IN-HOSPITAL USE FOR COVID-19

The drug Actemra (tocilizumab) has been granted an emergency use authorization (EUA). The EUA allows for in-hospital use of Actemra as a treatment for COVID-19 in certain cases. You should not take any prescription drug, including Actemra, unless your doctor recommends it.

For information about prevention and treatment, as well as expert advice, at our COVID-19 hub.

Actemra is a brand-name prescription drug. It’s FDA-approved to treat the following conditions:

For more information on these conditions and how Actemra is used to treat them, see the “Actemra uses” section below.

Drug details

Actemra contains the active drug tocilizumab. It belongs to a class of drugs called IL-6 antagonists. (A drug class describes a group of medications that work in the same way.) Actemra works to treat its approved conditions by helping to reduce inflammation in your body. This can result in fewer symptoms and an overall improvement in your condition.

Actemra is a biologic medication. Biologics are made from living cells rather than from chemicals.

Drug form and administration

Actemra comes as a solution that’s given as one of the following types of injection:

  • Subcutaneous injection. A subcutaneous injection is an injection under your skin. This solution comes in prefilled syringes and autoinjectors. And it’s available in one strength: 162 milligrams/0.9 milliliter (mg/mL).
  • Intravenous (IV) infusion. An IV infusion is an injection into your vein that’s given over a period of time. This solution comes in vials. And it’s available in one strength: 20 mg/mL.

Subcutaneous injections of Actemra can be given either at home or at a medical facility. But when you first start using Actemra, you’ll receive the injections at your doctor’s office. They’ll use the prefilled syringes to administer your doses. Your doctor can teach you how to give the injections to yourself at home if you’d like. To do self-injections, you’ll use prefilled syringes or autoinjector pens.

IV infusions of Actemra are given by healthcare professionals at a medical facility.

Your doctor will recommend whether you should receive injections or infusions of this drug.

Effectiveness

For information on the effectiveness of Actemra, see the “Actemra uses” section below.

Actemra is a biologic medication that contains the active drug tocilizumab. It’s available only as a brand-name medication. It’s not currently available in a biosimilar form.

Biologics are made from living cells rather than from chemicals. It isn’t possible to make exact copies of biologics, but it is possible to make drugs that are very similar to them. And these similar drugs are called biosimilars. With drugs made from chemicals, it is possible to make exact copies. And those exact copies are called generics.

Like generics, biosimilars tend to cost less than brand-name biologic medications.

Actemra can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Actemra. These lists don’t include all possible side effects.

For more information on the possible side effects of Actemra, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA of a side effect you’ve had with Actemra, you can do so through MedWatch.

Mild side effects

Mild side effects of Actemra can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Actemra. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Actemra’s Medication Guide.

Serious side effects

Serious side effects from Actemra aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Liver problems, such as liver failure. Symptoms can include:
    • loss of appetite
    • yellowing of your skin or the whites of your eyes
    • nausea and vomiting
  • Tears or small holes in your stomach and intestines. Symptoms can include:
    • pain in your belly that doesn’t go away
    • changes in your bowel habits, such as hard stools and having bowel movements less often than usual
  • Blood disorders, including low levels of platelets, white blood cells, or neutrophils (a type of white blood cell). Symptoms can include:
    • unexplained fatigue (lack of energy)
    • wounds that heal more slowly than usual
  • High cholesterol level, which doesn’t cause symptoms in most people. But lab tests can help show if your cholesterol level is high.
  • Multiple sclerosis (MS). Symptoms can include:
    • muscle weakness
    • numbness and tingling in your face or body
    • bladder problems, including loss of bladder control
    • muscle spasms and involuntarily movements
  • Allergic reaction.*
  • Serious infections,† including new or worsening tuberculosis (TB).*
  • Changes in weight, including weight gain or weight loss.*
  • Infusion effects.*
  • Possible increased risk of certain types of cancer.*

* For more information on this side effect, see “Side effect details” below.
† Actemra has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “FDA warning: Risk of serious infections” section at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with Actemra.Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Actemra. In clinical trials, up to 0.9% of people had to stop using Actemra due to allergic reaction.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing
  • chest pain
  • dizziness
  • belly pain or vomiting

Call your doctor right away if you have a severe allergic reaction to Actemra. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious infections

Actemra can increase your risk of serious infections, including tuberculosis (TB). In fact, Actemra has a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Actemra may increase your risk of infections because the drug can weaken the activity of your immune system. And this makes it harder for your body to fight off infections. Some infections that result from Actemra use may be severe enough to require hospitalization. And rarely, some infections may be fatal.

Before you start taking Actemra, your doctor may test you for TB. If you’re at risk for TB or you already have TB, your doctor may treat the infection before and during Actemra treatment. They may also check again to see if you have TB while you’re taking Actemra. This is because you may develop a TB infection while you’re using Actemra.

Symptoms of a serious infection, such as TB, may include:

  • coughing up blood
  • cough that lasts
  • fever
  • unexplained weight loss
  • chills
  • fatigue (lack of energy)

If you have any of these symptoms while you’re taking Actemra, tell your doctor right away. They’ll likely have you temporarily stop using Actemra, and they’ll treat the infection.

How often serious infections occurred in clinical studies

In clinical studies, serious infections were reported in people with any of the conditions Actemra is approved to treat. The studies showed that people who took Actemra, with or without certain other drugs, had:

  • higher rates of infection than did people who took one of the following:
  • lower rates of infection than did people who took prednisone over 52 weeks with a placebo

In addition, actual rates of infection were reported in the studies. These rates were reported as the number of infections for every 100 patient years. This means if 100 people took Actemra for 1 year, this is the number of infections that would occur.

For instance, for every 100 patient years, the following rates of serious infections were reported:

  • 3.6 to 12.2† in people who took Actemra
  • 1.5 in people who took methotrexate alone
  • 3.9 in people who took a DMARD with a placebo
  • 4.2 in people who took prednisone with a placebo for 26 weeks
  • 12.5 in people who took prednisone with a placebo for 52 weeks

Higher rates of infection were seen in people who took Actemra at a higher dose or took weekly doses compared with:

  • people who were on a lower dose, or
  • people who took Actemra every 2 to 4 weeks

Of people included in Actemra studies worldwide, 0.1% developed TB. Based on 2019 data, the risk of TB for any person in the United States is 0.0027%.

* Methotrexate, DMARDs, and prednisone are used to treat many of the conditions that Actemra is approved to treat.
† This number of infections varied depending on the condition being treated and whether people took Actemra with certain other drugs.

Weight gain or weight loss

Some people may have weight gain during Actemra treatment. In clinical studies, less than 2% of people taking Actemra for rheumatoid arthritis (RA) had weight gain. But some people taking Actemra for RA may have also used other drugs for the condition, such as methotrexate or a disease-modifying antirheumatic drug (DMARD).

