IN-HOSPITAL USE FOR COVID-19

The drug Actemra (tocilizumab) has been granted an emergency use authorization (EUA). The EUA allows for in-hospital use of Actemra as a treatment for COVID-19 in certain cases. You should not take any prescription drug, including Actemra, unless your doctor recommends it.

To learn what’s currently happening with COVID-19, check out our live updates. You can also find information about prevention and treatment, as well as expert advice, at our COVID-19 hub.

Actemra (tocilizumab) is a prescription, brand-name medication. It’s approved by the Food and Drug Administration (FDA) to treat the following conditions in certain situations:

Actemra may be used short term or long term, depending on the condition you use it to treat. Your doctor can tell you more about how long you’ll use Actemra.

Here are some fast facts about Actemra:

  • Active ingredient: tocilizumab, which is a biologic
  • Drug class: interleukin-6 antagonist
  • Drug forms:
    • single-dose prefilled ACTPen autoinjector for subcutaneous injection

Like other drugs, Actemra can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Actemra, including details about its uses, see this article.

Actemra can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Actemra in clinical studies:

* To learn more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Actemra use. This list doesn’t include all the possible mild side effects of the drug. For more information, you can refer to Actemra’s prescribing information.

Mild side effects that have been reported with Actemra include:

These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while using Actemra and want to tell the FDA about it, visit MedWatch.

* To learn more information about this side effect, see “Side effect specifics” below.

Actemra may cause serious side effects. The list below may not include all the possible serious side effects of the drug. For more information, you can refer to Actemra’s prescribing information.

If you develop serious side effects while using Actemra, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported, and their symptoms, include:

* To learn more information about this side effect, see “Side effect specifics” below.
Actemra has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA).

Side effects in children who received Actemra in clinical studies were the same as those in adults, with one exception. Diarrhea was a common side effect in children, but adults didn’t report diarrhea as a side effect. Diarrhea was reported by children who received Actemra as an IV infusion to treat systemic juvenile idiopathic arthritis.

In these same studies, children were also more likely than adults to report infusion-related side effects when Actemra was given as an IV infusion. For more information, see “Infusion-related side effects” in “Side effect specifics” below.

Learn more about some of the side effects that Actemra may cause.

Infusion-related side effects

If Actemra is given as an IV infusion, related side effects may occur. (With an IV infusion, a drug is injected into a vein over time.)

Infusion-related side effects weren’t common in Actemra’s clinical studies. Children were more likely to have infusion-related side effects than adults. Most cases of these side effects weren’t serious and didn’t require people to stop using the drug.

Infusion-related side effects of Actemra may happen during or shortly after you receive the treatment. These side effects may include:

What you can do

Actemra IV infusions are given by a healthcare professional in a medical facility. They’ll monitor you for infusion-related side effects. But you should also tell them right away if you experience a reaction during the infusion.

If you develop symptoms of infusion-related side effects after your infusion, talk with your doctor immediately. But you should call 911 or your local emergency number if you think you’re having a medical emergency or your symptoms feel life threatening.

Weight gain

It’s possible to gain weight with Actemra. This side effect was rare in clinical studies of adults using Actemra to treat rheumatoid arthritis (RA). Adults and children using Actemra to treat conditions other than RA didn’t report weight gain as a side effect.

It’s important to keep in mind that weight gain is common in people with RA. This is because symptoms can make it difficult to exercise on a regular basis.

What you can do

While using Actemra, talk with your doctor if you gain weight without trying to or weight gain bothers you. They can suggest ways to help you maintain a moderate weight.

Injection site reactions

If Actemra is given as a subcutaneous injection, injection site reactions can occur. These are reactions that appear at the site where the medication is injected.

Injection site reactions were common in clinical studies. But in most cases, they were temporary and went away on their own. In nearly every case, the reactions were mild or moderate. No one in the studies stopped using Actemra due to serious injection site reactions.

