Tocilizumab is used on its own or together with other medicines to treat rheumatoid arthritis (inflammation in joints of fingers, wrist, feet, ankles) in adults.
This medicine is also used on its own or together with other medicines to treat giant cell arteritis (inflammation of your blood vessels).
Your doctor or nurse will administer the injection for you. If you or a caregiver had been given the proper training on the preparation and injection techniques of Tocilizumab, you or your caregiver may do the administration.
Use this medicine exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor.
Tocilizumab is available as a single-use prefilled syringe. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area).
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject near the navel (belly button), into moles, scars or areas where the skin is tender, bruised, red, hard or not intact.
The dose of Tocilizumab will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition.
Administer the missed dose as soon as you remember.
If an every-1-week dose is not administered within 7 days, skip the missed dose and return to your normal dosing schedule.
If an every-2-week dose is not administered within 7 days, administer the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to use your medicine, let your doctor and pharmacist know.
Do not use Tocilizumab if you ever had an allergic reaction (rashes, breathlessness, swollen mouth or eyes) to similar medicines.
Alert your doctor if you are being treated for a serious infection (e.g. hepatitis B, active tuberculosis or TB, HIV infection) as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- history of recurring infections or diseases that increase your risk of having an infection (e.g. diabetes, infection or inflammation of the colon’s wall pouches)
- history of stomach ulcer
- damage to the protective covering of your brain or spinal cord
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Inform your doctor if you have been recently vaccinated. Do not receive any vaccinations without first asking your doctor.
If you are going for surgery, inform your doctor that you are using Tocilizumab.
You may need to have a screening for TB infection to assess the suitability of this medicine for you. For as long as you are using Tocilizumab, you may need to have regular blood tests (e.g. white blood cells, platelets, liver function tests) to check your body’s response to this medicine. Your doctor will advise you how often you need to have them.
Tocilizumab may make you dizzy. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects may include any of the following: headache, stomach pain, nausea, diarrhoea, swelling of the limbs, cough, blocked or runny nose, sore throat, breathlessness, mouth sores or ulcers, itchiness or redness of the eyes, rashes, itch and pain, irritation, and swelling at the injection site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swollen mouth or eyes
- signs and symptoms of an infection e.g. muscle pain, chills, fever, cough, mouth or skin blisters
- persistent cough, fever, weight loss
- frequent and/or painful urination
- worsening of stomach pain, unexplained change in bowel habits
- yellowing of the skin or eyes, dark urine
- unusual bleeding or bruising
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor or pharmacist if you are taking any of these medicines:
- other medicines for rheumatoid arthritis e.g. abatacept, etanercept, adalimumab, infliximab, rituximab
- blood-thinning medicines e.g. phenprocoumon, warfarin
- cholesterol-lowering medicines e.g. atorvastatin, lovastatin, simvastatin
- anti-inflammatory medicines e.g. dexamethasone, methylprednisolone
- medicines for mood disorders e.g. temazepam
- medicines for heart disease e.g. amlodipine
- medicines for asthma e.g. theophylline
- medicines for organ transplant or certain immune disorders e.g. ciclosporin
- medicines for epilepsy (fits or seizures) e.g. phenytoin
- birth control pills
This list does not include all medicines that may interact with Tocilizumab.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in the refrigerator, between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used. Protect from light.
Do not use this medicine if it becomes cloudy or if it has changed in colour. Medicines must not be used past the expiry date.