It’s not known how many people using Actemra for conditions other than RA had weight gain during the studies.

Weight loss, on the other hand, isn’t a direct side effect of Actemra. However, weight loss may be a symptom of a serious infection, which is a possible side effect of Actemra. (See the “Serious infections” section above to learn more.)

If you have unexplained weight loss during Actemra treatment, call your doctor right away. And if you’re concerned about weight gain with Actemra use, talk with your doctor. They can help you manage a body weight that’s healthy for you.

Cancer

It’s not known whether Actemra increases the risk of cancer. But cancer was seen in some people taking Actemra during clinical studies.

For example, in 24-week clinical study of people taking Actemra for rheumatoid arthritis (RA), cancer was diagnosed in:

Of people who took Actemra in studies worldwide, the rate of cancer was similar to the rate observed in this 24-week study.

Because Actemra suppresses your immune system, your body may not be able to fight off infections or abnormal cells like usual. And this may increase your risk of developing cancer, which is made up of abnormal cells. Symptoms of cancer can include extreme fatigue (lack of energy) and unexplained weight loss.

Before you start taking Actemra, tell your doctor if you have cancer or have had it in the past. Also, tell your doctor right away if you notice any symptoms of cancer while you’re taking Actemra.

* Methotrexate and DMARDs are used to treat many of the conditions that Actemra is approved to treat.

Infusion side effects

It’s possible to have an infusion reaction during or shortly after receiving Actemra as an intravenous (IV) infusion. (An IV infusion is an injection into your vein that’s given over a period of time.) But these types of reactions haven’t been seen in people taking the drug by subcutaneous injection. (A subcutaneous injection is an injection under your skin.)

Symptoms of infusion reaction can include:

  • skin rash or hives
  • flushing (skin that may appear red or feel warm)
  • itchiness
  • headache
  • belly problems, including nausea and diarrhea
  • increased or decreased blood pressure
  • joint pain
  • angioedema (severe swelling of the face, lips, mouth, and throat)

You’ll receive Actemra IV infusions from a healthcare professional in a medical facility. So be sure to tell your healthcare professional if you have any symptoms of infusion reaction during your infusion. And call your doctor right away if you develop any symptoms after having your infusion. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

How often infusion reaction occurred in clinical studies

In a clinical study of people with rheumatoid arthritis (RA), infusion reaction was seen in:

In a clinical study of people with polyarticular juvenile idiopathic arthritis (PJIA) who took Actemra with or without methotrexate:*

  • 6% of people had an infusion reaction during their infusion
  • 20.2% of people had an infusion reaction up to 24 hours after receiving their infusion

In a clinical study of people with systemic juvenile idiopathic arthritis (SJIA) who may or may not have taken corticosteroids* and/or methotrexate:

  • 4% of people taking Actemra had an infusion reaction during their infusion
  • 16% of people taking Actemra had an infusion reaction up to 24 hours after receiving their infusion
  • 0% of people taking a placebo had an infusion reaction during their infusion
  • 5% of people taking a placebo had an infusion reaction up to 24 hours after receiving their infusion

It’s not known how often infusion reaction occurred in people using Actemra for its other approved uses.

* Methotrexate, DMARDs, and corticosteroids are used to treat many of the conditions that Actemra is approved to treat.

The Actemra dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Actemra to treat
  • your body weight
  • other medical conditions you may have
  • whether you receive Actemra by either:

Typically, your doctor will have you start a recommended dosage of Actemra that’s based on your body weight in kilograms (kg). Your doctor will ultimately prescribe the dosage that provides the desired effect. Your doctor may lower your Actemra dosage if you have certain side effects from the drug.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs. And your doctor can help you set up a calendar for dosing so you can stay on track with your treatment plan.

Drug forms and strengths

Actemra comes as a solution inside:

  • Prefilled syringes and autoinjectors. This Actemra solution is available in one strength: 162 milligrams/0.9 milliliter (mg/mL). And it’s given as a subcutaneous injection.
  • Vials. This Actemra solution is available in one strength: 20 mg/mL. It’s mixed with another liquid and then given as an IV infusion.

Your doctor will recommend whether you should receive injections or infusions of Actemra.

If you receive subcutaneous injections of Actemra, you’ll receive injections of the drug at your doctor’s office when you begin treatment. They’ll use the prefilled syringes to administer your dose. But your doctor can teach you how to give the injections to yourself at home if you’d like. To do self-injections, you’ll use either prefilled syringes or autoinjector pens.

If you receive IV infusions of Actemra, you’ll receive them at your doctor’s office or in a hospital.

Dosage for giant cell arteritis (GCA)

For GCA, Actemra can be given as an IV infusion or a subcutaneous injection.

Dosage for IV infusion

The recommended IV infusion dosage of Actemra for GCA is 6 mg of the drug per kg* of body weight. Infusions are typically given once every 4 weeks.

For example, if someone weighs 150 lb (about 68 kg), they would receive 408 mg of Actemra per infusion. However, your doctor might change, pause, or stop your dosage depending on changes in lab results or side effects during the treatment.

* One kg is equal to about 2.2 pounds.

Dosage for subcutaneous injection

The typical subcutaneous injection dosage of Actemra for GCA is 162 mg. This dose is given once every 1 to 2 weeks, depending on how your body responds to the treatment.

Dosage for rheumatoid arthritis (RA)

For RA, Actemra can be given as either an IV infusion or subcutaneous injection. Dosages of Actemra for RA are based on body weight in kilograms (kg). One kilogram is about equal to 2.2 pounds (lb). Your exact dosage will be based on how your body responds to treatment.

Dosage for IV infusion

The typical IV infusion dosage of Actemra for RA is 4 mg to 8 mg of drug per kg of body weight.

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

Typically, your doctor will start you on the lowest possible dosage. Then they’ll increase your dosage as needed. Most people taking IV infusions of Actemra for RA receive their dose once every 4 weeks.

Dosage for subcutaneous injection

Typical subcutaneous injection Actemra doses for RA and how often they’re given are as follows:

Dose of ActemraHow often it’s given
For people who weigh less than 100 kg162 mgonce every 1 to 2 weeks
For people who weigh 100 kg or more162 mgonce every week

Dosage for systematic sclerosis-related interstitial lung disease (SSc-ILD)

For SSc-ILD, Actemra is given as a subcutaneous injection. The recommended dosage is 162 mg given once every week. For this use, Actemra is typically injected using a prefilled syringe instead of an autoinjector pen.

Your doctor might change, pause, or stop your dosage depending on whether you have changes in lab results or side effects during the treatment.

Dosage for cytokine release syndrome (CRS)

For CRS, Actemra is given as an IV infusion.

