• Moderate-severe rheumatoid arthritis used alone or with methotrexate or other non-biologic DMARDs:
    • IV infusion: Initially 4mg/kg every 4 weeks; may increase to 8mg/kg every 4 weeks based on clinical response
      • Max 800mg/dose every 4weeks
    • SC injection:
      • Weight <100kg: SC 162mg every 2 weeks, followed by an increase to weekly based on clinical response
      • Weight ≥100 kg: SC 162mg weekly
  • Systemic juvenile idiopathic arthritis in children ≥2 years with/without methotrexate::
    • IV:
      • <30kg: 12mg/kg/dose every 2 weeks
      • >30kg: 8mg/kg/dose every 2 weeks
    • SC:
      • <30kg:162mg every 2 weeks
      • >30kg: 162mg weekly
  • Polyarticular juvenile idiopathic arthritis in children in children ≥2 years with/without methotrexate:
    • IV:
      • <30kg: 10mg/kg/dose every 2 weeks
      • >30kg: 8mg/kg/dose every 2 weeks
    • SC:
      • <30kg:162mg every 3 weeks
      • >30kg: 162mg every 2 weeks
  • Giant cell arteritis (GCA):
    • IV: 6mg/kg/dose every 4 weeks. Max: 600mg/dose
    • SC: 162mg weekly
    • Use with tapering course of glucocorticoids, then may continue as monotherapy
  • Slowing the rate of decline in pulmonary function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD):
    • SC 162mg weekly
  • Chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome (CRS) in adults and children ≥2 years:
    • ≥30kg: IV 8mg/kg *1
    • <30kg: IV 12mg/kg *1
    • Max 800mg/dose
    • Used alone or with corticosteroids
  • COVID-19 in adults and children ≥2 years:
    • ≥30kg: IV 8mg/kg *1
    • <30kg: IV 12mg/kg *1
    • Max 800mg/dose
    • Used with systemic corticosteroids
    • For hospitalized patients requiring supplemental oxygen, mechanical ventilation or extracorporeal membrane oxygenation (ECMO)

Injection: 20mg/mL

Pre-filled syringe: 162mg/0.9mL

  • SC not recommended for CRS
  • Infuse over 1 hour with an infusion set
  • Do NOT administer as bolus or push
  • Do not infuse with any other drugs as no compatibility studies have been conducted
  • Rotate SC injection sites (i.e, thighs, abdomen, outer area of upper arm)

DMARD; Immunomodulator; Monoclonal antibody

It binds to and inhibits IL-6 receptors, reducing inflammation and altering immune response

  • Injection site reaction (SC use)
  • Infusion reaction (IV use)
  • Dyslipidemia
  • Constipation
  • URI
  • Nasopharyngitis
  • Headache
  • Acute kidney injury
  • Hypertension
  • Anxiety
  • Diarrhea
  • Elevated ALT/AST
  • Hypokalemia
  • Hyperglycemia
  • Insomnia
  • Delirium
  • Nausea
  • Hypoglycemia
  • Pain
  • Dizziness
  • Bronchitis
  • Rash
  • Oral ulcer
  • Abdominal pain
  • Gastritis
  • Thrombosis
  • Hypersensitivity to class/components
  • Active hepatic disease
  • Active infection
  • ANC <2000 (except COVID-19 use)
  • ANC <1000 (COVID-19 use)
  • Plt <100,000 (except COVID-19 use)
  • Plt <50,000 (COVID-19 use)
  • ALT or AST >1.5x ULN (except COVID-19 use)
  • ALT or AST >10x ULN (COVID-19 use)

WARNING

  • Weigh treatment benefit vs risk in patients with chronic or recurrent infection
  • Pulmonary and extrapulmonary tuberculosis (TB), invasive fungal infections and other opportunistic infections observed and fatal
  • Most infections occur in combo with other immunosuppressants
  • Live bacterial vaccines
  • Tamoligene

                          Drug Status

Availability Prescription only
Pregnancy Weigh risk vs benefit
Breastfeeding Use with caution
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Actemra 80mg Injection 4mL F. Hoffman-La Roche Roche Kenya
Actemra 400mg Injection 20mL F. Hoffman-La Roche Roche Kenya