TOCILIZUMAB
(Actemra)Standard Prescription
tocilizumab __ mg IV {frequency} ( __ mg/kg/dose)
Dosages
Systemic juvenile idiopathic arthritis:
Uveitis:
8 mg/kg/ dose IV Q4wks
Maximum 800 mg/dose
<30 kg: 12 mg/kg/dose IV Q2wks
>=30 kg: 8 mg/kg/ dose IV Q2wks
SC dosing
<30 kg: 162 mg SC Q2wks
>=30 kg: 162 mg SC weekly
Polyarticular juvenile idiopathic arthritis:<30 kg: 162 mg SC Q2wks
>=30 kg: 162 mg SC weekly
<30 kg: 8 - 10 mg/kg/ dose IV Q4wks
>=30 kg: 8 mg/kg/dose IV Q4wks
SC dosing
<30 kg: 162 mg SC Q2wks
>=30 kg: 162 mg SC weekly
<30 kg: 162 mg SC Q2wks
>=30 kg: 162 mg SC weekly
Uveitis:
8 mg/kg/ dose IV Q4wks
Cytokine release syndrome (secondary to CAR T-cell therapy):
<30 kg: 12 mg/kg/dose IV
>=30 kg: 8 mg/kg/dose IV
May repeat Q8-12H PRN. Usual max 2-3 doses
<30 kg: 12 mg/kg/dose IV
>=30 kg: 8 mg/kg/dose IV
May repeat Q8-12H PRN. Usual max 2-3 doses
Mechanism of Action
Monoclonal antibody against IL6 - receptor
Forms Supplied
injection: 80 mg, 200 mg, 400 mg vials
Comments
Adverse effects include injection site irritation, infusion reaction, headache, dizziness, abdominal pain, diarrhea, elevated liver enzymes, and infection.
Consider dose modification if elevated liver enzymes, neutropenia or thrombocytopenia.
Neutropenia occurred at a rate of 17% in research trials. Refer to rheumatology guidelines for dose modification.
Risk of infection: do not use in patients with severe infection. All patients should be evaluated for both active and latent tuberculosis before starting treatment.
Administration of live vaccinations to patients on tocilizumab not recommended.
Conversion from IV to SC dosing: Administer first SC dose instead of next scheduled IV dose.
References
44, 331, 332, 333, 510
Product Monograph: ACTEMRA tocilizumab solution for injection. Hoffmann-La Roche Limited. Mississauga, Ontario 2021.
Last Edited
2021-08-03 06:00:42