Actemra Dosage, forms & strengths
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Get started todayActemra is an FDA-approved (U.S. Food and Drug Administration) medication manufactured by Genentech. It is classed as an interleukin-6 (IL-6) receptor antagonist and is used to treat a range of inflammatory autoimmune diseases including:
- Moderate to severely active rheumatoid arthritis in adults
- Active Polyarticular juvenile idiopathic arthritis (PJIA) in children two years of age and above
- Active Systemic juvenile idiopathic arthritis (SJIA) in children two years of age and above
- Giant cell arteritis (GCA) in adults
- Severe or life-threatening cytokine release syndrome (CRS) following chimeric antigen receptor T-cell treatment in adults and children two years of age and above
Most autoimmune conditions can’t be cured (cytokine release syndrome can). You have them for life, but your symptoms can be reduced and managed with medications that reduce inflammation, like Actemra.
Actemra forms and strengths
Actemra is available as a single-dose prefilled syringe in 162mg/0.9mL for subcutaneous injection, Actemra ACTPen autoinjector, or intravenous Infusion in 80 mg/4 mL, 200 mg/10 mL, or 400 mg/20 mL in single-dose vials for further dilution prior to IV infusion.
How does Actemra work?
The active ingredient in Actemra is called tocilizumab, an immunosuppressive drug that reduces how much inflammation your immune system can trigger. Tocilizumab works by blocking the action of certain cytokines.
White blood cells release cytokines that attach to the outside of cells at areas called interleukin receptors, stimulating the receptors, and causing them to activate the inflammatory process within the cells. Tocilizumab attaches to these interleukin receptors instead, stopping your cytokines from attaching to them. This stops your cytokines from triggering inflammation, giving you relief from the symptoms of your inflammatory disease.
Actemra dosage for Adults
Actemra may be used as an intravenous infusion or as a subcutaneous injection alone or in combination with methotrexate. Do not change the dose based on a single visit body weight measurement, as weight may fluctuate.
Rheumatoid Arthritis: Recommended Adult Intravenous (IV) Dosage:
When used with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.
Recommended Adult Subcutaneous (SC) Dosage Chart
| Weight | Dosage |
|---|---|
| Patients weighing less than 100 kg | 162 mg given subcutaneously every other week, followed by an increase to every week based on clinical response |
| Patients weighing above 100 kg | 162 mg given subcutaneously every week |
Giant Cell Arteritis (GCA): Recommended Adult Subcutaneous (SC) Dosage:
The recommended dose of Actemra for adult patients with GCA is 162 mg once every week as a subcutaneous injection, with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, with a tapering course of glucocorticoids, may be prescribed.
Actemra can be used alone following the discontinuation of glucocorticoids.
Polyarticular Juvenile Idiopathic Arthritis Chart
| Weight | Recommended Intravenous PJIA Dosage Every 4 Weeks |
|---|---|
| Patients weighing less than 30 kg | 10 mg per kg |
| Patients weighing above 30 kg | 8 mg per kg |
Systemic Juvenile Idiopathic Arthritis Chart
| Weight | Recommended Intravenous SJIA Dosage Every 2 Weeks |
|---|---|
| Patients weighing less than 30 kg | 12 mg per kg |
| Patients weighing above 30 kg | 8 mg per kg |
Cytokine Release Syndrome Chart
| Weight | Dosage Alone or in combination with corticosteroids |
|---|---|
| Patients weighing less than 30 kg | 12 mg per kg |
| Patients weighing above 30 kg | 8 mg per kg |
Actemra dosage restrictions
Actemra may cause problems if you have certain medical conditions. Contraindications include whether you have suffered from hypersensitivity reactions to the active ingredient tocilizumab or to any of the other ingredients in Actemra.
