Actemra (tocilizumab)

Actemra is a brand-name prescription drug. It’s approved by the Food and Drug Administration (FDA) for use in certain age groups with specific conditions. The drug’s approved uses are as follows.

Actemra is used to treat these conditions in certain situations. For more information about the conditions and how the drug is used, see the “Actemra: Uses” section below.

Note: Actemra is also used to treat COVID-19 under an Emergency Use Authorization (EUA) Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source from the FDA. For more information about this condition and Actemra’s EUA, see the “Actemra: Uses” section below.

The following table provides key facts about Actemra.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Actemra contains the active drug tocilizumab. It only comes as a brand-name medication. And it isn’t currently available as a biosimilar.

A biosimilar medication is a drug that’s similar to a brand-name biologic drug (parent drug). Actemra is a biologic medication, which is also called a biologic.

Biologics are made from living cells. It isn’t possible to copy biologics exactly. A generic, on the other hand, is a drug made from chemicals. A generic is an identical copy of the active drug found in a brand-name medication.

Biosimilars are considered as effective and safe as their parent drug. Like generics, biosimilars often cost less than brand-name drugs.

As with most drugs, it’s possible to have side effects with Actemra. These can include some mild side effects but also some serious ones.

To learn more about Actemra’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Actemra, you can do so through MedWatch.

Mild and serious side effects of Actemra are listed in the table below. This table does not include all of Actemra’s possible side effects.

* This is not a complete list of Actemra’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For more information about this side effect, see “Actemra’s side effects explained” below.
‡ Actemra has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  for this side effect. This is the most serious warning from the FDA. To learn more, see “Actemra’s side effects explained” below.

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

Serious side effects from Actemra aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Below, you can find detailed information about some of Actemra’s side effects. To learn more about other side effects of this medication, talk with your doctor.  

In rare cases, Actemra may increase your risk of getting serious infections caused by bacteria, fungi, or viruses. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

Infections with Actemra may be serious enough to cause you to stay in the hospital. Although rare, these infections may be fatal.

For this reason, Actemra has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  for an increased risk of serious infections. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Below are a few of the serious infections that were commonly reported in clinical studies of Actemra:

• tuberculosis (TB)
• cellulitis (a type of skin infection)
• pneumonia
• urinary tract infection (UTI)
• shingles

While you’re taking Actemra, watch for symptoms of serious infections. These can vary depending on the specific type of infection. Generally, infections may cause fever, chills, fatigue, and weight loss.

Your doctor will likely test you for TB before starting Actemra treatment and periodically while you’re taking the drug. If you have TB before taking Actemra, your doctor will treat it before having you start the drug. And if you develop TB while taking Actemra, they may temporarily stop the drug until they have treated the infection.

If you have symptoms of infection while taking Actemra, tell your doctor right away. They may test you for infection. If needed, your doctor may have you stop the drug until they treat your infection. If the infection is serious, your doctor will also have you stop Actemra until the infection has been treated.

Infusion-related side effects can occur when you receive Actemra as an IV infusion. These are side effects that happen during the infusion or shortly after. However, they weren’t common in clinical studies of the drug. To learn more about how often these side effects occurred in clinical studies, see Actemra’s prescribing information.

Infusion-related side effects won’t happen when Actemra is given as a subcutaneous injection. Instead, injection site reactions may occur when the drug is given this way. To learn more about this side effect, see this article.

Most infusion-related side effects with Actemra are mild. Examples include:

• changes in blood pressure, which may be higher or lower than usual
• headache
• rash, itching, or hives
• nausea, diarrhea, or abdominal pain
• joint pain
• dizziness

However, in rare cases, serious and life threatening infusion reactions can occur. These cause symptoms that are similar to those of an allergic reaction. For more information, see “Allergic reaction” directly below.

Actemra infusions are given in a healthcare facility. The healthcare professional who gives you the infusion will watch for these side effects during your infusion. However, infusion-related side effects can happen up to 24 hours after your infusion ends. So it’s important to let your healthcare professional know if you have any of the symptoms listed above after your infusion.

