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Actemra (Tocilizumab)

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 AR, is overactive and targets tissues in our own body. Blocking IL-6 helps tamp down the overactive immune system.1,3

What are the possible side effects of Actemra?

Common side effects with Actemra include4:

  • 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

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 you5:

  • 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

Dosing information

Actemra is given as an intravenous (IV) infusion or as an injection either alone or in combination with methotrexate and/or other DMARDs. For the intravenous infusion, the recommended starting dose for Actemra is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response. An IV infusion of Actemra typically takes about 1 hour.4

As an injection, the recommended starting dose for patients at or above 100 kg is 162 mg and is administered subcutaneously every week. For patients who weigh less than 100 kg, the recommended started dose is 162 mg and is administered subcutaneously every other week with a possible increased to every week based on clinical response to the drug.8

When you are injecting the medication under the skin, it is important to change the injection site, so the same one is not used multiple times. Some patients will start seeing improvements in a few weeks, but it can take a few months for Actemra to take full effect.6

Written by: Sara Finkelstein | Last reviewed: September 2019.
  1. Medication Guide. Actemra. Genentech, Inc. South San Francisco, CA. Revised May 2018. Accessed May 26, 2018.
  2. Carolina Negrei, Violeta Bojinca, Andra Balanescu, et. al., Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016 Apr; 11(4): 1177–1183. Published online 2016 Feb 2. doi: 10.3892/etm.2016.3045 Accessed May 26, 2018.
  3. Tocilizumab Injection. MedLine Plus. US National Library of Medicine. Bethesda, MD. Revised December 15, 2017. Accessed May 26, 2018.
  4. Actemra (tocilizumab) Prescribing Information. Genentech, Inc; South San Francisco, CA: 2013. Accessed May 26, 2018.
  5. Actemra. Genentech 2018. Accessed May 26, 2018.
  6. Tocilizumab (Actemra). American College of Rheumatology. Updated July 2017. Accessed May 26, 2018.
  7. ACTEMRA Recommended Dosing Regimen for RA. Accessed on September 12, 2019.