Other medical conditions may require closer monitoring for side effects, these include if you:
- Are taking any of the medications that could interact with Actemra
- Have any liver or renal impairment
- Have any stomach problems, like stomach ulcers or diverticulitis
- Have or have had a condition that affects your nervous system, like multiple sclerosis
- Have recently had a vaccine or are due to have a vaccine
- Are due to have surgery or another medical or dental procedure
- Have serious Infections
- Have any laboratory abnormalities
- Have rheumatoid arthritis, giant cell arteritis, and systemic sclerosis-associated interstitial lung disease (SSC_ILD)
- Have an absolute neutrophil count (ANC) below 2000 per mm 3
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed – It is unknown if this drug passes into breast milk. Talk to a healthcare professional about the best way to feed your baby
How to take Actemra
Actemra may be used as monotherapy or in combination with methotrexate or other non-biologic DMARDs (disease-modifying anti-rheumatic drugs) as an intravenous infusion or as a subcutaneous injection. Your doctor may prescribe Actemra in combination with a corticosteroid, such as prednisone.
You take Actemra by injecting it under your skin (subcutaneous injection) or by having it injected into a vein (intravenous injection). The amount you take, and how often, will depend on your condition and will be decided upon by the doctor who prescribes it to you.
You are advised to read the full prescribing information, including the medication guide and boxed warning for the full drug information. Always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.
Actemra dosage FAQs
How long does it take Actemra to work?
Actemra will work within 3 to 6 months, although some people may see symptom relief 2 weeks after starting treatment
How long does Actemra stay in your system?
Actemra stays in your system for up to 3.5 months. This is based on the half-life of Actemra which is the time it takes for half of the medicine to leave your body.
What happens if I miss a dose of Actemra?
If you miss a dose call your doctor for instructions.
How long can I take Actemra?
Actemra can be taken for up to 1 year to treat Giant cell arteritis. How long you take it will depend on how well you tolerate the side effects and how long it works for you.
Can I overdose on Actemra?
Yes, call the Poison Help line at 1-800-222-1222 for emergency medical attention
What drug interactions are there with Actemra?
- Any other immunosuppressant medications – etanercept, rituximab, golimumab
- Alpha-blockers – alfuzosin, doxazosin, tamsulosin
- Anticancer medications – cabazitaxel, docetaxel, doxorubicin
- Azole antifungals – itraconazole, ketoconazole, voriconazole
- Calcium channel blockers – diltiazem, nifedipine, verapamil
- Hepatitis C antivirals – asunaprevir, dasabuvir, velpatasvir
- HIV protease inhibitors – atazanavir, indinavir, ritonavir, saquinavir
- Macrolide antibiotics – clarithromycin, erythromycin
- Proton pump inhibitors – lansoprazole, omeprazole
- Statins – atorvastatin, lovastatin, simvastatin
- Vaccines
- Medications that affect how your liver enzymes work
What are the side effects of Actemra
Common side effects of Actemra in clinical trials include:
- Injection site reactions
- Headaches
- Nasopharyngitis
- Increased ALT
- Increased blood pressure (hypertension)
- An increase in upper respiratory tract infections, like the common cold, sinus infections, and the flu
Serious side effects include:
- Severe allergic reactions including anaphylaxis – skin rashes, dizziness, tight chest, and swelling in your face, tongue, and throat that can make it difficult to breathe
- Increased risk of serious infection, like tuberculosis, fungal, and opportunistic infections leading to hospitalization or death, as Actemra can reduce your immune system’s ability to fight infections
- An increased risk of developing certain cancers, like non-Hodgkin lymphoma (NHL) and cancers of the lung, kidney, and liver
- Liver problems that can reduce your liver function, and in severe cases lead to liver failure and death
- A reoccurrence of a hepatitis B infection if you’ve previously had one
- Increased risk for GI perforation – gastrointestinal perforation reported, primarily as a complication of diverticulitis. Evaluate patients presenting with new onset abdominal symptoms for early identification of gastrointestinal perforation
- Tears (perforations) in your stomach or intestines
- Treatment-related laboratory abnormalities in neutrophils, platelets, lipids, and liver function tests
- Neutropenia
- Thrombocytopenia (reduction in platelet counts)
- Elevated liver enzymes – do not start Actemra treatment if you have increased ALT, AST, or ULN levels
- Lipid abnormalities and an increase in total cholesterol, triglycerides, LDL cholesterols, and/or HDL cholesterol
Your caregiver will assess the benefits of using Actemra against your risk of adverse events. You are encouraged to report negative side effects or adverse reactions to the FDA, or visit www.fda.gov/medwatch, or call 1-800-FDA-1088.