Anakinra


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : SC Rheumatoid arthritis 100 mg/day. Cryopyrin associated periodic syndromes Initial: 1-2 mg/kg/day. Severe: Adjust dose in increments of 0.5-1 mg/kg after 1-2 mth. Maintenance: 3-4 mg/kg/day. Max: 8 mg/kg/day.
Dosage Details
Subcutaneous
Rheumatoid arthritis
Adult: 100 mg daily, administered at approx the same time each day. May be used w/ methotrexate.

Subcutaneous
Cryopyrin associated periodic syndromes
Adult: Initially, 1-2 mg/kg daily. Severe: Adjust dose in increments of 0.5-1 mg/kg after 1-2 mth if necessary. Maintenance: 3-4 mg/kg daily. Max: 8 mg/kg daily.
Child: ≥8 mth ≥10 kg: Same as adult dose.
Renal Impairment
CrCl (mL/min) Dosage
<30 Contraindicated.
Contraindications
Hypersensitivity to E. coli-derived proteins or anakinra. Neutropenia (absolute neutrophil count <1.5 x 109/L). Severe renal impairment (CrCl <30 mL/min).
Special Precautions
Patient w/ active infections, including chronic or localised infections, history of recurrent infections or w/ underlying conditions that may predispose to infections, asthma. Moderate renal (CrCl 30-50 mL/min) and severe hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Infection (e.g. upper resp tract infection, sinus infection), mild to moderate inj site reactions w/ symptoms of erythema, bruising, swelling and pain, headache, nausea, diarrhoea, abdominal pain, elevated transaminases, non-infectious hepatitis. Rarely, allergic reactions e.g. rashes.
MonitoringParameters
Monitor neutrophil counts before initiating treatment, mthly during the 1st 6 mth, and quarterly thereafter.
Drug Interactions
Enhanced adverse effects of live vaccines. Co-admin w/ etanercept or other tumour necrosis factor (TNF) inhibitors may induce serious infection and neutropenia.
Action
Description: Anakinra is a recombinant receptor antagonist of interleukin-1 (IL-1). It competitively inhibits IL-1 binding to interleukin-1 type I receptor (IL-1RI) and hence blocks the activity of endogenous IL-1α and IL-1β. IL-1 is involved in inflammatory and immunological responses, cartilage degradation (loss of proteoglycans), stimulates bone resorption and its production is induced by inflammatory stimuli.
Pharmacokinetics:
Absorption: Absolute bioavailability: 95%. Time to peak plasma concentration: 3-7 hr.
Excretion: Excreted mainly in the urine. Terminal half-life: Approx 4-6 hr.
Chemical Structure

Chemical Structure Image
Anakinra

Source: National Center for Biotechnology Information. PubChem Database. Anakinra, CID=139595263, https://pubchem.ncbi.nlm.nih.gov/compound/Anakinra (accessed on Jan. 20, 2020)

Storage
Store between 2-8°C. Do not freeze. Protect from light.
ATC Classification
L04AC03 - anakinra ; Belongs to the class of interleukin inhibitors. Used as immunosuppressants.
References
Anon. Anakinra. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/12/2015.

Buckingham R (ed). Anakinra. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/12/2015.

Kineret Injection Solution (Swedish Orphan Biovitrum AB). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 01/12/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Anakinra. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 01/12/2015.

Disclaimer: This information is independently developed by MIMS based on Anakinra from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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