For CRS treatment, Actemra usually only needs to be given once as single dose. However, some people may need additional doses of Actemra. But that depends on the severity of their CRS and whether symptoms of the condition have improved after one dose.

Typically, doses of Actemra for CRS are based on body weight in kilograms (kg),* as follows:

Dose of Actemra
For people who weigh less than 30 kg12 mg/kg
For people who weigh 30 kg or more8 mg/kg

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

* One kilogram is about equal to 2.2 pounds.

Dosage for polyarticular juvenile idiopathic arthritis (PJIA)

For PJIA, Actemra may be given as either an IV infusion or subcutaneous injection. Dosages of Actemra for PJIA are based on body weight in kilograms (kg). One kilogram is about equal to 2.2 pounds (lb). But your exact dosage will be based on how your body responds to treatment.

Dosage for IV infusion

Typical IV infusion Actemra doses for PJIA and how often they’re given are as follows:

Dose of ActemraHow often it’s given
For people who weigh less than 30 kg10 mg/kgonce every 4 weeks
For people who weigh 30 kg or more8 mg/kgonce every 4 weeks

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

Dosage for subcutaneous injection

Typical subcutaneous injection Actemra doses for PJIA and how often they’re given are as follows:

Dose of ActemraHow often it’s given
For people who weigh less than 30 kg162 mgonce every 3 weeks
For people who weigh 30 kg or more162 mgonce every 2 weeks

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

Dosage for systemic juvenile idiopathic arthritis (SJIA)

For SJIA, Actemra may be given as either an IV infusion or subcutaneous injection. Dosages of Actemra for SJIA are based on body weight in kilograms (kg). One kilogram is about equal to 2.2 pounds (lb). Your exact dosage will be based on how your body responds to treatment.

Dosage for IV infusion

Typical IV infusion Actemra doses for SJIA and how often they’re given are as follows:

Dose of ActemraHow often it’s given
For people who weigh less than 30 kg12 mg/kgonce every 2 weeks
For people who weigh 30 kg or more8 mg/kgonce every 2 weeks

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

Dosage for subcutaneous injection

Typical subcutaneous injection Actemra doses for SJIA and how often they’re given are as follows:

Dose of ActemraHow often it’s given
For people who weigh less than 30 kg162 mgonce every 2 weeks
For people who weigh 30 kg or more162 mgonce each week

For example, if someone weighs 150 lb (about 68 kg) and they’re receiving 8 mg/kg of Actemra, their dose would be 544 mg of Actemra.

Pediatric dosage

Actemra is approved for the following uses in children ages 2 years and older:

The dosages for these conditions aren’t based on age. Instead they’re based on body weight. For information on the recommended dosages for these conditions, see these sections above:

  • “Dosage for polyarticular juvenile idiopathic arthritis (PJIA)”
  • “Dosage for systemic juvenile idiopathic arthritis (SJIA)”
  • “Dosage for cytokine release syndrome (CRS)”

What if I miss a dose?

If you’re receiving Actemra at a medical facility, it’s important to keep your appointments for the injections or infusions. If you happen to miss an appointment, call your doctor’s office right away to reschedule.

If you’re using Actemra at home and you forget to take a dose, take it as soon as you remember. Then be sure to talk with your doctor. They can help you adjust your dosage schedule if needed.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Will I need to use this drug long term?

How long you’ll likely take Actemra depends on the condition you’re using the drug to treat. For instance, you’ll likely take Actemra long term for:

However, for giant cell arteritis (GCA), Actemra is typically only used for up to 1 year.

And for cytokine release syndrome (CRS), Actemra is typically used for just a short period of time. In fact, CRS treatment usually only lasts until symptoms of CRS have resolved, which is typically 1 to 2 weeks.

If you have questions about how long you’ll need to take Actemra, talk with your doctor.

As with all medications, the cost of Actemra can vary.

The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Actemra at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Actemra, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Actemra, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Actemra, or if you need help understanding your insurance coverage, help is available.

Genentech USA, Inc., the manufacturer of Actemra, offers a patient assistance program that may help lower the cost of Actemra. They also offer a copay card for this drug. For more information and to find out if you’re eligible for support, call 800-ACTEMRA (800-228-3672) or visit the manufacturer’s website.

Generic or biosimilar version

Actemra is a biologic medication that contains the active drug tocilizumab. It’s available only as a brand-name medication. It’s not currently available in a biosimilar form.

Biologics are made from living cells rather than from chemicals. (Most drugs are made from chemicals.) It isn’t possible to make exact copies of biologics, but it is possible to make drugs that are very similar to them. And these similar drugs are called biosimilars. With drugs made from chemicals, it is possible to make exact copies. And those exact copies are called generics.

Like generics, biosimilars tend to cost less than brand-name biologic medications.

The Food and Drug Administration (FDA) approves prescription drugs such as Actemra to treat certain conditions. Actemra may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Actemra for giant cell arteritis (GCA)

Actemra is approved to treat GCA in adults. GCA is a condition that affects your blood vessels, causing swelling and inflammation in them. This condition typically involves blood vessels in your head, scalp, and temples. If left untreated, GCA can affect your vision.

Symptoms of GCA can include:

  • headache
  • pain in your jaw, especially when you’re chewing
  • pain in your tongue, throat, or face
  • unexplained fever
  • fatigue (lack of energy)
  • flu-like symptoms, such as fever and chills
  • weight loss

Actemra works to treat GCA by helping to reduce inflammation in your body. This can result in fewer symptoms of GCA and an overall improvement in your condition.

For GCA treatment, Actemra is often given with corticosteroids.

Effectiveness for giant cell arteritis

One clinical study looked at Actemra treatment in people with GCA. In this study, Actemra was given as a subcutaneous injection (an injection under the skin). People in the study were given prednisone (Rayos) with either Actemra or a placebo (treatment with no active drug).

This study reported how many people with GCA reached remission. For this study, remission was reached when people had all of the following:

  • no symptoms of GCA
  • no need to take more than 100 mg of prednisone for GCA
  • normal results on certain lab tests

After 26 weeks of treatment, remission from GCA was reached in:

  • 56% of people taking 162 mg of Actemra once weekly with prednisone
  • 53.1% of people taking 162 mg of Actemra once every 2 weeks with prednisone
  • 14% of people taking prednisone with a placebo

Actemra for rheumatoid arthritis (RA)

Actemra is approved to treat moderate to severe RA in adults. For this use, the drug is prescribed for people who’ve tried one or more disease-modifying antirheumatic drugs (DMARDs) in the past. But these treatments didn’t provide enough improvement in their RA.

With RA, which is an autoimmune disease, your immune system attacks your own body. This results in inflammation, swelling, and decreased movement in your joints.

