TOCILIZUMAB

Background and Date of Approval

Tocilizumab received U.S. FDA approval on 08/01/2010. This medicine is a monoclonal antibody, a protein derived from specific immune cells.

Uses

This is used in conditions such as moderate to severe active rheumatoid arthritis (RA) and who have inadequate response with other rheumatoid drugs, giant cell arteritis (disease in arteries), children with systemic juvenile idiopathic arthritis (sJIA), polyarticular juvenile idiopathic arthritis (pJIA).

How is it administered?

The medicine will be administered to you by a healthcare professional in a hospital setting. It is usually administered in the vein (intravenous). Your doctor will decide the dose, route of administration, and frequency based on your disease condition and other factors.

Side Effects

The common side effects that are experienced while you are on the treatment with tocilizumab upper respiratory tract infections characterised by symptoms like cough, a blocked or runny nose, sore throat, and headaches. It can also result in elevated blood fat (cholesterol) levels. Injection site reactions may occur, and in some cases, lung infections like pneumonia can develop. Other potential side effects encompass conditions like shingles (herpes zoster), cold sores, and blisters, as well as eye infections such as conjunctivitis. Some individuals may experience headaches, dizziness, and high blood pressure. Mouth ulceration and stomach pain are also possible, along with fluid retention in the lower legs leading to weight gain. Additionally, this medication might cause coughing and shortness of breath, low white blood cell counts (neutropenia and leucopenia), abnormal liver function tests indicated by increased transaminases, increased bilirubin levels in blood tests, and low fibrinogen levels in the blood, which is a protein crucial for blood clotting Report your doctor immediately, if you experience any allergic reaction like difficulty in breathing, swelling of the eyelids, face or lips, rash or itching, Fever and chills, Mouth or skin blisters, Stomach ache.

Warnings

Children with allergic reactions to ingredients and severe infections should consult their doctor before taking the medicine. Talk to your doctor immediately if you have any allergic reaction (difficulty with breathing, chest tightness rash, itching, hives, swelling lips, tongue, or face), infection (short- or long-term), tuberculosis, intestinal ulcers or diverticulitis (small bulging pouches developed in the digestive tract), liver disease, cancer, kidney function problems, and persistent headaches.

Precautions

Inform your doctor if the Children have a history of macrophage activation syndrome (activation and uncontrolled proliferation of specific blood cells). The elderly are more likely to develop infections than the general population, so it is important to be cautious when treating them. Consult your doctor if you are planning to get pregnant or think you may be pregnant or while you are breastfeeding.

Word of Advice

Inform your doctor if you have recently received a vaccination or plan to undergo vaccination, as live vaccines should not be administered while taking tocilizumab. Your doctor may recommend blood tests to assess white blood cell count, platelet count, and liver enzyme levels before initiating tocilizumab therapy.

References

Roche Products Limited, Electronic Medicines Compendium (EMC), [Revised on Apr 2020] [Accessed on 26th Sep 2023], https://www.medicines.org.uk/emc/files/pil.13280.pdf Genentech, Inc., US Food and Drug Administration, [Revised on Aug 2017] [Accessed on 26rd Sep 2021], https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/125276s114lbl.pdf Ahmed A. Negm & Daniel E. Furst, Nonsteroidal Anti-Inflammatory Drugs, Disease-Modifying Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout, Lange’s Basic & Clinical Pharmacology, 14th Edition, 2018, 642-666.

Frequently Asked Questions

What precautions should I take while on Tocilizumab?

Be aware of any potential infections that could come up, and consult your doctor. Your doctor will advise you to check the blood test to check. Let them know if you're having any new or worse symptoms immediately.

Can I drive when I take tocilizumab?

It is recommended to avoid driving when you take the medicine, as it can cause drowsiness. Consult your doctor before driving.

Can an elderly individual safely take tocilizumab?

The elderly are more likely to develop infections than the general population, so it is important to be cautious and consult your doctor before taking the medicine.

Can I take a vaccination while under tocilizumab medication?

Talk to your doctor if you have recently been vaccinated or are planning a vaccination because a certain vaccination (Live vaccine) should not be given while taking tocilizumab medicine.

What is the purpose of tocilizumab in children?

It is used to treat children with systemic juvenile idiopathic arthritis (sJIA) and polyarticular juvenile idiopathic arthritis (pJIA), which result in the pain and swelling in one or more joints in children of 1 to 2 years and above.

Available Brands 5

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS