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Actemra (Subcutaneous)

Generic Name: Tocilizumab (Subcutaneous) (toe si LIZ oo mab)
Brand Name: Actemra

Medically reviewed on September 5, 2018

Warning

  • Very bad and sometimes deadly infections have happened in patients who take Actemra (tocilizumab (subcutaneous)). Most people who had these infections were taking other drugs to lower the immune system like methotrexate or steroid drugs. If you have any infection, are taking antibiotics now or in the recent past, or have had many infections, talk with your doctor.
  • TB (tuberculosis) has been seen in patients started on Actemra (tocilizumab (subcutaneous)). These patients were exposed to TB in the past, but never got the infection. You will be tested to see if you have been exposed to TB before starting Actemra (tocilizumab (subcutaneous)).

Uses of Actemra:

See also: Orencia

What do I need to tell my doctor BEFORE I take Actemra?

  • If you have an allergy to tocilizumab or any other part of Actemra (tocilizumab (subcutaneous)).
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have liver disease or raised liver enzymes.
  • If you have an infection.
  • If you are taking any of these drugs: Abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, or rituximab.

This is not a list of all drugs or health problems that interact with Actemra (tocilizumab (subcutaneous)).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Actemra (tocilizumab (subcutaneous)) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Actemra?

  • Tell all of your health care providers that you take Actemra (tocilizumab (subcutaneous)). This includes your doctors, nurses, pharmacists, and dentists.
  • Very bad and sometimes deadly allergic side effects have rarely happened. Talk with your doctor.
  • You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
  • If you have high blood sugar (diabetes), talk with your doctor. You may be more likely to get infections.
  • If you have had hepatitis B before or carry the virus, talk with your doctor. This medicine can cause the virus to become active again.
  • Hepatitis B testing needs to be done as you were told by the doctor. Talk with the doctor.
  • This medicine may add to the chance of getting some types of cancer. Talk with the doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Make sure you are up to date with all your vaccines before treatment with Actemra (tocilizumab (subcutaneous)).
  • Talk with your doctor before getting any vaccines. Use with Actemra (tocilizumab (subcutaneous)) may either raise the chance of an infection or make the vaccine not work as well.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
  • Treatment with Actemra (tocilizumab (subcutaneous)) may lead to higher cholesterol and triglycerides. The effect of these changes on heart health is not known. Talk with the doctor.
  • This medicine may affect how much of some other drugs are in your body. If you are taking other drugs, talk with your doctor. You may need to have your blood work checked more closely while taking Actemra (tocilizumab (subcutaneous)) with your other drugs.
  • If your weight changes, talk with your doctor. The dose of Actemra (tocilizumab (subcutaneous)) may need to be changed.
  • If you are 65 or older, use Actemra (tocilizumab (subcutaneous)) with care. You could have more side effects.
  • Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use some other kind of birth control also like a condom when taking Actemra (tocilizumab (subcutaneous)).
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Actemra (tocilizumab (subcutaneous)) while you are pregnant.
  • If you used Actemra (tocilizumab (subcutaneous)) when you were pregnant, tell your baby's doctor.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

How is this medicine (Actemra) best taken?

Use Actemra (tocilizumab (subcutaneous)) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • It is given as a shot into the fatty part of the skin.
  • If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
  • Follow how to use as you have been told by the doctor or read the package insert.
  • Do not use if the solution is cloudy, leaking, or has particles.
  • This medicine is colorless to a faint yellow. Do not use if the solution changes color.
  • Before using Actemra (tocilizumab (subcutaneous)), take it out of the refrigerator and leave it at room temperature for 30 minutes.
  • Do not heat or microwave.
  • Move the site where you give the shot with each shot.
  • Do not give into red or irritated skin.
  • Do not give into a mole, scar, or bruise.
  • Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

What do I do if I miss a dose?

  • Call your doctor to find out what to do.

See also: Dosage Information (in more detail)

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of bleeding like throwing up blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop.
  • Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of high or low blood pressure like very bad headache or dizziness, passing out, change in eyesight.
  • Signs of nervous system problems like change in mood or actions, feeling confused, fever, numbness or tingling in the hands or feet, stiff neck, bright lights bother your eyes, or very bad muscle weakness.
  • A skin lump or growth.
  • Change in color or size of a mole.
  • Shortness of breath.
  • Chest pain or pressure.
  • Very upset stomach or throwing up.
  • Change in bowel habits.
  • Tears in the stomach or bowel wall have happened in certain people taking Actemra (tocilizumab (subcutaneous)). Call your doctor right away if you have swelling or pain in your stomach that is very bad, gets worse, or does not go away. Call your doctor right away if you throw up blood or have throw up that looks like coffee grounds; upset stomach or throwing up that does not go away; or black, tarry, or bloody stools.

What are some other side effects of Actemra?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Headache.
  • Signs of a common cold.
  • Nose and throat irritation.
  • Irritation where the shot is given.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

See also: Side effects (in more detail)

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Actemra?

  • Store in a refrigerator. Do not freeze.
  • Store in original container.
  • Protect from light.
  • Keep dry.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer information use

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time Actemra (tocilizumab (subcutaneous)) is refilled. If you have any questions about Actemra (tocilizumab (subcutaneous)), please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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