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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › IMMUNOSUPPRESSANTS › IMMUNOSUPPRESSANTS › Interleukin inhibitors
tocilizumab
L04AC07
Forms & Strengths
- 160mg and 200mg solution for injection in pre-filled syringe
- 80mg/4mL, 200mg/10mL, and 400mg/20mL solution for injection in vial
Adult Dosing
- 4mg/kg IV every 4 weeks, may increase to 8mg/kg IV every 4 weeks
- 162mg SC every week or every 2 weeks, may also be administered every 4 weeks in some patients
Pediatric Dosing
- Systemic juvenile idiopathic arthritis (sJIA): 8mg/kg (up to a max of 400mg) IV every 2 weeks
- Polyarticular juvenile idiopathic arthritis (pJIA): 10mg/kg (up to a max of 400mg) IV every 4 weeks or 162mg SC every week
Indications
- Treatment of rheumatoid arthritis (RA) in combination with methotrexate or other disease-modifying anti-rheumatic drugs
- Treatment of giant cell arteritis
- Treatment of systemic juvenile idiopathic arthritis (sJIA) and polyarticular juvenile idiopathic arthritis (pJIA)
- Treatment of cytokine release syndrome (CRS) and COVID-19 pneumonia
Mechanism of Action
- Interleukin-6 (IL-6) receptor antagonist
- Binds to both soluble and membrane-bound forms of IL-6 receptors
- Inhibits IL-6-mediated signaling and reduces inflammation
Contraindications
- Active serious infection
- Hypersensitivity to tocilizumab or any of its excipients
Adverse Reactions
- Upper respiratory infections
- Nasopharyngitis
- Gastrointestinal perforation
- Hepatic enzyme elevations
- Hyperlipidemia
- Neutropenia
- Thrombocytopenia
Drug Interactions
- Concomitant use with biologic DMARDs, Janus kinase inhibitors, or potent immunosuppressants may increase risk of serious infections
- CYP450 substrate interactions: monitor and adjust doses as necessary
- Use caution with live vaccines and avoid concomitant use with live vaccines
Curated Content: Needs Vetting Before Put to Clinical Use