Tocilizumab

Tocilizumab

Tocilizumab, also known by brand names like Actemra, Tofidence, or Tocilizumab-anoh, Tocilizumab-aazg (Tynenne) is a medication that works by blocking interleukin-6 (IL-6), a protein involved in inflammation.

Conditions Treated 

• Tocilizumab is approved for various autoimmune conditions, including:

• Moderate to severe rheumatoid arthritis (RA) when other treatments haven't been effective.

• Polyarticular and systemic juvenile idiopathic arthritis (pJIA and sJIA).

• Giant cell arteritis (GCA).

• Systemic sclerosis-associated interstitial lung disease (SSc-ILD), where it can help slow the decline in lung function.

Administration 

The medication can be administered as an injection under the skin or as an intravenous infusion. It can be used alone or with other non-biologic disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, but generally not with other biologic DMARDs.

Important Warnings and Potential Side Effects

Patients should be vigilant for the following:

Serious Infections

Tocilizumab can weaken the immune system, increasing the risk of serious infections that may require hospitalization or be fatal. It is crucial to contact your doctor immediately if you develop any symptoms of infection .

Gastrointestinal Perforation

Some patients have experienced serious stomach and intestinal issues, including perforation. Seek immediate medical attention if you have a fever, severe and persistent abdominal pain, or changes in bowel habits.

Allergic Reactions

Though uncommon, severe allergic reactions, including anaphylaxis and death, have been reported. Serious skin reactions can also occur.

Liver Toxicity

Liver function tests should be monitored regularly, especially during the initial months of treatment. Dosage adjustments or discontinuation may be necessary if liver enzyme levels become too high.

Blood Count Changes

Tocilizumab can lead to low neutrophil counts (neutropenia) and low platelet counts (thrombocytopenia). Regular monitoring of blood counts is important, and dosage changes or discontinuation might be needed.

Elevated Lipids

Patients may experience an increase in total cholesterol and LDL cholesterol. Lipid levels should be checked, particularly 4 to 8 weeks after starting treatment.

Vaccinations

Live vaccines should not be administered while taking tocilizumab.

Pregnancy and Lactation

The risk to a fetus or infant cannot be ruled out, and effective contraception is advised.

Dosage

The dose of tocilizumab is dependent on the route of administration. For intravenous administration the dose is based on weight (for example 8mg/kg, or 6 mg/kg, or 3mg/kg, etc) and is given every 28 days (4 weeks). For injection into the skin (subcutaneous) it is given weekly or every other week and the dose of the injection is 162 mg per injection.

This information is not a substitute for professional medical advice. Always discuss your specific situation with your healthcare provider.