What is Actemra Uses, warnings & interactions
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Actemra 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 used to treat a range of inflammatory autoimmune diseases, such as:
- 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.
What is Actemra used for?
To treat a range of inflammatory autoimmune diseases.
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 cytokines from triggering inflammation, giving you relief from the symptoms of your inflammatory disease.
Alternatives to Actemra
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.
Read the full prescribing information, including the medication guide and boxed warning for the full drug information, and speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.
Actemra side effects
Common side effects of Actemra in clinical trials include:
- Injection site reactions
- 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:
- Blood in your urine or stools, coughing up blood, vomit that looks like coffee grounds,
- Loss of appetite, right-sided abdominal pain, clay-colored stools, yellowing of the skin or eyes (jaundice)
- 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 infections, 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 types of cancer, 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 was reported, primarily as a complication of diverticulitis. Evaluate patients presenting with new onset abdominal symptoms for early identification of gastrointestinal perforation
- Treatment-related laboratory abnormalities in neutrophils, platelets, lipids, and liver function tests
- Lipid abnormalities and an increase in total cholesterol levels, 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.
Actemra isn’t suitable for everyone. You shouldn’t take Actemra if 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
Actemra drug interactions
Actemra can interact with other medications. In some instances, this can change how it and other medications work. It can even increase the likelihood and severity of some side effects. Medications that are known or thought to interact with Actemra include:
- Any other immunosuppressant medications – abatacept, 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
- Live vaccines
- Medications that affect how your liver enzymes work
Tell your prescribing physician about all drugs you’re taking, including over-the-counter medication, vitamins, and dietary supplements.
Can Actemra be used to treat Covid-19?
The FDA has issued an Emergency use authorization (EUA) for the use of Actemra to treat Covid-19 in adult and pediatric patients who are in the hospital and are receiving corticosteroids and require oxygen, or a machine that helps with their breathing or a machine that adds oxygen to the blood outside the body.
Does Actemra cause weight gain?
Weight gain is a side effect of using Actemra. Speak to your doctor if this is a concern.
How long does it take for 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.
How much does Actemra cost?
Without insurance, prices for Actemra will vary depending on where you buy it and how much you buy. As a guide, a one-dose pack of Actemra, typically a month’s supply, will cost around $350.
Actemra may be covered by your healthcare plan, but you may have to make co-payments. With NiceRx, you may be able to get Actemra for a flat fee of only $49 per month. See how we can help you access affordable Actemra medication.