Tocilizumab(toe sih liz’ oo mab)
Actemra
PREGNANCY CATEGORY C
Drug Classes
Antirheumatic
Interleukin-6 receptor inhibitor
Monoclonal antibody
Therapeutic Actions
Binds with interleukin receptors, inhibiting interleukin-6-mediated signaling to a variety of cells, including T cells, B cells, lymphocytes, monocytes, and fibroblasts. This action decreases the inflammatory processes that occur in rheumatoid arthritis. Also decreases rheumatoid factor, erythrocyte sedimentation rate, serum amyloid A, and neutrophil counts and increases Hgb level.
Indications
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Treatment of patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more tumor necrosis factor (TNF) antagonist therapies
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Treatment of active systemic juvenile idiopathic arthritis in patients 2 yr and older.
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Treatment of Still disease (systemic idiopathic juvenile arthritis) in patients 2 yr and older
Contraindications and Cautions
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Contraindicated with history of serious allergy to components of the drug, pregnancy, lactation, active infection.
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Use cautiously with GI perforation or history of ulcers, bone marrow suppression, liver impairment, history of TB or hepatitis B.
Available Forms
Single-use vials—80 mg/4 mL, 200 mg/10 mL, 400 mg/20 mL
Dosages
Adults
4 mg/kg by IV infusion over 1 hr, followed by an increase to 8 mg/kg based on clinical response; can repeat infusion once every 4 wk. Maximum dose, 800 mg/infusion.
Pediatric patients 2 yr and older
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Weighing 30 kg or more: 8 mg/kg IV every 2 wk.
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Weighing less than 30 kg: 12 mg/kg IV every 2 wk.
Pharmacokinetics
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