The reactions can include pain, itching, and reddening or discoloration of the skin.

What you can do

To reduce your risk of injection site reactions, rotate the site where you inject Actemra. This means choosing a different site for each dose. You also should not inject the medication into skin that’s bruised, hard, or tender. In addition, avoid injecting Actemra into skin that’s red, discolored, or cut.

If you have injection site reactions that bother you or don’t go away, talk with your doctor. They may recommend trying a different treatment than Actemra.

Increased risk of certain types of cancer

It’s possible that Actemra could increase the risk of certain types of cancer. This side effect was seen in people using the medication in clinical studies.

Actemra weakens your immune system. A weakened immune system is less able to detect abnormal cells or fight infections* that can lead to cancer.

Symptoms of cancer vary depending on the type of cancer, but some common symptoms include fatigue and unexplained weight loss.

* Actemra has a boxed warning for the risk of serious infections. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Risk of serious infections” below.

What you can do

Before you begin treatment with Actemra, tell your doctor if you have cancer or have had it in the past. Talk with them right away if you notice any symptoms of cancer during your Actemra treatment. Your doctor will investigate your symptoms. This may include ordering lab tests.

Risk of serious infections

Actemra has a boxed warning about the risk of serious infections. This is a serious warning from the FDA.

Serious infections, including tuberculosis (TB), have been reported in people using Actemra. In rare cases, these infections have required treatment in a hospital. And in extreme cases, they led to death.

Actemra can increase your risk of infections because the drug works by changing how your immune system works. To be specific, Actemra weakens your immune system. This makes it harder for your body to fight infections.

Other serious infections besides TB that were reported in people who used Actemra include:

Symptoms of a serious infection, such as TB, can include:

  • chills
  • coughing up blood
  • cough that lasts
  • fatigue
  • fever
  • unexplained weight loss

What you can do

Your doctor will test you for TB before you start using Actemra. If you have TB, they’ll likely treat it before you begin using Actemra. Your doctor will continue to monitor you for TB and other serious infections during treatment with Actemra.

You should tell your doctor right away if you notice symptoms of a serious infection. If you have an infection, they may pause your Actemra doses, especially if it’s a serious infection.

Before beginning treatment with Actemra, be sure to tell your doctor if you have any infections. They’ll likely treat them before prescribing Actemra to you.

Allergic reaction

As with most drugs, Actemra can cause allergic reactions in some people. But this side effect was rare in the drug’s clinical studies.

Symptoms of allergic reactions may be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep using Actemra. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Actemra may cause several side effects. Here are some frequently asked questions about the drug’s side effects, as well as their answers.

Should I expect hair loss when using Actemra?

No. People using Actemra in clinical studies didn’t report hair loss.

Other medications used to treat the same conditions that Actemra treats can cause hair loss as a side effect. For example, some biologics and disease-modifying antirheumatic drugs (DMARDs) are used for rheumatoid arthritis (RA) and can cause hair loss.

It’s also important to note that some of the conditions that Actemra is prescribed to treat can cause hair loss. These conditions include RA, polyarticular juvenile idiopathic arthritis (JIA), and systemic JIA.

These are examples of autoimmune diseases, which occur when your immune system attacks your own body by mistake. In some people, hair follicles may be affected, which can lead to hair loss. (Hair follicles are sacs beneath your skin that hold the roots of your hair).

If you’re concerned about hair loss, talk with your doctor. They may be able to suggest ways to help prevent or treat it.

Can stopping Actemra treatment cause withdrawal symptoms?

Withdrawal symptoms weren’t reported in clinical studies when people stopped using Actemra.

Keep in mind that if you stop Actemra treatment, symptoms of the condition you’re using the medication for may return. This shouldn’t be confused with withdrawal symptoms.

It’s important that you don’t stop using Actemra unless you first speak with your doctor. They can help find an alternative treatment for your condition, which may help prevent symptoms of your condition from coming back.