Symptoms of RA can also include:

  • pain or stiffness in your joints, which is sometimes more noticeable in the morning
  • fatigue (lack of energy)
  • loss of appetite
  • fever
  • dry mouth and dry eyes
  • firm lumps or nodules below your skin, often on your hands or elbows

For RA, your doctor may recommend that you use Actemra either alone or in combination with other drugs. These other drugs may include DMARDs, such as methotrexate (Trexall, Otrexup, Rasuvo).

Actemra works to treat RA by helping to reduce inflammation in your body. This can result in fewer symptoms and an overall improvement in your condition.

Effectiveness of Actemra IV infusion for RA

Three clinical studies looked at Actemra treatment in people with moderate to severe RA. In these studies, Actemra was given with methotrexate. The studies looked at people who hadn’t had enough of an improvement in their RA with certain other treatments.

In these studies, Actemra was given by intravenous (IV) infusion. (With an IV infusion, a drug is injected into your vein over a period of time.) Some people were given either 4 mg or 8 mg of Actemra per kilogram (kg) of body weight. Other people were given a placebo (treatment with no active drug). And everyone was given methotrexate.

After 24 weeks of treatment, based on the treatment given, the following results were seen.

Actemra 4 mg/kgActemra 8 mg/kgPlacebo
Percentage of people with at least a 20% reduction in RA symptoms30% to 51%50% to 59%10% to 27%
Percentage of people with at least a 50% reduction in RA symptoms17% to 32%29% to 44%4% to 11%
Percentage of people with at least a 70% reduction in RA symptoms5% to 12%12% to 22%1% to 2%

Another clinical study looked at IV infusion Actemra treatment in people with moderate to severe RA. The people in this study hadn’t had enough of an improvement in their RA with certain other treatments. Some people were given 8 mg of Actemra per kilogram (kg) of body weight. Other people were given methotrexate.

After 24 weeks of treatment, based on the treatment given, the following results were seen.

Actemra 8 mg/kgMethotrexate
Percentage of people with at least a 20% reduction in RA symptoms70%53%
Percentage of people with at least a 50% reduction in RA symptoms44%34%
Percentage of people with at least a 70% reduction in RA symptoms28%15%

An additional clinical study looked at IV infusion Actemra treatment in people with moderate to severe RA. The people included hadn’t had enough of an improvement in their RA with certain other treatments. Some people were given 8 mg of Actemra per kilogram (kg) of body weight plus a disease-modifying antirheumatic drug (DMARD). Other people were given a placebo (treatment with no active drug) plus a DMARD.

After 24 weeks of treatment, based on the treatment given, the following results were seen.

Actemra 8 mg/kg + DMARDPlacebo + DMARD
Percentage of people with at least a 20% reduction in RA symptoms61%24%
Percentage of people with at least a 50% reduction in RA symptoms38%9%
Percentage of people with at least a 70% reduction in RA symptoms21%3%

Effectiveness of subcutaneous injection vs. IV infusion of Actemrafor RA

In one study, some people were given Actemra 162 mg once every week as a subcutaneous injection (an injection under the skin). Other people were given 8 mg of Actemra per kilogram (kg) of body weight once every 4 weeks by intravenous (IV) infusion. (With an IV infusion, a drug is injected into your vein over a period of time.)

And everyone was also given a DMARD.

After 24 weeks of treatment, based on the treatment given, the following results were seen.

Actemra 162 mg + DMARDActemra 8 mg/kg + DMARD
Percentage of people with at least a 20% reduction in RA symptoms69%73.4%
Percentage of people with at least a 50% reduction in RA symptoms47%49%
Percentage of people with at least a 70% reduction in RA symptoms24%28%

Effectiveness of Actemra subcutaneous injection for RA

A second study looked at Actemra treatment given by subcutaneous injection (an injection under the skin) in people with RA. Some people were given Actemra 162 mg once every other week. Other people were given a placebo (treatment with no active drug) once every 4 weeks. Everyone received a DMARD.

After 24 weeks of treatment, based on the treatment given, the following results were seen.

Actemra 162 mg + DMARDPlacebo + DMARD
Percentage of people with at least a 20% reduction in RA symptoms61%32%
Percentage of people with at least a 50% reduction in RA symptoms40%12%
Percentage of people with at least a 70% reduction in RA symptoms20%5%

Actemra systematic sclerosis-related interstitial lung disease (SSc-ILD)

Actemra is approved to treat interstitial lung disease related to SSc-ILD in adults. Specifically, it’s prescribed to slow down the worsening of lung function caused by SSc-ILD.

This health condition hardens lung tissue, causing it to become thick and scarred. Possible symptoms of SSc-ILD may include:

  • chest pain
  • cough
  • shortness of breath

Actemra treats SSc-ILD by helping to reduce inflammation in your body. This can result in fewer symptoms and can help prevent further lung damage.

For SSc-ILD, your doctor may prescribe Actemra on its own or in combination with other treatments.

Effectiveness for SSc-ILD

Clinical studies have found Actemra to be an effective SSc-ILD treatment in adults. People in studies who took Actemra for this purpose had a slower rate of decline in their lung function over time.

Actemra for cytokine release syndrome (CRS)

Actemra is approved to treat a type of CRS that’s severe or life threatening after treatment with chimeric antigen receptor (CAR) T-cell therapy. For this use, the drug can be given to adults and children ages 2 years and older.

With CRS, you have abnormally high levels of cytokines. Cytokines are small proteins that are released by your immune system when an infection or abnormal cells are detected. Normally, cytokines let your body know that defense or repair is needed.

However, if too many cytokines are released, they can cause harmful levels of inflammation in your body. And this inflammation may lead to problems with your organs. Specifically, CRS may affect your heart, brain, and lungs.

Possible symptoms of CRS may include:

Actemra works to treat CRS by helping to reduce inflammation in your body. This can result in fewer symptoms and an overall improvement in your condition.

For CRS, Actemra can be used with or without corticosteroids.

Effectiveness for CRS

In one clinical study, Actemra was given to 45 people ages 3 to 23 years who had severe or life threatening CRS after treatment with chimeric antigen receptor (CAR) T-cell therapy. People in this study may or may not have also received corticosteroids.

After 14 days of receiving a first dose of Actemra, 69% of people had achieved a response to treatment. Responding to treatment meant that each of the following were true:

  • Their condition had gone away within 14 days of receiving one dose of Actemra.
  • No more than two doses of Actemra were needed.
  • No drugs other than Actemra and corticosteroids were used for their treatment.

Actemra for polyarticular juvenile idiopathic arthritis (PJIA)

Actemra is approved to treat PJIA in children ages 2 and older. With PJIA, you have arthritis in 5 or more joints in your body. PJIA is an autoimmune condition, which means it results from your immune system attacking your own body. PJIA can occur in children of any age.

