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Tocilizumab

Last updated on 04/08/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions  |   Tips  |   Where To Buy  

GENERIC NAME: Tocilizumab

CHINESE NAME: 托珠單抗

BRAND NAME(S) IN HONG KONG: Actemra 雅美羅

DRUG CLASS: Immunosuppressants

SUB CLASS: Monoclonal antibodies, Biologics disease-modifying anti-rheumatic drugs, Interleukin inhibitors

USED FOR: Moderate to severe rheumatoid arthritis, Juvenile idiopathic arthritis, Giant cell arteritis, Cytokine release syndrome, Systemic sclerosis-associated interstitial lung disease 

AVAILABLE DOSAGE FORMS:
– 80mg/4ml, 200mg/10ml, 400mg/20ml (IV infusion)
– 162mg/0.9ml (injections)

What is Tocilizumab for?

Tocilizumab, which is a monoclonal antibody and a biologics disease-modifying anti-rheumatic drug (DMARDs), belongs to  a class of medications called interleukin inhibitors. It can modulate the activity of immune system cells to suppress inflammatory signals. It is used to treat, but not limited to
– moderate to severe rheumatoid arthritis,
– polyarticular juvenile idiopathic arthritis,
– systemic juvenile idiopathic arthritis,
– giant cell arteritis,
– severe or life-threatening cytokine release syndrome induced by CAR T-cell therapy,
– systemic sclerosis-associated interstitial lung disease.

How to use it?

Tocilizumab can be administered through intravenous (IV) infusion, or injected subcutaneously. 

For moderate to severe rheumatoid arthritis:
IV: 4 mg/kg once every 4 weeks, and can be increased to 8 mg/kg once every 4 weeks based on clinical response. The maximum dose is 800 mg.
SubQ:
<100 kg: 162 mg once every 2 weeks, and can be increased to 162 mg
once every week based on clinical response
≥100 kg: 162 mg once every week

For polyarticular juvenile idiopathic arthritis in children ≥2 years and adolescents:
IV:
<30 kg: 10 mg/kg once every 4 weeks
≥30 kg: 8 mg/kg once every 4 weeks
SubQ:
<30 kg: 162 mg/kg once every 3 weeks
≥30 kg: 162 mg/kg once every 2 weeks

For systemic juvenile idiopathic arthritis in children ≥2 years and adolescents:
IV:
<30 kg: 12 mg/kg once every 2 weeks
≥30 kg: 8 mg/kg once every 2 weeks
SubQ:
<30 kg: 162 mg/kg once every 2 weeks
≥30 kg: 162 mg/kg once every week

For severe or life-threatening cytokine release syndrome induced by CART-cell therapy:
IV: If clinical improvement does not occur after the first dose, up to 3 additional doses may be administered (with at least an 8-hour interval between consecutive doses).
<30 kg: 12 mg/kg
≥30 kg: 8 mg/kg

For giant cell arteritis:
SubQ: 162 mg once to twice weekly, based on clinical considerations, in combination with a corticosteroid.

For systemic sclerosis-associated interstitial lung disease:
SubQ: 162 mg once weekly.

What are the side effects of Tocilizumabiss?

Common side effects of Tocilizumab include constipation, upper respiratory tract infections, nasopharyngitis, headache, hypertension, liver enzymes elevation.

Who should not take Tocilizumab?

People who are allergic to Tocilizumab or any component of the formulation.

Pharmacist Tips:

– Use effective contraception during treatment to avoid pregnancy.
– Store your new, unused medicine syringe in its original carton in the refrigerator.
– Remove one prefilled syringe from the refrigerator and wait 30 minutes to allow it to reach room temperature. Do not speed up the warming process in any way, such as using the microwave or placing the syringe in warm water. Also, do not remove the needle cover while allowing the prefilled syringe to reach room temperature.
– Each prefilled syringe is for one use only.
– Change (rotate) your injection site with each injection. Do not use the same site for each injection.
– This drug may make you more susceptible to serious infections. Seek medical help immediately if you have symptoms such as fever. sore throat, or fatigue.

Common dosing schedule:
Tocilizumab can be injected subcutaneously in the thigh and stomach by yourself, or upper arm by your caregiver only.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Tocilizumab may interact with:
– Live vaccine
– Warfarin
– Omeprazole
– Lipid-regulating drugs, e.g. Simvastatin, Atorvastatin, Lovastatin
– Oral contraceptives, e.g. Levonorgestrel, Ethinylestradiol
– Other biologics disease-modifying anti-rheumatic drugs, e.g. Infliximab, Rituximab

Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Tocilizumab in Hong Kong?

In Hong Kong, Tocilizumab is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Tocilizumab in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.