Actemra (tocilizumab) is a biologic medicine used to treat conditions where the immune system attacks the body. It's most commonly prescribed for:

Rheumatoid Arthritis (RA):

If you have moderate to severe RA and other treatments haven't worked well enough, Actemra can help reduce joint pain, swelling, and stiffness. It can be used on its own or alongside other medicines like methotrexate.

Giant Cell Arteritis (GCA):

Actemra is used to treat GCA, a condition that causes inflammation in the blood vessels, most often in the head and neck, which can lead to headaches, jaw pain, and vision problems.

Juvenile Idiopathic Arthritis (JIA):

Actemra is approved for children aged 2 and over with certain types of JIA, helping to reduce inflammation and protect developing joints.

Cytokine Release Syndrome (CRS):

Actemra is also used in hospital settings to treat a serious immune reaction called cytokine release syndrome, which can occur after some cancer treatments.

Your doctor will decide the right dose and how you receive it based on your condition, weight, and overall health. Always follow their instructions.

It happens. Here's what to do:

• If you're using the injection and remember the same day: go ahead and take it, then continue your usual schedule
• If it's nearly time for your next dose: skip the missed one and carry on as normal
• Never take two doses at once to make up for a missed one
• If you've missed an IV infusion: call your healthcare provider or infusion centre to reschedule as soon as possible

If you're unsure what to do, your pharmacist or doctor can give you advice based on your specific situation.

If you think you or someone else has had too much Actemra, call 000 or go to your nearest emergency department straight away.

Signs that something might be wrong include:

• Signs of infection: fever, chills, feeling unusually unwell
• Unusual bruising or bleeding
• Feeling very tired or weak
• Yellowing of the skin or eyes

There is no specific antidote for Actemra, so treatment will focus on monitoring and managing any symptoms. Don't wait to see if you feel better. Get help immediately.

• Keep it in the fridge at 2°C to 8°C
• Don't freeze it. If it has been frozen, don't use it
• Keep it in the original packaging to protect it from light
• Don't open the packaging until you're ready to use it
• If you need to travel: prefilled syringes or autoinjectors can be kept at room temperature (up to 30°C) for up to 8 days, but once removed from the fridge, don't put it back
• Keep out of reach of children and pets

If you have any questions about storage, especially around travel, ask your pharmacist.

Like all medicines, Actemra can cause side effects, though not everyone experiences them. The most important ones to know about are:

• Infections: Because Actemra affects your immune system, you may be more likely to pick up infections. See your doctor promptly if you develop a fever, chills, persistent cough, or feel generally unwell
• Liver changes: Your liver enzymes may rise while on Actemra, which is why regular blood tests are important
• Low white blood cell count: This can make it harder for your body to fight infections
• Cholesterol changes: Some people see an increase in cholesterol levels during treatment
• Headache: A commonly reported side effect, usually mild
• High blood pressure: Your doctor may monitor your blood pressure during treatment
• Injection site reactions: If using the subcutaneous form, you may notice some redness, itching, or mild pain where you inject

If you notice anything that concerns you, even if it's not on this list, contact your doctor or pharmacist.

Tell your doctor and pharmacist about everything you're taking before starting Actemra.

Key things to be aware of:

• Other biologics: Using Actemra alongside other biologic medicines (such as Humira or Enbrel) is generally not recommended as it can increase your risk of serious infection
• Live vaccines: Avoid live vaccines while on Actemra. Talk to your doctor before any vaccinations
• Blood thinners and other medicines: Actemra can affect how some medicines are processed by your body, including warfarin. Your doctor may need to adjust doses of other medicines you take
• Steroids: Often used alongside Actemra, but close monitoring is needed as the combination can further lower your immune response
• Methotrexate: Commonly prescribed with Actemra for RA. Both can affect the liver, so regular monitoring is essential

Never start, stop, or change any medicine without speaking to your doctor first.

How long does Actemra take to work?

Some people notice an improvement in symptoms within a few weeks, but it can take 3 to 6 months to feel the full benefit. Don't be discouraged if results are gradual, as this is normal for biologic medicines.

Can I drink alcohol while taking Actemra?

Actemra can affect your liver, and alcohol adds extra strain. It's best to limit alcohol and discuss this with your doctor.

Will Actemra affect my ability to fight infections?

Yes. Because Actemra works by calming your immune system, you may be more susceptible to infections. Wash your hands regularly, avoid contact with people who are sick, and let your doctor know immediately if you feel unwell.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.