Possible symptoms of PJIA may include:

  • joint pain and stiffness
  • swelling of your joints
  • decreased movement of your joints

Actemra works to treat PJIA by helping to reduce inflammation in your body. This can result in fewer symptoms and an overall improvement in your condition.

Effectiveness for PJIA

In one clinical study, children ages 2 to 17 years old with PJIA were given either Actemra or a placebo (treatment with no active drug). Either treatment was given as an intravenous (IV) infusion. (With an IV infusion, a drug is injected into a vein over a period of time.)

After 40 weeks of treatment, based on the treatment given, the following results were seen.

ActemraPlacebo
Percentage of children with at least a 30% reduction in PJIA symptoms74%54%
Percentage of children with at least a 50% reduction in PJIA symptoms73%52%
Percentage of children with at least a 70% reduction in PJIA symptoms65%42%

Actemra for systemic juvenile idiopathic arthritis (SJIA)

Actemra is approved to treat SJIA in children ages 2 years and older. SJIA begins with repeating fever that cause inflammation your joints, leading to arthritis. SJIA can also cause inflammation and damage to your organs, such as your liver and spleen.

Possible symptoms of SJIA may include:

Actemra works to treat SJIA by helping to reduce inflammation in your body. This can result in fewer symptoms and an overall improvement in your condition.

Effectiveness for systemic juvenile idiopathic arthritis

In one clinical study, Actemra was given to children ages 2 to 17 years old with SJIA. Some children received Actemra, while other children received a placebo (treatment with no active drug). Either treatment was given by intravenous (IV) infusion. (With an IV infusion, a drug is injected into a vein over a period of time.)

Actemra treatment regimens were as follows:

  • Children weighing 30 kilograms (kg) or more received 8 mg of Actemra per kg of body weight once every 2 weeks.
  • Children weighing less than 30 kg received 12 mg of Actemra once every 2 weeks.

If it was part of their usual treatment for SJIA, children in this study could also have used:

After 12 weeks of treatment, based on the treatment given, the following results were seen.

ActemraPlacebo
Percentage of children with at least a 30% reduction in PJIA symptoms91%24%
Percentage of children with at least a 50% reduction in PJIA symptoms85%11%
Percentage of children with at least a 70% reduction in PJIA symptoms71%8%

Actemra and children

Actemra is approved for use in children with any of the following conditions:

For more information on these conditions and Actemra’s effectiveness in treating them, see these sections above :

  • “Actemra for polyarticular juvenile idiopathic arthritis (PJIA)”
  • “Actemra for systemic juvenile idiopathic arthritis (SJIA)”
  • “Actemra for cytokine release syndrome (CRS)”

Actemra for other conditions

In addition to the uses listed above, you may wonder if Actemra is used for certain other conditions. Below is information on other possible uses for Actemra.

Actemra for depression (under study)

Actemra isn’t approved to treat depression. However, the drug is being studied for this condition.

Actemra is called an IL-6 antagonist, which means it reduces the effect of the IL-6 protein in your body. It’s thought that IL-6 proteins may play a role in depression.

IL-6 antagonists, including Actemra, have been or are currently being studied in people with depression. But there’s currently not enough evidence to show that Actemra treats depression. So the FDA hasn’t approved the drug for this condition.

If you have questions about treatment options for depression, talk with your doctor.

Depending on the condition you’re using Actemra to treat, your doctor may recommend other drugs with Actemra. Some drugs that are commonly used with Actemra include:

If you have questions about drugs you may need to take with Actemra, talk with your doctor. They can recommend whether you should take Actemra alone or with other medications.

There aren’t any known interactions between Actemra and alcohol. If you drink alcohol, talk with your doctor about how much is safe for you to drink during Actemra treatment.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Actemra, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for giant cell arteritis (GCA)

Examples of other drugs that may be used to treat GCA include:

Alternatives for rheumatoid arthritis (RA)

Examples of other drugs that may be used to treat RA include:

Alternatives for cytokine release syndrome (CRS)

Examples of other treatments that may be used to treat CRS include:

Alternatives for polyarticular juvenile idiopathic arthritis (PJIA)

Examples of other drugs that may be used to treat PJIA include:

  • oral steroids, such as prednisone (Rayos)
  • disease-modifying antirheumatic drugs (DMARDs), such as:
    • methotrexate (Trexall, Otrexup, Rasuvo)
    • leflunamide (Arava)
  • biologic drugs, such as:
    • etanercept (Enbrel)
    • infliximab (Remicade)
    • adalimumab (Humira)
    • abatacept (Orencia)
    • anakinra (Kineret)
    • canakinumab (Ilaris)
    • rituximab (Rituxan)

Alternatives for systemic juvenile idiopathic arthritis (SJIA)

Examples of other drugs that may be used to treat systemic SJIA include:

  • oral steroids, such as prednisone (Rayos)
  • disease-modifying antirheumatic drugs (DMARDs), such as:
    • methotrexate (Trexall, Otrexup, Rasuvo)
    • leflunamide (Arava)
  • biologic drugs, such as:
    • etanercept (Enbrel)
    • infliximab (Remicade)
    • adalimumab (Humira)
    • abatacept (Orencia)
    • anakinra (Kineret)
    • canakinumab (Ilaris)
    • rituximab (Rituxan)

Alternatives for interstitial lung disease related to systematic sclerosis (SSc-ILD)

Examples of other drugs that may be used for SSc-ILD include:

  • oral steroids, such as prednisone (Rayos)
  • tyrosine kinase inhibitors, such as nintedanib (Ofev)
  • immunosuppressant drugs, such as:
    • cyclophosphamide (Cytoxan)

You may wonder how Actemra compares with other medications that are prescribed for similar uses. Here we look at how Actemra and Kevzara are alike and different.

Ingredients

Actemra contains the active drug tocilizumab, while Kevzara contains the active drug sarilumab. Both medications belong to a group of drugs called IL-6 antagonists.

Uses

Here’s a list of conditions that the Food and Drug Administration (FDA) has approved Actemra and Kevzara to treat.

Drug forms and administration

Actemra and Kevzara both come as a solution inside prefilled syringes and autoinjector pens. These forms of the drugs are given by subcutaneous injection (an injection under your skin). Your doctor will show you how to inject either Actemra or Kevzara when you first start treatment. Then, if you’re comfortable to do so, you can give injections of either drug to yourself at home.

Actemra also comes as a solution that’s given by healthcare professionals as an intravenous (IV) infusion. (With an IV infusion, the drug is injected into your vein over a period of time.)

Side effects and risks

Actemra and Kevzara are both IL-6 antagonists. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Actemra and Kevzara (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Actemra, with Kevzara, or with both drugs (when taken individually).

* Actemra and Kevzara both have a boxed warning regarding the risk of serious infections. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “FDA warning: Risk of serious infections” section at the beginning of this article.

