Actemra
Form: IV Infusion
Strength: 200mg/10ml
Generic Name: Tocilizumab
Company: Roche Bangladesh Pharmaceutical
MRP:৳ 23545.6 (10ml vial)
Is Antibiotic: No
Indications
Actemra is used for the treatment of:
- Rheumatoid Arthritis (RA): For adults with moderate to severe rheumatoid arthritis who haven’t responded well to one or more disease-modifying drugs.
- Polyarticular Juvenile Idiopathic Arthritis (PJIA): For children aged 2 and older with active polyarticular juvenile idiopathic arthritis.
- Systemic Juvenile Idiopathic Arthritis (SJIA): For children aged 2 and older with active systemic juvenile idiopathic arthritis.
- COVID-19: For hospitalized adults and children (2 years and older) with severe symptoms who need extra oxygen or ventilation.
- Cytokine Release Syndrome (CRS): For patients with severe CRS caused by CAR T-cell therapy.
- Giant Cell Arteritis (GCA): For adults with giant cell arteritis.
- Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): To slow the decline in lung function in adults with this condition.
Pharmacology
Actemra is a medication that blocks the IL-6 receptor, which plays a role in inflammation. By blocking IL-6, Actemra helps reduce inflammation and improve symptoms in conditions like rheumatoid arthritis. IL-6 is produced by various cells in the body and contributes to several processes like immune response and red blood cell production.
Dosage & Administration
Rheumatoid Arthritis: The recommended dose is 4 mg per kg of body weight every 4 weeks, which can be increased to 8 mg per kg after assessing the clinical response.
Polyarticular Juvenile Idiopathic Arthritis: For children less than 30 kg, 10 mg per kg every 4 weeks. For children 30 kg or more, 8 mg per kg every 4 weeks.
Systemic Juvenile Idiopathic Arthritis: For children less than 30 kg, 12 mg per kg every 2 weeks. For children 30 kg or more, 8 mg per kg every 2 weeks.
COVID-19: The recommended dose is 8 mg per kg for patients 30 kg or more, and 12 mg per kg for patients less than 30 kg. If no improvement occurs, one more dose can be given after 8 hours. The maximum dose is 800 mg per infusion.
Cytokine Release Syndrome: The recommended dose for patients under 30 kg is 12 mg per kg and for those 30 kg or more is 8 mg per kg. If there’s no improvement, up to 3 additional doses can be given.
Giant Cell Arteritis: The recommended dose is 6 mg per kg every 4 weeks, combined with a tapering course of glucocorticoids.
Systemic Sclerosis-Associated Interstitial Lung Disease: The recommended dose is 162 mg once a week as a subcutaneous injection.
Interaction
Be cautious when using Actemra with drugs like oral contraceptives, lovastatin, or atorvastatin. Actemra may also affect the activity of certain liver enzymes, and this effect could last for several weeks after stopping the treatment.
Contraindications
Actemra is contraindicated for patients who are allergic to Actemra.
Side Effects
Common side effects include upper respiratory infections, headache, hypertension, injection site reactions, and increased liver enzymes. In COVID-19 patients, side effects like constipation, anxiety, diarrhea, and nausea are also reported.
Pregnancy & Lactation
Actemra may harm the fetus based on animal studies. During pregnancy, Actemra should only be used if the benefits outweigh the risks. If breastfeeding, the mother should discuss with a doctor whether to continue using Actemra while breastfeeding.
Precautions & Warnings
Do not use Actemra during an active infection. If a serious infection occurs, treatment should be paused until the infection is under control. Monitor for tuberculosis, liver problems, and other issues that may arise during treatment. Avoid using live vaccines or combining Actemra with other biological treatments.
Overdose Effects
If overdosed, the patient should be monitored for symptoms and receive appropriate treatment as needed.
Therapeutic Class
Actemra is used to treat rheumatoid arthritis.
Storage Conditions
Store Actemra between 2°C to 8°C in a dry place. Do not freeze.