Description
Actemra is a prescription medication used to treat several conditions. It helps adults with rheumatoid arthritis when other medications have not worked well.
Actemra also treats giant cell arteritis (a type of blood vessel inflammation) and slows lung damage in people with systemic sclerosis-associated interstitial lung disease.
For children aged two and older, it treats two types of arthritis (PJIA and SJIA) and helps manage severe reactions from certain cancer treatments. Actemra is also used for hospitalized adults with severe COVID-19 who need extra oxygen or a ventilator.
Common side effects include infections, headaches, high blood pressure, and reactions at the injection site. Actemra is available as an intravenous infusion or a subcutaneous injection.
Indications and Benefits of Actemra
Actemra is FDA-approved for the following conditions:
- Rheumatoid Arthritis (RA)
- Giant Cell Arteritis
- Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)
- Polyarticular Juvenile Idiopathic Arthritis (PJIA)
- Systemic Juvenile Idiopathic Arthritis (SJIA)
- Cytokine Release Syndrome (CRS)
- COVID-19 (hospitalized patients)
What Are the Benefits of Actemra?
- Reduces inflammation and joint damage
- Slows the progression of lung disease
- Helps manage serious immune overreactions
- Reduces the severity of symptoms in autoimmune diseases
How It Works
Actemra targets the immune system’s attack on the body, a problem in conditions like rheumatoid arthritis (RA).
It blocks interleukin-6 (IL-6), a substance involved in this harmful attack. By blocking IL-6, Actemra helps reduce inflammation and joint damage.
Dosage
Intravenous Infusion:
- 80 mg/4 mL solution in a 20 mg/mL single-dose vial
- 200 mg/10 mL solution in a 20 mg/mL single-dose vial
- 400 mg/20 mL solution in a 20 mg/mL single-dose vial
Subcutaneous Injection:
- 162 mg/0.9 mL solution in a single-dose prefilled syringe
- 162 mg/0.9 mL solution in a single-dose prefilled ACTPen® autoinjector
Usage Guide
Actemra can be administered in two ways:
- Intravenous (IV) infusion
- Subcutaneous (SC) injection
Important Notes Before Starting Actemra
- Do not use Actemra with other biologic disease-modifying antirheumatic drugs (DMARDs), such as TNF blockers or IL-1R antagonists, to avoid serious infections.
- Before treatment, your doctor will do lab tests to check your:
- White blood cell count (ANC)
- Platelet count
- Liver enzymes (ALT, AST)
Actemra Dosage Chart by Condition and Route
| Condition | Route | Dosage | Frequency | Notes |
| Rheumatoid Arthritis (RA) | Intravenous (IV) | Start with 4 mg/kg, increase to 8 mg/kg | Every 4 weeks | Given by a healthcare provider; 60-minute infusion; max 800 mg |
| Subcutaneous (Injection at home) | 162 mg | Every other week if under 100 kg; Every week if 100 kg or more | Rotate injection sites; dose can be adjusted based on labs | |
| Giant Cell Arteritis (GCA) | Intravenous (IV) | 6 mg/kg | Every 4 weeks | Used with tapering steroids; max 600 mg per infusion |
| Subcutaneous | 162 mg | Every week or every other week | Can be used alone after steroids are stopped | |
| Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD) | Subcutaneous only | 162 mg | Every week | Use a prefilled syringe |
| Polyarticular Juvenile Idiopathic Arthritis (PJIA) | Intravenous (IV) | 10 mg/kg if under 30 kg
8 mg/kg if 30 kg or more |
Every 4 weeks | 60-minute infusion; dose based on weight |
| Subcutaneous | 162 mg | Every 3 weeks if under 30 kg
Every 2 weeks if 30 kg or more |
Can be given at home with training | |
| Systemic Juvenile Idiopathic Arthritis (SJIA) | Intravenous (IV) | 12 mg/kg if under 30 kg
8 mg/kg if 30 kg or more |
Every 2 weeks | 60-minute infusion |
| Subcutaneous | 162 mg | Every 2 weeks if under 30 kg
Every week, if 30 kg or more |
Home injection with guidance | |
| Cytokine Release Syndrome (CRS) | Intravenous (IV) only | 12 mg/kg if under 30 kg
8 mg/kg if 30 kg or more |
Single dose (repeat every 8 hours if needed, up to 4 total doses) | Max dose is 800 mg per infusion; subcutaneous use not approved |
How to Administer Actemra
Actemra can be administered in two ways: as an intravenous (IV) infusion or as a subcutaneous (SC) injection.
The method of administration and frequency of dosage depends on the specific condition being treated.
