Tocilizumab
Generic Details
Generic Name
Tocilizumab
Other Names
- Actemra
Drug Class
- Interleukin-6 (IL-6) receptor antagonist
Chemical Formula
C6428H9978N1722O2018S42
Molecular Weight
145476.9 g/mol
Mechanism of Action
- Blocks the interleukin-6 (IL-6) receptor, inhibiting IL-6 mediated signaling
Indications
- Rheumatoid arthritis
- Juvenile idiopathic arthritis
- Systemic juvenile idiopathic arthritis
- Giant cell arteritis
- Cytokine release syndrome
- Severe or life-threatening cytokine storm syndrome
- COVID-19 pneumonia
Common Dosage Forms
- Injection
Typical Dosage
- 4-8 mg/kg every 4 weeks for rheumatoid arthritis
- 8-12 mg/kg every 2 weeks for systemic juvenile idiopathic arthritis
Pediatric Dosage
- <30 kg: dose based on weight, ≥30 kg: adult dosage may be used
Geriatric Dosage
- Dose adjustments based on renal function
Side Effects
- Upper respiratory tract infections
- Increased liver enzymes
- Elevated cholesterol levels
- Headache
- Hypertension
- Nasopharyngitis
Contraindications
- Hypersensitivity to tocilizumab or any component of the formulation
Pregnancy Category
- Category C
Lactation Safety
- Limited data available, use with caution
Drug Interactions
- Avoid use with live vaccines
- May increase risk of infection when used with other immunosuppressive agents
Overdose Symptoms
- Not well-defined, monitor for signs of infection or adverse effects
Antidote for Overdose
- No specific antidote, provide supportive care
Storage Conditions
- Refrigerate at 2-8°C (36-46°F), do not freeze
Pharmacokinetics
- Absorption: Bioavailability: ~80%
- Distribution: Distributed into the systemic circulation
- Metabolism: Primarily hepatic metabolism
- Excretion: Mainly excreted in the feces
Precautions
- Monitor for signs of infection during treatment
- Risk of gastrointestinal perforations
- Hepatotoxicity potential
Warnings
- Increased risk of serious infections
- Risk of gastrointestinal perforations
- Hepatotoxicity
- Hypersensitivity reactions