Skip to Content

Actemra (tocilizumab) Disease Interactions

There are 7 disease interactions with Actemra (tocilizumab):

Major

Interleukin inhibitors (applies to Actemra) immunization

Major Potential Hazard, Moderate plausibility. Applicable conditions: Vaccination

Patients requiring non-live vaccination during a course of therapy with interleukin inhibitors may not be protected from the vaccine as the immune response might not be sufficient to prevent the disease. It is recommended to be up-to-date with all required immunizations, as recommended by current immunization guidelines, before initiating therapy with these agents. Patients treated with interleukin inhibitors should not receive live vaccines due to potentially increased risk of infections. Caution is advised when administering live vaccines to household contacts of patients receiving interleukin inhibitors because of the potential risk for shedding from the household contact and transmission to patient.

Moderate

Interleukin inhibitors (applies to Actemra) infections

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

There have been reports of serious infections, including infections with opportunistic pathogens, and reactivation of latent infections in patients receiving interleukin inhibitors. Treatment with these agents should not be initiated in patients with an active infection until the infection resolves or is adequately treated. Caution is recommended when considering the use of interleukin inhibitors in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections.

Moderate

Interleukin inhibitors (applies to Actemra) tuberculosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Tuberculosis -- Active, Tuberculosis -- Latent, History - Tuberculosis

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Moderate

Tocilizumab (applies to Actemra) demyelinating disorders

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Multiple Sclerosis

Clinical studies have reported that tocilizumab may have an effect on demyelinating disorders such as multiple sclerosis and chronic inflammatory demyelinating polyneuropathy. Monitor patients for signs and symptoms potentially indicative of demyelinating disorders. Caution should be exercise when considering the use of tocilizumab in patients with preexisting or recent onset demyelinating disorders.

Moderate

Tocilizumab (applies to Actemra) gastrointestinal perforation

Moderate Potential Hazard, Moderate plausibility.

The use of tocilizumab may cause gastrointestinal (GI) perforation. Use with caution in patients who may be at increased risk for GI perforation. It is recommended to closely monitor patients for symptoms indicative or that may be associated with GI perforation.

Moderate

Tocilizumab (applies to Actemra) liver dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The safety and efficacy of tocilizumab have not been studied in patients with hepatic impairment, including patients with positive HBV and HCV serology. Treatment with tocilizumab is not recommended in patients with active hepatic disease or hepatic impairment.

Moderate

Tocilizumab (applies to Actemra) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

No dose adjustment is required in patients with mild renal impairment. Care should be taken and close monitoring is recommended in patients with moderate to severe renal impairment as tocilizumab has not been studied in these patients. Clinical monitoring of renal function is recommended.

Actemra (tocilizumab) drug interactions

There are 271 drug interactions with Actemra (tocilizumab)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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