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Generic name: anakinra [ an-na-KIN-rah ]
Brand name: Kineret
Dosage form: subcutaneous solution (100 mg/0.67 mL)
Drug classes: Antirheumatics, Interleukin inhibitors

Medically reviewed by on Apr 6, 2021. Written by Cerner Multum.

What is anakinra?

Anakinra is used to treat the symptoms of moderate to severe rheumatoid arthritis in adults. Anakinra may also help slow the progress of the disease. Anakinra is usually given after other arthritis medications did not work or have stopped working.

Anakinra is also used in newborn babies to treat a rare genetic condition called neonatal onset multisystem inflammatory disease (NOMID). NOMID is a form of cryopyrin-associated periodic syndromes (CAPS). This condition causes uncontrolled inflammation in many parts of the body, including the skin, joints, and central nervous system.

Anakinra is also used to control symptoms of a condition called Deficiency of Interleukin-1 Receptor Antagonist (DIRA) in adults and children. DIRA is a very rare genetic condition that causes a severe inflammatory reaction during the first days of life and can lead to organ failure throughout the body.

Anakinra may also be used for purposes not listed in this medication guide.


You should not use anakinra if you are allergic to medicines that contain E. coli bacteria proteins, or if you have an active infection.

Before taking this medicine

You should not use this medicine if you are allergic to anakinra or if you have:

  • an active infection; or

  • an allergy to any medicine that contains E. coli bacteria proteins.

Tell your doctor if you have ever had:

  • kidney disease;

  • an active or chronic infection;

  • fever, chills, or open sores on your skin;

  • a weak immune system (caused by disease or by using certain medicines):

  • asthma; or

  • tuberculosis.

Tell your doctor if you are pregnant or plan to become pregnant. Having rheumatoid arthritis or CAPS during pregnancy may increase the risk of premature birth or low birth weight. The benefit of treating rheumatoid arthritis or CAPS may outweigh any risks to the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Do not give this medicine to a child without medical advice. Anakinra is not approved to treat rheumatoid arthritis in anyone younger than 18 years old.

How should I use anakinra?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Anakinra is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Anakinra is given either once per day or once every other day. Follow your doctor's dosing instructions very carefully. Inject your dose at the same time of day when you use the medicine.

Your healthcare provider will show you where on your body to inject anakinra. Use a different place each time you give an injection. Each injection should be given at least 1 inch away from where you last injected the medicine.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Do not shake the prefilled syringe or you may ruin the medicine.

Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.

Call your doctor if your arthritis symptoms do not improve, or if they get worse while using anakinra.

Anakinra affects your immune system. You may get infections more easily. You will need frequent medical tests while using anakinra and for several months after you stop using it.

Store in the refrigerator, do not freeze. Protect from light. Throw away any unused medicine after the expiration date on the label has passed.

Each prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using anakinra?

Do not receive a "live" vaccine while using anakinra, or you could develop an infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Anakinra side effects

Get emergency medical help if you have signs of an allergic reaction: hives, sweating, severe itching; wheezing, difficult breathing; fast or pounding heartbeats; dizziness, fainting; swelling of your face, lips, tongue, or throat.

If you are using anakinra for DIRA, you may have an increased risk of allergic reactions, especially in the first weeks of treatment.

Anakinra may cause serious side effects. Call your doctor at once if you have:

  • fever or chills;

  • open sores on your body; or

  • signs of tuberculosis: fever, cough, night sweats, loss of appetite, weight loss, and feeling very tired.

Common side effects of anakinra may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Anakinra dosing information

Usual Adult Dose for Rheumatoid Arthritis:

100 mg subcutaneously once daily at approximately the same time each day

-Alternating the injection site is recommended to avoid discomfort at the site of injection.

Use: To reduce symptoms and slow the progression of structural damage in moderately to severely active rheumatoid arthritis (RA) in patients who have failed 1 or more disease modifying antirheumatic drugs (DMARDs)

Usual Adult Dose for Interleukin-1 Receptor Antagonist Deficiency:

Initial dose: 1 to 2 mg/kg subcutaneously daily
Dose escalation: Adjust doses in 0.5 to 1 mg/kg increments
Maximum dose: 8 mg/kg subcutaneously daily

Use: For the treatment of Deficiency of Interleukin-1 Receptor Antagonist (DIRA)

Usual Pediatric Dose for Cryopyrin-Associated Periodic Syndrome:

Initial dose: 1 to 2 mg/kg subcutaneously daily
Dose escalation: Adjust doses in 0.5 to 1 mg/kg increments
Maximum dose: 8 mg/kg subcutaneously daily
NOTE: Once daily administration is generally recommended, but the dose may be split into twice daily administrations.

-The therapeutic response is primarily reflected by reduction in symptoms such as fever, rash, joint pain, and headache, but also in inflammatory serum markers (CRP/SAA levels), or occurrence of flares.

Use: Cryopyrin-Associated Periodic Syndromes (CAPS): Treatment of Neonatal-Onset Multisystem Inflammatory Disease (NOMID)

Usual Pediatric Dose for Interleukin-1 Receptor Antagonist Deficiency:

1 month and older:
Initial dose: 1 to 2 mg/kg subcutaneously daily
Dose escalation: Adjust doses in 0.5 to 1 mg/kg increments
Maximum dose: 8 mg/kg subcutaneously daily

Use: For the treatment of Deficiency of Interleukin-1 Receptor Antagonist (DIRA) in children 1 month and older

What other drugs will affect anakinra?

You may have a higher risk of infection from anakinra if you are also using:

This list is not complete. Other drugs may affect anakinra, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Frequently asked questions

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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