Tocilizumab belongs to a new class of medicines called biological disease modifying antirheumatic drugs (biological DMARDs).
These medicines block natural substances called cytokines, which are found in excessive amounts in the blood and joints of people with rheumatoid arthritis, psoriatic arthritis, juvenile arthritis and ankylosing spondylitis.
The increased levels of cytokines cause inflammation, which results in symptoms of pain, joint swelling and stiffness, and can lead to joint damage.
By blocking the cytokine called interleukin-6 (IL-6), tocilizumab reduces inflammation, lessens the symptoms and helps stop further joint damage.
You may experience side effects with your treatment. Contact your doctor if you have any concerns about possible side effects
Most common possible side effects
Less common or rare possible side effects
If you have an active infection of any kind, treatment with tocilizumab will not be given until the infection is treated successfully.
Tocilizumab will not be given if you have active untreated tuberculosis or HIV infection, as it is likely to worsen these conditions.
If you have latent (inactive) tuberculosis, preventive anti-tuberculosis treatment will be started at least 4 weeks before tocilizumab. The anti-tuberculosis treatment will need to be taken for 9 months.
Hepatitis B or C infection may not necessarily exclude treatment.
Before of the risks associated with infection, laboratory tests will be conducted before commencing treatment with tocilizumab.
Blood tests will be required during your treatment to monitor your condition and to determine the effectiveness of treatment.
You should receive annual pneumococcal and seasonal flu vaccinations to reduce risks of infections.
If you require surgery for any reason, treatment will be stopped before surgery and restarted again after the surgery at a time determined by your surgeon and rheumatologist.
If cancer has previously been treated and cured, it is unclear whether a biological DMARD such as tocilizumab can be used safely.
At present an interval of at least 5 years is recommended between cure of a cancer and starting biological DMARDs.
Talk to your rheumatologist if you have any concerns about issues relating to cancer risk.
You may drink alcohol while taking tocilizumab
However, since you are likely to be also taking methotrexate, you should be cautious about your alcohol intake
It is not known precisely what level of drinking is safe when on methotrexate, however there is general agreement that 1 to 2 standard drinks taken once or twice a week is unlikely to cause a problem
Drinking more than 4 standard drinks on one occasion, even if infrequently, is strongly discouraged
Tocilizumab is given as a drip (infusion) into the vein.
The infusion normally takes one hour and is followed by a period of observation for at least one hour to make sure you do not have any side effects.
Doses are usually given every 4 weeks.
Dosing is based on weight, so each person's dose may differ.
Tocilizumab may be used with other arthritis medicines including:
If tocilizumab treatment is stopped for more than a few weeks there is a risk that your condition will get worse again.
Continue with your treatment unless advised by your doctor or unless side effects develop.
If you stop tocilizumab for any reason you must contact your doctor.