- Intravenous Infusion: Administered by a healthcare provider, this method involves injecting the medication into a vein over about one hour. The frequency of infusions varies:
- For rheumatoid arthritis and giant cell arteritis: every 4 weeks.
- For systemic juvenile idiopathic arthritis: every 2 weeks.
- For cytokine release syndrome and COVID-19: typically a single dose, with a possible second dose if needed.
- Subcutaneous Injection: This can be done at home after proper training. It involves injecting the medication under the skin. The dosing schedule includes:
- Weekly or bi-weekly injections for rheumatoid arthritis, giant cell arteritis, and systemic sclerosis-associated interstitial lung disease.
- For polyarticular and systemic juvenile idiopathic arthritis, the frequency depends on the patient’s weight and condition severity.
Always follow your healthcare provider’s instructions and keep all follow-up appointments to monitor your response to the treatment and adjust dosages as necessary.
Side Effects
Common Side Effects
- Upper respiratory tract infections
- Headache
- High blood pressure
- Injection site reactions
Serious but Rare Side Effects
- Tiredness, vomiting, chills
- Dark urine, yellow skin or eyes
- Clay-colored stool
- Stomach discomfort, skin rash
- Appetite loss, fever, muscle aches
- Shortness of breath, chest pain
- Swelling (face, lips, tongue)
- Dizziness or fainting
- Abdominal pain or vomiting
Missed Dose
If you miss your weekly dose of Actemra and remember within 7 days, skip the missed dose and wait until your next scheduled dose. Do not take two doses to make up for the missed one. If you are not sure what to do, talk to your doctor or pharmacist.
Overdose
Overdosing with Actemra is not common, and there is little to no available information about it. In one case, a person with multiple myeloma accidentally got a high dose through an IV, but they didn’t have any bad reactions.
In another study, healthy individuals received single doses of Actemra up to a certain amount, and they mostly experienced low white blood cell counts, but these were not serious.
Warnings
Boxed Warning and Precautions for Actemra Patients on Actemra might get serious infections that could require hospitalization or even result in death.
Infections include:
- Tuberculosis (test required before treatment)
- Invasive fungal infections
- Bacterial, viral, and opportunistic infections
General Precautions
- Risk of serious infections
- Gastrointestinal perforations
- Liver injury (hepatotoxicity)
- Blood abnormalities
- Lipid abnormalities
- Immunosuppression and potential cancer risk
- Hypersensitivity reactions (including anaphylaxis)
- Demyelinating disorders (e.g., multiple sclerosis)
- Avoid live vaccines during treatment
Contraindications
Do not use Actemra if you have a known allergy to it. If you had a serious reaction to Actemra in the past, it is not safe to take it again. Inform your doctor if you have had allergic reactions to any medications before starting Actemra.
Interactions
- methotrexate
- non-steroidal anti-inflammatory drugs
- corticosteroids
- biological DMARDs such as TNF antagonists
- CYP450 substrates
- omeprazole
- simvastatin
- warfarin
- cyclosporine
- theophylline
- oral contraceptives
- lovastatin
- atorvastatin
- live vaccines
Storage Information
Store Actemra in the refrigerator at a temperature between 36 degrees Fahrenheit and 46 degrees Fahrenheit or 2 degrees Celsius and 8 degrees Celsius. Do not freeze the medication. Keep it in its original packaging to protect it from light.
If needed, Actemra can be stored at room temperature, up to 86 degrees Fahrenheit (30 degrees Celsius), for up to two weeks after it has been removed from the refrigerator.
Alternatives
If Actemra is not right for you, alternatives may include:
- Remicade
- Celebrex
- Hydroxychloroquine
- Prednisone
- Sulfasalazine
- Meloxicam
Cost & Discounts for Actemra in Canada
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Explore our Actemra (Tocilizumab) Offerings:
| Strength | Quantity | Price (USD) |
|---|---|---|
| 80mg/4mL | 1 vial | $287.00 |
| 2 vials | $560.00 | |
| 3 vials | $810.00 | |
| 162mg/0.9mL | 4 pens | $2499.00 |
| 8 pens | $4960.00 | |
| 12 pens | $7410.00 | |
| 200mg/10mL | 1 vial | $719.00 |
| 2 vials | $1420.00 | |
| 3 vials | $2100.00 | |
| 400mg/20mL | 1 vial | $1439.00 |
| 2 vials | $2860.00 | |
| 3 vials | $4260.00 |
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Disclaimer
| Pharma Giant provides medical information to help you better understand medications and medical conditions. This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications. |
