What is Tocilizumab (Actemra®)?
Tocilizumab is in a class of drugs called biologics. Tocilizumab is a treatment for adults with moderate to severe rheumatoid arthritis (RA), giant cell arteritis, and polyarticular and systemic juvenile idiopathic arthritis. You must have tried and failed another medication for RA before starting tocilizumab. Tocilizumab blocks a substance called IL-6, known to cause inflammation. People with RA often have too much IL-6. Tocilizumab is commonly known as Actemra®.
How do I take it?
Tocilizumab is given as an injection once a week or as an IV infusion once a month. If you are on the infusion, you will have this medicine at a center where nurses will place a needle in your vein and give you the medicine through it. It takes about one hour for the medicine to be infused. Tocilizumab is given every 4 weeks.
If you are on the injection, you will be taught to give yourself a needle. Tocilizumab comes in a pre-filled syringe. You will give yourself a shot once a week.
What about side effects?
- Some people have serious infections while taking tocilizumab. You should call your doctor if you think you have an infection.
- Let your rheumatologist know if you live or have lived in places where fungal infections are more common. For example, histoplasmosis is more common in the Ohio River Valley.
- You should have a TB (tuberculosis) test and a test for hepatitis B before beginning tocilizumab.
- There have been some cases of tears in the stomach or intestines, call your doctor if you have fever and stomach pain or there is a change in your bowel habits.
- Other side effects may include changes in your liver and other blood tests. It is important to have any blood tests that your doctor orders. Your doctor will monitor this blood work to look for problems.
- You should let your doctor know if you are planning any surgery. Tocilizumab affects your immune system and may affect healing.
- If you are on the shot, the medicine can cause itching or redness near the injection site. If this happens, the discomfort should be mild. If you have pain, swelling, warmth, or discoloration near the injection site, you should contact your healthcare provider.
- If you are getting an infusion, allergic reactions may happen. Let your infusion nurse know if you have any signs of an allergic reaction, such as rashes or hives; swollen face, eyelids, lips, or tongue; and difficulty breathing. Call 911 if this happens at home.
What about other medications?
When you are taking tocilizumab, it is very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements.
What else should I know?
You must continue your regular visits to the rheumatologist. Your doctor will monitor you for any improvements in your disease and for any signs of infections. Most patients notice an improvement in symptoms by one month of starting treatment.