Tocilizumab

What is Tocilizumab

Tocilizumab is a humanized interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody produced in mammalian (Chinese hamster ovary) cells.

In patients with inflammatory diseases such as rheumatoid arthritis, IL-6 concentrations correlate with disease activity and joint or tissue damage.

In adults, tocilizumab is FDA approved for the treatment of moderate to severe rheumatoid arthritis (RA) after inadequate response to disease-modifying antirheumatic drugs (DMARDs).

Brand Name

Actemra

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. angioedema
  5. antibody formation
  6. arthralgia
  7. candidiasis
  8. cough
  9. diarrhea
  10. dizziness
  11. dyspnea
  12. elevated hepatic enzymes
  13. fatigue
  14. gastritis
  15. GI perforation
  16. headache
  17. hepatic failure
  18. hepatitis
  19. hepatotoxicity
  20. hypercholesterolemia
  21. hyperlipidemia
  22. hypertension
  23. hypertriglyceridemia
  24. hypotension
  25. infection
  26. infusion-related reactions
  27. injection site reaction
  28. jaundice
  29. macrophage activation syndrome
  30. neutropenia
  31. new primary malignancy
  32. optic neuritis
  33. oral ulceration
  34. pancreatitis
  35. peripheral neuropathy
  36. pharyngitis
  37. pruritus
  38. rash
  39. Stevens-Johnson syndrome
  40. thrombocytopenia
  41. urticaria
  42. visual impairment
  43. weakness

Monitoring Parameters

  • CBC with differential
  • LFTs
  • platelet count
  • serum lipid profile

Contraindications

  • breast-feeding
  • children
  • corticosteroid therapy
  • diabetes mellitus
  • diverticulitis
  • fungal infection
  • geriatric
  • GI perforation
  • hepatic disease
  • hepatitis
  • hepatitis B exacerbation
  • hepatotoxicity
  • human immunodeficiency virus (HIV) infection
  • hypercholesterolemia
  • hyperlipidemia
  • hypertriglyceridemia
  • immunosuppression
  • infants
  • infection
  • influenza
  • jaundice
  • labor
  • multiple sclerosis
  • neonates
  • neoplastic disease
  • neurological disease
  • neutropenia
  • new primary malignancy
  • obstetric delivery
  • pregnancy
  • sepsis
  • surgery
  • thrombocytopenia
  • tuberculosis
  • vaccination

Interactions

  • Abatacept
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Alfentanil
  • Amlodipine; Atorvastatin
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anakinra
  • Apixaban
  • Aspirin, ASA; Omeprazole
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Baricitinib
  • Basiliximab
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Caffeine; Ergotamine
  • Canakinumab
  • Carbamazepine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Cisapride
  • Cyclosporine
  • Daclizumab
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dihydroergotamine
  • Efalizumab
  • Ergotamine
  • Ethosuximide
  • Everolimus
  • Ezetimibe; Simvastatin
  • Fentanyl
  • Fosphenytoin
  • Hydrocortisone
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Live Vaccines
  • Lovastatin
  • Lovastatin; Niacin
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Muromonab-CD3
  • Niacin; Simvastatin
  • Ofatumumab
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Oral Contraceptives
  • Phenytoin
  • Pimozide
  • Quinidine
  • Rituximab
  • Rituximab; Hyaluronidase
  • Rivaroxaban
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Sarilumab
  • Secukinumab
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Sirolimus
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Tacrolimus
  • Theophylline, Aminophylline
  • Thioridazine
  • Tizanidine
  • Tofacitinib
  • Tumor Necrosis Factor modifiers
  • Typhoid Vaccine
  • Upadacitinib
  • Ustekinumab
  • Varicella-Zoster Virus Vaccine, Live
  • Warfarin
  • Yellow Fever Vaccine, Live
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