellowing of skin/eyes, light-colored stools, dark urine)
- Low white blood cell and platelet counts
- Increased liver function tests
- Raised blood cholesterol levels
Important Warnings
There are several important conditions and situations where Actemra should not be used or requires special monitoring.
Who Should Not Take Actemra
Don’t use Actemra if you’re allergic to tocilizumab, any ingredients, or similar antibody proteins, or if you have an active severe infection. For COVID-19 treatment, don’t use if you have a serious active infection other than COVID-19.
Medical Conditions to Discuss
Tell your doctor if you have: liver disease, HIV/AIDS, tuberculosis, diverticulitis, intestinal ulcers, low white blood cell or platelet counts, diabetes, cancer, heart problems, high blood pressure, high cholesterol, kidney disease, nervous system conditions like multiple sclerosis, or if you’re planning vaccinations.
Pregnancy and Breastfeeding
Actemra should not be used during pregnancy as it may harm your unborn baby. Women of childbearing age should use adequate contraception during treatment and for several months after. It’s not known if Actemra passes into breast milk, so breastfeeding should be discontinued during treatment.
Infection Risk: Actemra reduces your body’s ability to fight infections and may worsen existing infections or increase your risk of new ones.
Drug Interactions
Several medications can interact with Actemra, either increasing side effect risks or requiring dose adjustments.
Vaccine Warning: Certain vaccines should not be given while receiving Actemra – discuss all vaccinations with your doctor.
- Other biological medicines for RA (infliximab, adalimumab, etanercept, certolizumab pegol, golimumab, anakinra, abatacept, rituximab)
- Vaccines (certain types should not be given during treatment)
- Warfarin (blood thinner)
- Cyclosporin (organ transplant medicine)
- Atorvastatin and simvastatin (cholesterol medicines)
- Calcium channel blockers like amlodipine (blood pressure medicines)
- Theophylline (asthma medicine)
- Phenytoin (seizure medicine)
- Benzodiazepines like diazepam (anxiety medicines)
Alcohol & Driving
Be careful when driving or operating machinery until you know how Actemra affects you.
Alcohol
No specific alcohol warnings mentioned in the source material.
Driving and Operating Machinery
Actemra hasn’t been shown to impair driving ability, but if you experience dizziness (a reported side effect), don’t drive or operate machinery until it resolves.
Storage
Since Actemra is administered by healthcare professionals, the medicine will be stored at the facility where you receive your treatment.
Overdose Information
If you think you’ve received too much Actemra, seek urgent medical care immediately. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital Emergency Department, even if you don’t feel unwell.
Frequently Asked Questions
The timing varies by condition. You’ll continue receiving Actemra until your doctor determines it’s working effectively for you. Your doctor will monitor your response and discuss the treatment duration with you.
No, Actemra is not addictive. It’s a monoclonal antibody medication that works by blocking specific proteins in your immune system.
Your doctor will monitor liver enzymes, blood counts, and cholesterol levels regularly. For RA, tests are done every 4-8 weeks initially, then every 12 weeks. For juvenile arthritis, testing occurs at the second dose and then every 2-8 weeks depending on your condition.
Certain vaccines should not be given while receiving Actemra. It’s particularly recommended that children with sJIA receive all necessary vaccinations before starting Actemra. Always discuss any planned vaccinations with your doctor.
Tell your doctor immediately if you develop infection symptoms like fever, sweating, chills, fatigue, cough, shortness of breath, muscle aches, or any unusual symptoms. Actemra can reduce your body’s ability to fight infections.
Actemra is given as an infusion into your vein over about one hour by a doctor or nurse. For certain conditions like juvenile arthritis, CRS, and COVID-19, it must be given in a hospital setting.
Tell your doctor if you’re planning to become pregnant. Women of childbearing potential should use adequate contraception during treatment and for several months after, as Actemra may harm an unborn baby.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.