Uses

An IL-6 receptor antagonist indicated for moderately to severely active rheumatoid arthritis in adults inadequately responding to DMARDs, giant cell arteritis, polyarticular and systemic juvenile idiopathic arthritis, and cytokine release syndrome.

Do not use if

Contraindicated in patients with known hypersensitivity to tocilizumab products.

Side effects

Common adverse reactions include upper respiratory tract infections, nasopharyngitis, headache, hypertension, and elevated liver enzymes. Serious risks include severe infections, gastrointestinal perforations, neutropenia, thrombocytopenia, and hypersensitivity reactions including anaphylaxis.

Warnings

Boxed warning: patients are at increased risk of serious infections that may lead to hospitalization or death. Do not start treatment during active infection. Monitor for tuberculosis reactivation and opportunistic infections. Monitor liver enzymes, neutrophil, and platelet counts regularly.

How it works

Tocilizumab binds to both soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated pro-inflammatory signaling. IL-6 is a pleiotropic cytokine involved in immune activation, acute-phase response, and hematopoiesis. Blockade reduces CRP, ESR, and inflammatory markers.

Storage

Refrigerate at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect vials and prefilled syringes from light.