† With reactivation, the infection is already inside your body and it flares up, causing symptoms.

Effectiveness

The only condition both Actemra and Kevzara are used to treat is moderate to severe rheumatoid arthritis (RA). For this use, both drugs are approved for use in adults who’ve tried one or more disease-modifying antirheumatic drugs (DMARDs) in the past.

These drugs haven’t been directly compared in clinical studies. But separate studies of the two drugs were compared in a larger review of studies. In this review, researchers looked at the effectiveness of Kevzara and Actemra. The review showed that Actemra, when used alone or with methotrexate, was more likely to reduce RA symptoms than was Kevzara.

Costs

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy or medical facility where you receive either drug.

Actemra and Kevzara are both brand-name drugs. There are currently no biosimilar forms of either drug. To learn about what biosimilars are, see the “Actemra generic or biosimilar” section above.

Like Kevzara, discussed above, other medications are prescribed for similar uses as Actemra. Here we look at how Actemra and Orencia are alike and different.

Ingredients

Actemra contains the active drug tocilizumab. Orencia contains the active drug abatacept. These drugs belong to different classes of medications. (A medication class describes a group of drugs that work in the same way.)

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Actemra and Orencia to treat.

Drug forms and administration

Actemra and Orencia both come as a solution inside prefilled syringes and autoinjector pens. These forms of the drugs are given by subcutaneous injection (an injection under your skin). Your doctor will show you how to inject either Actemra or Orencia when you first start treatment. Then, if you’re comfortable to do so, you can give injections of either drug to yourself at home.

Actemra also comes as a solution that’s given by healthcare professionals as an intravenous (IV) infusion. (With an IV infusion, the drug is injected into your vein over a period of time.) And Orencia comes as powder that’s mixed with solution and given by healthcare professionals as an IV infusion.

Side effects and risks

Actemra and Orencia both contain drugs that work to help symptoms of RA. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Actemra and Orencia (when taken individually).

  • Can occur with Actemra:
  • Can occur with Orencia:
    • nausea
    • diarrhea
    • fever
    • cough
    • belly pain
  • Can occur with both Actemra and Orencia:
    • headache
    • injection site reaction, which may cause pain, redness, or swelling at or near areas of injections

Serious side effects

These lists contain examples of serious side effects that can occur with Actemra, with Orencia, or with both drugs (when taken individually).

* Actemra has a boxed warning regarding the risk of serious infections. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “FDA warning: Risk of serious infections” section at the beginning of this article.

† With reactivation, the infection is already inside your body and it flares up, causing symptoms.

Effectiveness

The only conditions both Actemra and Orencia are used to treat are:

  • polyarticular juvenile idiopathic arthritis (PJIA) in children ages 2 years and older
  • moderate to severe rheumatoid arthritis (RA) in certain adults

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Actemra and Orencia to be effective in treating PJIA and RA.

Costs

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy or medical facility where you receive either drug.

Actemra and Orencia are both brand-name drugs. There are currently no biosimilar forms of either drug. Brand-name medications usually cost more than biosimilars. To learn about what biosimilars are, see the “Actemra generic or biosimilar” section above.

Depending on your condition and other factors, Actemra may be given by either:

Below, we describe how the drug is given in each of these ways.

Actemra by subcutaneous injection

When you start using Actemra as a subcutaneous injection, your doctor will give injections of the drug to you at their office. They can also teach you how to give the injections to yourself at home if you’d like. If you’re giving Actemra injections to yourself, be sure to follow your doctor’s instructions.

If you’re giving Actemra injections to yourself, it can be injected into the following areas:

  • thigh
  • belly, staying a few inches away from your belly button

If a healthcare professional or caregiver is giving Actemra to you, it can also be injected into the outer side of your upper arm.

Genentech, the manufacturer of Actemra, provides a video that explains how to inject prefilled syringes of Actemra. The manufacturer also provides written step-by-step instructions.

Be sure to read instructions carefully before giving injections of Actemra to yourself. And if you have any questions about how to correctly administer the drug, ask your doctor or pharmacist for help.

Actemra by IV infusion

If you’re receiving Actemra as an IV infusion, you’ll receive doses from a healthcare professional. Your doses will be given at your doctor’s office or medical facility.

When to take

How often you’ll take Actemra depends on several factors, including:

  • the condition you’re treating
  • your body weight
  • your age

See the “Actemra dosage” section above for information on how often you’ll need to take Actemra for your condition.

In general, you can take Actemra at any time of the day. If you’re giving yourself injections at home, take Actemra at the time of day that best fits your schedule. If you’re receiving the drug from a healthcare professional, schedule a time that’s convenient for you to get your dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

It isn’t known if Actemra is safe to use during pregnancy. Animal studies have shown some risk to developing fetuses when Actemra was given to pregnant animals. However, animal studies don’t always predict what will happen with humans.

If you become pregnant or think you may be pregnant while you’re taking Actemra, talk with your doctor right away. They can recommend a safe treatment plan for you.

Actemra pregnancy registry

If you take Actemra during pregnancy, you can enroll in the drug’s pregnancy registry.

Pregnancy registries collect information about a drug’s use during pregnancy. This includes information about any side effects the drug causes for the pregnant mother and her baby. This information is used by doctors and other people who want to know about the drug’s safety when it’s used during pregnancy.

To enroll in Actemra’s pregnancy registry, visit the registry’s website or call 877-311-8972.

It’s not known if Actemra is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Actemra.

For more information about taking Actemra during pregnancy, see the “Actemra and pregnancy” section above.

It’s not known if Actemra passes into human breast milk. If you’re considering Actemra treatment while breastfeeding, talk with your doctor about the risk and benefits of using this drug.

Here are answers to some frequently asked questions about Actemra.

Does Actemra cause hair loss?

No, Actemra doesn’t cause hair loss. In clinical trials, hair loss wasn’t reported by anyone taking Actemra.

However, some other medications that treat the same conditions as Actemra treats may cause hair loss. This includes disease-modifying antirheumatic drugs (DMARDs) and biologics.

Also, certain conditions treated by Actemra may cause hair loss. For example, people with rheumatoid arthritis (RA), polyarticular juvenile idiopathic arthritis (PJIA), or systemic juvenile idiopathic arthritis (SJIA) may experience hair loss.

With these conditions, which are autoimmune diseases, your immune system attacks your own body. If your immune system attacks your skin tissue, which may include your hair follicles, you may have some hair loss.

If you’re concerned about hair loss during Actemra treatment, talk with your doctor.

Can I take Actemra with antibiotics?

You shouldn’t take Actemra with an antibiotic that’s being used to treat an active infection.

There aren’t any known interactions between Actemra and antibiotics. However, keep in mind that if you’re taking antibiotics, you may be treating an infection. And if you have an active infection, you shouldn’t take Actemra.

