The drug is administered by monthly intravenous infusions. An infusion takes about an hour.
Most common adverse reactions include headache, upper respiratory tract infections, nasopharyngitis, hypertension, increased ALT and injection site reactions.
- The use of this medication is contraindicated during the acute infections, as well as under the latent tuberculosis.
- Do not administer this medication during an active infection, including localized infections. If a serious infection occurs, interrupt tocilizumab dosage until the infection is controlled.
- Patients should be evaluated for the risk factors of tuberculosis and should be tested for the latent infection before initiating actemra.
- Patients should be closely monitored for the development of the signs and symptoms of infection during and after treatment with the tocilizumab 200 mg.
- This drug should be used with caution in patients who are at the increased risk for the gastrointestinal perforation.
- The use of this medicine is not recommended in patients who may develop an absolute neutrophil count less than 500 per mm.
- Patients must be monitored for the neutrophils 4 to 8 weeks after initiating the therapy and every 3 months thereafter. Patients should be monitored for ALT and AST levels 4 to 8 weeks after initiating the therapy and every 3 months thereafter.
- Intravenously use of tocilizumab should only be infused by a healthcare professional with the appropriate and sufficient medical support in order to manage the anaphylaxis.
- Patients need to be monitored for the signs and symptoms potentially indicative of demyelinating disorders.
- Do not administer this injection in patients with the known hypersensitivity to tocilizumab.
- Live vaccines should be avoided as clinical safety has not been established.
- In the event of an overdose, patients should be monitored for the signs and symptoms of the adverse reactions.
- Patients who experience adverse reactions should take appropriate symptomatic treatment.
Care should be exercised in the handling of ACTEMRA. ACTEMRA injection should not be opened or crushed. Vials and syringes should be protected from light by storage in the original package until time of use, and keep syringes dry. Store permitted between 2ºC to 8ºC (36°F to 46°F). Do not freeze.
WHAT IS TOCILIZUMAB AND WHAT IT IS USED FOR:
Temozolomide is an alkylating agent indicated for the treatment of some brain cancers; as a second-line treatment for astrocytoma and a first-line treatment for glioblastoma multiforme.
Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for the treatment of:
Rheumatoid arthritis: moderate to severe rheumatoid arthritis, in combination with the methotrexate, if other drugs like disease-modifying antirheumatic drugs (DMARDs) and TNF alpha blockers have proven to be ineffective or were not tolerated.
Systemic juvenile idiopathic arthritis: for treating systemic juvenile idiopathic arthritis is similar to RA treatment: tocilizumab is combined with the methotrexate unless the latter is not tolerated.
- Castleman’s disease: for treatment of a rare benign tumor of B cells.
- Neuromyelitis optica: effective in otherwise refractory neuromyelitis optica (NMO, Devic’s disease).
- Giant cell arteritis: for giant cell (temporal) arteritis.
- Cytokine release syndrome: for cytokine release syndrome, a kind of side effect of CAR-T cell therapies.