Where can I find reviews from people who have had Actemra injections?

The manufacturer of Actemra publishes reviews from people who have used the drug, and you may view these here. It’s important to keep in mind that each person’s body responds differently to medications. Someone else’s experience may not predict how your body will respond to a drug.

Talk with your doctor to help you decide whether Actemra is a good treatment choice for you. They can create a treatment plan that’s based on your unique health history and the current scientific evidence.

Actemra has a boxed warning, as well as some other precautions to consider before starting the treatment.

Boxed warning: Risk of serious infections

Actemra’s boxed warning is about the risk of serious infections. This is a serious warning from the Food and Drug Administration (FDA). For details, see “Side effect specifics” above.

Other precautions

Be sure to talk with your doctor about your health history before you use Actemra. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Infection. Actemra works by weakening the immune system, which can make it harder than usual for your body to fight infections.* Due to this risk, doctors typically will not prescribe Actemra if you currently have an infection. Your doctor will likely treat your infection before you start using Actemra.

Tuberculosis. Actemra can weaken your immune system, making it difficult for your body to fight infections.* Your doctor will check you for an infection called tuberculosis (TB) before they prescribe the medication. If you have TB, they’ll likely treat it before you start using Actemra.

Hepatitis B. If you have hepatitis B, or you had it in the past, talk with your doctor before using Actemra. It’s possible that using Actemra could reactivate the virus that causes hepatitis B. By looking at your medical history, your doctor can see whether Actemra is a good option for you.

Liver problems. Actemra can cause liver damage as a side effect, and the drug may not be safe for people with liver problems. Before beginning treatment with Actemra, be sure to talk with your doctor about any liver problems you may have. They can help determine the right treatment for your condition.

Ulcers in your stomach or intestines. Actemra can cause perforations in your stomach or intestines or worsen them. Before you use Actemra, tell your doctor if you have ulcers in your stomach or intestines. They can advise you on the right treatment for you.

Multiple sclerosis and other nervous system conditions. Some people have developed multiple sclerosis (MS) while using Actemra, but this was rare. It isn’t known how the drug may affect people who already have MS or another nervous system problem. If your doctor prescribes Actemra for you, they’ll likely monitor you closely to see if your condition worsens.

Allergic reaction. If you’ve had an allergic reaction to Actemra or any of its ingredients, your doctor will likely not prescribe the drug for you. Ask your doctor what other medications may be better options.

* Actemra has a boxed warning about the risk of serious infection. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect specifics” above.

Alcohol use with Actemra

There isn’t a known interaction between using Actemra and drinking alcohol. If you drink alcohol, talk with your doctor about how much is safe to consume during your treatment.

Pregnancy and breastfeeding while using Actemra

Here’s some information about pregnancy, breastfeeding, and Actemra.

Pregnancy. It’s not known whether it’s safe to use Actemra while pregnant. Animal studies showed potential risk to the fetus, but animal studies don’t always predict what will happen in humans. If you become pregnant or think you may be pregnant while using Actemra, talk with your doctor right away. They can advise you on the right treatment plan for you.

Your doctor may also recommend that you enroll in the pregnancy registry for Actemra. It gathers information about the safety of the drug when used while pregnant. To learn more, you can visit the registry’s website or call 866-626-6847. You can also talk with your doctor.

Breastfeeding. It’s not known whether Actemra passes into human breast milk or if the drug could cause side effects in a child who is breastfed. If you’re breastfeeding or thinking about it, talk with your doctor. They can review treatment options and healthy ways to feed your child during your Actemra treatment.

Side effects of Actemra can occur, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention.

Talk with your doctor if you develop symptoms of an infection* while using Actemra. You should also talk with them if you become pregnant during your Actemra treatment.

If you’d like to learn more about Actemra, talk with your doctor or pharmacist. They can help answer any questions you have about side effects of the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

* Actemra has a boxed warning about the risk of serious infection. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect specifics” above.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.