So, if you need to take an antibiotic, your doctor or pharmacist may recommend that you stop taking Actemra.

If you have questions about drug interactions that may affect you while you’re taking Actemra, ask your doctor or pharmacist.

Is Actemra a TNF inhibitor?

No, Actemra isn’t a TNF inhibitor. TNF stands for tumor necrosis factor. TNF inhibitors work by inhibiting (blocking) the action of TNF, reducing inflammation in your body. These drugs are often used for autoimmune diseases, including some of those that Actemra is approved to treat.

Instead, Actemra belongs to a group of drugs called IL-6 antagonists. Similar to TNF, IL-6 proteins also play a role in inflammation in your body. Actemra helps to decrease inflammation by blocking the action of IL-6.

So, while Actemra isn’t a TNF inhibitor, it works in a similar way as TNF inhibitors do.

Can I take Actemra at home?

Yes, you may be able to, depending on your doctor’s recommendation.

Actemra can be given as subcutaneous injection, which may be done at home. (With a subcutaneous injection, the drug is injected under your skin.) For these injections, you can use either prefilled syringes or autoinjector pens of Actemra.

To see if either of these forms of Actemra is appropriate for you, talk with your doctor. If they feel it’s appropriate, your doctor can teach you how to give the injections to yourself at home.

Actemra can also be given as an intravenous (IV) infusion. (With an IV infusion, a drug is injected into a vein over a period of time.) If your doctor determines that you should receive Actemra by IV infusion, you’ll receive the drug at your doctor’s office or a hospital.

If you’d like to know more about the different ways to receive Actemra, talk with your doctor.

Will Actemra cure my condition?

No, unfortunately, Actemra isn’t a cure for any of the conditions it’s approved to treat. However, the drug can help reduce symptoms and improve your condition.

When Actemra is used to treat:

  • cytokine release syndrome (CRS), most people have a full recovery from CRS and they don’t have further symptoms. But that doesn’t mean CRS won’t develop again later.
  • giant cell arteritis (GCA), people typically take Actemra for up to 1 year. And GCA rarely returns after it’s been treated with Actemra. But that doesn’t mean GCA can’t come back.

For arthritic conditions, such as rheumatoid arthritis (RA), polyarticular juvenile idiopathic arthritis (PJIA), and systemic juvenile idiopathic arthritis (SJIA), there’s also currently no known cure. However, many people taking Actemra have reduced symptoms related to these conditions.

For interstitial lung disease related to systematic sclerosis, Actemra works to slow down how quickly your lung function gets worse. This can help keep your condition from causing new symptoms or more severe symptoms. But the drug likely won’t resolve existing lung damage caused by your condition.

If you have questions about how Actemra will affect your condition, talk with your doctor.

Will I need to have lab tests done while I’m using Actemra?

Yes, you will need to have lab tests while you’re taking Actemra. Actemra can affect your liver function, cholesterol level, and blood cell levels. Because of this, you’ll need to have lab tests done while you’re taking the drug.

Some blood tests your doctor may order include:

Your doctor will order lab tests as needed to make sure your levels are within a healthy range. If you have questions about how often you’ll need lab tests, talk with your doctor.

Actemra can interact with several other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Actemra and other medications

Below, medications that can interact with Actemra are listed. This article doesn’t contain all the drugs that may interact with Actemra.

Before taking Actemra, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Actemra and simvastatin

Taking Actemra with simvastatin (Zocor) may lower simvastatin’s effectiveness in treating high cholesterol. This means simvastatin may not work as well as usual to lower your cholesterol level.

In addition, if you stop taking Actemra, the level of simvastatin in your body may increase. And this could raise your risk of side effects from simvastatin.

If you must take simvastatin while you’re using Actemra, your doctor will closely monitor your cholesterol level. And they may adjust your dosage of simvastatin if needed.

Actemra and omeprazole

Taking Actemra with omeprazole (Prilosec) may decrease your level of omeprazole, which is used to treat heartburn. And this may lower omeprazole’s effectiveness.

If you take omeprazole while you’re using Actemra, talk with your doctor. They can help you determine if a drug other than omeprazole should be used.

Actemra and dextromethorphan

Taking Actemra with dextromethorphan may lower your level of dextromethorphan, which is used to treat certain types of cough. This means dextromethorphan may not work as well as usual.

Dextromethorphan is found in many over-the-counter (OTC) medications. Some examples of products that contain dextromethorphan include:

  • Delsym
  • Robitussin
  • Dimetapp
  • Mucinex DM
  • Vicks Formula 44

If you need to take dextromethorphan while you’re using Actemra, talk with your doctor. They’ll help you choose another drug for your cough, if needed.

Actemra and antibiotics (not an interaction)

Antibiotics aren’t known to interact with Actemra. However, if you’re taking antibiotics, you may be treating an infection. And if you have an active infection, you shouldn’t take Actemra.

Symptoms of an infection may include:

  • fever
  • chills
  • cough that lasts
  • unexplained weight loss

If you have any symptoms of infection while you’re taking Actemra, tell your doctor right away. Also, tell them right away if you think you may have an infection. Your doctor will likely pause your Actemra treatment to treat the infection.

Actemra and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Actemra. However, you should still check with your doctor or pharmacist before using any of these products while taking Actemra.

Actemra and foods

There aren’t any foods that have been specifically reported to interact with Actemra. If you have any questions about eating certain foods with Actemra, talk with your doctor.

Actemra and vaccines

While you’re taking Actemra, you should avoid getting live vaccines. With live vaccines, you receive a small amount of a live virus. This is unlike inactive vaccines, which don’t contain any live virus. In general, all vaccines help protect your body from certain infections.

You should avoid live vaccines while you’re using Actemra because the drug may weaken the activity of your immune system. And if this happens, your body won’t be able to properly respond to the vaccine. In this case, you may actually develop the infection that the vaccine was meant to protect you from.

Live vaccines that should be avoided while you’re taking Actemra include:

Before you begin taking Actemra, talk with your doctor about whether you may need any live vaccines. You and your doctor can decide whether to delay Actemra treatment until after you’ve received the live vaccines you need.

Actemra is approved for the following uses:

With all of these conditions, you have increased inflammation in your body.

Actemra contains the active drug tocilizumab. It belongs to a class of drugs called IL-6 antagonists. (A drug class describes a group of medications that work in the same way.)

The drug works by antagonizing (blocking) the action of IL-6 proteins. These proteins cause inflammation in your body. IL-6 proteins also activate other immune system cells, leading to more inflammation.

By blocking the action of IL-6, Actemra helps reduce inflammation in your body. Treatment with Actemra may result in fewer symptoms or an overall improvement in your condition.

