Actemra (tocilizumab)

Reviewed by: HU Medical Review Board | Last reviewed: March 2022 | Last updated: April 2022

Actemra is a biologic medication synthesized in the laboratory. It is a kind of medicine called a monoclonal antibody. Antibodies are substances in the body that help the immune system fight disease. Actemra was specially formulated to bind to human interleukin-6 (IL-6) receptors and block the action of IL-6, which stimulates inflammation.1

In people with RA, Actemra can improve disease symptoms like joint pain and swelling, it is relatively fast-acting, and it can stop disease progression, as seen in certain radiology procedures.2

Actemra is approved for the treatment of adult patients with moderately to severely active RA who have had an inadequate response to one or more disease-modifying anti-rheumatic drugs (DMARDs). It is also approved for the treatment of types of juvenile idiopathic arthritis.1

Actemra is not available in generic forms.

What are the ingredients in Actemra?

The active ingredient in Actemra is tocilizumab.1

How does Actemra work?

Actemra is a laboratory-produced human immunoglobulin monoclonal antibody. Antibodies are substances that our bodies naturally produces to fight disease agents like bacteria and viruses. Drug makers have engineered different antibodies designed to target the mechanisms that cause a variety of diseases, including RA.

This antibody was specially formulated to bind to human interleukin-6 (IL-6) receptors and block the action of IL-6. It therefore belongs to a class of medications called IL-6 receptor inhibitors. IL-6 helps activate inflammation in the body, which in the case of RA, is overactive and targets tissues in our own body. Blocking IL-6 helps tamp down the overactive immune system.1,3

Possible side effects of Actemra

Common side effects with Actemra include:4

  • Headache
  • Runny nose and sneezing
  • Increased blood pressure
  • Redness, pain, swelling, or itching at the injection site
  • Increased ALT liver enzymes

In some patients, Actemra can cause more harmful side effects. Patients who take Actemra are at increased risk for serious infections, including tuberculosis, invasive fungal infections, viral infections, bacterial infections, and other opportunistic infections (infection caused by a microorganism that does not normally cause infection in humans, typically due to an abnormally functioning immune system).4

Some people taking Actemra are also at higher risk for tears in the stomach or intestinal lining, especially if they are also taking non-steroidal anti-inflammatory drugs, corticosteroids, or methotrexate. Other serious side effects include changes in blood cell numbers, liver functioning, and rarely, neurological symptoms.6 For more information, see the FDA black box warning for Actemra.

This is not an exhaustive list of all potential side effects of Actemra. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

Things to note about Actemra

Before taking Actemra, tell your doctor if you:5

  • Are pregnant or plan to become pregnant or are breastfeeding
  • Have a current infection or are prone to recurring infections
  • Have HIV, diabetes, or a weak immune system
  • Have tested positive for TB or have been in close contact with someone who has TB
  • Have or have had Hepatitis B
  • Live in areas of the US where known for fungal infections, including the Ohio and Mississippi Valley and the southwest
  • Have or have had diverticulitis, or inflammation in the large intestine

People taking Actemra should not receive live vaccines. Talk to your doctor first before receiving any vaccines if you are unsure about what kind of vaccine you are getting.

Actemra should not be given to patients who are allergic to the medication or to its components. It should also not be given to patients who have an active infection. If a serious infection develops while taking Actemra, the drug should be discontinued until the infection is resolved.4

Before you take Actemra and while you are on the medication, your doctor should conduct blood tests at regular intervals to be sure your blood cells (including neutrophils and platelets), liver functioning, and cholesterol levels are not affected by the medicine.5 Before taking Actemra, your doctor should also conduct a tuberculosis test.

Actemra should not be given in conjunction with other biologic medications.6

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