Actemra (Tocilizumab) is a biologic medicine that suppresses an overactive immune system in order to treat rheumatoid arthritis and some types of juvenile arthritis.
Actemra works by blocking the interleukin-6 receptor (IL-6R) found on the surface of cells within the body. Interleukin 6 (IL-6) is a signalling protein, or cytokine, that plays an important role in the immune response. IL-6 can cause pain and swelling in the joints of people with arthritis. Blocking it can help improve their symptoms.
Actemra is a type of protein known as a monoclonal antibody.
Actemra is available as an injection (Actemra SC), and as an IV infusion (Actemra IV). The injection can be done quickly at home. The infusion is done at a specialized infusion clinic. There is no option to receive Actemra infusions at home like there is with Orencia, another type of biologic medication.
The normal dose for the injection is 162 mg, every 1 or 2 weeks depending on the patient’s body weight. To learn how take the injection at home, watch our video to learn how to self-inject: Learn how to inject: subcutaneous injections. Subcutaneous injections are easy to do compared to other types of injections. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
The dose for Actemra IV infusions is based on the patients’ weight, either at 4mg/kg or 8mg/kg. That means typical doses range from 200 mg to a maximum of 800 mg per infusion.
It can take 6-12 weeks for patients to feel the effects of this medication.
Actemra is often given in combination with methotrexate.
Important Tests and Risks
Actemra can make it a bit harder for people to fight off infections. Patients taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection. Patients should coordinate with their doctor to stop treatment before any surgery. It can be re-started once things have healed and there’s no sign of infection. Patients should discuss all vaccinations with their doctor because some are not advisable to get while taking Actemra.
All patients should have a TB (tuberculosis) skin test and a chest x-ray before starting Actemra.
It is important for patients who are taking Actemra to get regular blood tests as requested by their doctor. It is necessary to make sure Actemra isn’t affecting the liver, blood counts, or cholesterol levels.
Drug Identification Number (DIN): 02350092 (IV), 02350106 (IV), 02350114 (IV), 02424770 (SC)
How Actemra Works
Actemra works by blocking the interleukin-6 receptor (IL-6R) found on the surface of cells within the body. Interleukin 6 (IL-6) is a signalling protein, or cytokine, that plays an important role in immune response.
IL-6 is secreted by the immune system’s white blood cells, including T-cells and macrophages, to stimulate an immune response. They might release IL-6 during an infection, or after an injury that damages tissue, and its release leads to inflammation.
Some patients with arthritis might have abnormally high IL-6 levels. This can cause pain and swelling in the joints.
Actemra is a type of protein known as a monoclonal antibody that blocks IL-6 from working. In blocking IL-6, Actemra suppresses the body’s immune system. Although this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system.
Side Effects of Actemra
Actemra (tocilizumab) can cause headaches or pain/redness/swelling at the injection site. People taking this medication should call their doctor if these symptoms persist or get worse.
Actemra can rarely cause an allergic reaction during an infusion.
Actemra has rarely been associated with an injury to the bowel (holes in the wall of the bowel). Patients should tell their doctor if they develop stomach pain during treatment with this medicine.
Patients have very rarely developed conditions of the nervous system while taking Actemra.
Who Should NOT Take Actemra
People that should NOT be taking Actemra include:
- Anyone who has had a previous serious allergic reaction to Actemra
- Pregnant women, women who are planning on becoming pregnant in the near future, women who are currently breastfeeding
- People with an active infection (such as tuberculosis)
- Possibly people who have cancer or have had a past history of certain cancers.
People taking Actemra who are about to have surgery should discuss stopping the medication with their doctor.
When to Call a Doctor
People taking Actemra should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons for people taking Actemra to call a doctor include:
- Fever or possible infection
- Upcoming surgery
- Becoming pregnant
- Before getting any vaccinations
- Developing a rash
- Developing stomach pain
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Actemra.