How long does Actemra take to work?

Actemra starts working in your body right away. But it may take a few doses of Actemra for you to notice an improvement in your condition. And keep in mind that doses of Actemra may be given weekly or once every few weeks.

How long does Actemra stay in your system?

Actemra can stay in your system for up to a few months. The level of Actemra inside your body depends on several factors, including:

  • your body weight
  • your dose of Actemra
  • how often you take Actemra

When you get Actemra from the pharmacy, the pharmacist will add an expiration date to the label on the medication. This date is typically 1 year from the date they dispensed the drug.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Actemra should be stored in the refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). The drug should be kept dry and in its original packaging until ready to use.

Before taking Actemra injections, allow prefilled syringes to sit at room temperature for 30 minutes. If you are using autoinjector pens, allow them sit at room temperature for 45 minutes before using.

Disposal

Right after you’ve used a syringe, needle, or autoinjector for Actemra, dispose of it in an FDA-approved sharps disposal container. This helps prevent others, including children and pets, from taking the drug by accident or harming themselves with the needle. You can buy a sharps container online, or ask your doctor, pharmacist, or health insurance company where to get one.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

This drug comes with several precautions.

FDA warning: Risk of serious infections

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Actemra may increase your risk of serious infections. In fact, people taking Actemra have developed fungal and viral infections. Some people have also had tuberculosis (TB) while taking Actemra. All of these infections can lead to hospitalization, or in rare cases, even death.

If you have an infection while you’re taking Actemra, it is important to call your doctor right away. They’ll typically recommend treatment and help you safely stop taking Actemra until your infection has gone away.

Also, when you’re first starting Actemra treatment, your doctor will most likely check you for TB. It’s possible to have latent TB, which means TB is already inside your body, but you don’t have any symptoms from it. If you have TB or any other infections, your doctor will need to treat the infection before you start using Actemra.

Other precautions

Before taking Actemra, talk with your doctor about your health history. Actemra may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Active infections or history of repeated infections. You shouldn’t take Actemra if you currently have an infection or if you’ve had infections in the past that kept coming back. If you develop an infection while you’re taking Actemra, or you’re taking an antibiotic, tell your doctor right away.
  • Tuberculosis (TB). If you have TB that’s causing symptoms (active TB) or TB that’s not causing symptoms (latent TB), you may need TB treatment before starting Actemra. Your doctor will check you for TB before you start treatment with Actemra. You shouldn’t take Actemra if you have active TB.
  • Hepatitis B infection. If you have hepatitis B or you’ve had it in the past, taking Actemra may reactivate the virus. With reactivation, the infection is already inside your body and it flares up, causing symptoms. If you’ve had or currently have hepatitis B, talk with your doctor before starting Actemra.
  • Live vaccines. While taking Actemra, you should avoid getting live vaccines. With live vaccines, you receive a small amount of a live virus. Because Actemra may weaken the activity of your immune system, your body won’t be able to properly respond to the vaccine. In this case, you may actually develop the infection that the vaccine was meant to protect you from. For examples of live vaccines that should be avoided while using Actemra, see the “Actemra interactions” section above.
  • Liver problems. Actemra may affect your liver, leading to liver failure. If you have a history of liver problems, talk with your doctor before starting Actemra.
  • Ulcers (holes or sores) in your stomach or intestines. If you have ulcers in your stomach or intestines or you’ve had ulcers in the past, tell your doctor. Also tell them about if you’ve had belly pain or diverticulitis (swelling and inflammation of your intestines). Actemra may cause or worsen ulcers. Before starting Actemra, tell your doctor about any ulcers or intestinal inflammation you’ve had.
  • Nervous system conditions, such as multiple sclerosis (MS). It’s not known if Actemra is related to conditions that affect your nervous system. But some people taking Actemra developed MS while taking Actemra. Before you start Actemra, let your doctor know about any nervous system conditions you’ve had.
  • Allergic reaction. If you’ve had an allergic reaction to Actemra or any of its ingredients, you shouldn’t take Actemra. Ask your doctor what other medications are better options for you. And if you’re unsure about your medication allergies, talk with your doctor.
  • Pregnancy. It isn’t known if Actemra is safe to use during pregnancy. For more information, see the “Actemra and pregnancy” section above.
  • Breastfeeding. It’s not known if Actemra passes into breast milk. For more information, see the “Actemra and breastfeeding” section above.

Note: For more information about the potential negative effects of Actemra, see the “Actemra side effects” section above.

Using more than the recommended dosage of Actemra can lead to serious side effects. Do not use more Actemra than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

The following information is provided for clinicians and other healthcare professionals.

Indications

Actemra is indicated for the following:

  • moderate to severe rheumatoid arthritis (RA) in adults who have previously used one or more disease-modifying antirheumatic drugs (DMARDs)
  • giant cell arteritis (GCA) in adults
  • interstitial lung disease related to systematic sclerosis in adults
  • systemic juvenile idiopathic arthritis (SJIA) in children ages 2 years and older
  • polyarticular juvenile idiopathic arthritis (PJIA) in children ages 2 years and older
  • chimeric antigen receptor (CAR) T-cell-induced cytokine release syndrome (CRS) that is severe or life threatening in adults and children ages 2 years and older

Administration

Actemra can be administered either by subcutaneous injection or intravenous (IV) infusion.

The drug comes as a solution inside prefilled syringes and autoinjector pens, which can be used for subcutaneous administration in the thigh, outer abdomen, or upper arm.

Actemra also comes as a solution that requires further dilution for IV administration.

For its approved uses, Actemra dosage is based on body weight, dose, and frequency of administration.

For more information on dosages of Actemra, see the “Actemra dosage” section above.

Mechanism of action

Actemra contains the humanized monoclonal antibody tocilizumab. It blocks interleukin-6 (IL-6) by directly binding to the protein, blocking IL-6 from binding with its receptor. Blocking the activity of IL-6 prevents activation of proinflammatory cytokines. And it works to decrease inflammation.

Pharmacokinetics and metabolism

Absolute bioavailability ranges from 80% to 96% following subcutaneous injection.

Steady-state varies based on the dose, route of administration, and condition being treated. Steady-state ranges from 8 weeks to 14 weeks.

Actemra elimination half-life varied based on dose, route of administration, and condition being treated. Elimination half-life is estimated to be up to 18.9 days.

Contraindications

Actemra should not be used in people with a history of serious hypersensitivity reaction to the drug or any of its ingredients.

Vaccines

People receiving Actemra should avoid receiving live vaccines.

Storage

Actemra should be stored in the refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). Store the drug in its original container and packaging to protect it from light and moisture. Do not freeze Actemra.

Before administering, allow prefilled syringes to sit at room temperature for 30 minutes and autoinjector pens to sit at room temperature for 45 minutes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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