If you’re concerned about having infusion-related side effects with Actemra, talk with your doctor.

Weight gain is possible with Actemra, although this side effect was rare in clinical studies of the drug. To learn more about how often this side effect occurred in clinical studies, see Actemra’s prescribing information.

If you’re concerned about weight gain while using Actemra, talk with your doctor. They can suggest ways to maintain a body weight that’s healthy for you.

Below, you’ll find dosages that are commonly recommended for Actemra. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Most often, doctors start by prescribing the recommended dosage of Actemra. Then, they may change the dosage over time to an amount that’s right for the condition they are treating. Doctors typically prescribe the smallest dosage that gives the desired outcome.

The dosage of Actemra your doctor prescribes will depend on factors such as:

• the form of Actemra you use
• your age
• your body weight
• any health conditions you have
• the condition you’re using Actemra to treat and the severity of the condition
• the side effects that you may have

Actemra is available as follows.

• Forms:
  • solution inside syringes and autoinjectors, which is given as a subcutaneous injection
  • solution inside vials, which is given as an IV infusion
• Strengths:
  • 162 milligrams per 0.9 milliliters (mg/mL) in syringes and autoinjectors
  • 20 mg/mL in vials

The form you use will depend on your age and the condition you’re using Actemra to treat.

Actemra infusions are given by a healthcare professional, usually in a hospital, clinic, or infusion center.  However, you can give Actemra injections to yourself. Or a caregiver can give them to you instead.

For some of the drug’s uses, Actemra may be given as both an injection and an infusion. If both forms of Actemra are an option for your condition, doctors will recommend the form that’s best for you.

Recommended dosages for Actemra in adults and children are described below. Certain dosages may be based on a person’s weight in kilograms (kg). One kg is about 2.2 pounds (lb).

Doctors will calculate your Actemra dosage for you. You won’t need to use a dosing calculator to determine your own dosage.

Actemra’s approved uses vary between adults and children. For some of its uses, doctors may prescribe Actemra in combination with other medications. See the “Actemra: Uses” section below for more information.

Recommended dosages for Actemra in adults are described below.

Actemra infusion

Actemra’s recommended infusion dosage for rheumatoid arthritis (RA) in adults is as follows:

• Starting dosage: 4 mg per kg (mg/kg) given every 4 weeks
• Maintenance dosage: 4 mg to 8 mg/kg given every 4 weeks
• Maximum dosage: 800 mg per infusion

Actemra’s recommended infusion dosage* for cytokine release syndrome (CRS) in adults is as follows:

• Starting dosage:
  • body weight less than 30 kg: 12 mg/kg given once
  • body weight of 30 kg or greater: 8 mg/kg given once
• Maintenance dosage:
  • body weight less than 30 kg: 12 mg/kg given every 8 hours for up to 3 doses
  • body weight of 30 kg or greater: 8 mg/kg given every 8 hours for up to 3 doses
• Maximum dosage: 800 mg per infusion

* You may only receive a one-time starting dose of Actemra for CRS. Maintenance dosages of Actemra for CRS are typically given only if the symptoms of the condition haven’t eased after one dose.

Actemra injection

Actemra’s recommended injection dosage for RA in adults is as follows:

• Starting dosage:
  • body weight less than 100 kg: 162 mg given once every 2 weeks
  • body weight of 100 kg or greater: 162 mg given once every week
• Maintenance dosage: 162 mg given once every week

Actemra’s recommended injection dosage for giant cell arteritis (GCA) in adults is as follows:

• Starting dosage: 162 mg given once every week
• Maintenance dosage: 162 mg given once every week or once every 2 weeks

Actemra’s recommended injection dosage for interstitial lung disease related to systemic sclerosis (SSc-ILD) in adults is as follows:

• Starting dosage: 162 mg given once every week
• Maintenance dosage: 162 mg given once every week

Recommended dosages for Actemra in children are described below.

Actemra infusion

Actemra’s recommended infusion dosage for systemic juvenile idiopathic arthritis (sJIA) in children is as follows:

• Dose:
  • body weight less than 30 kg: 12 mg/kg
  • body weight of 30 kg or greater: 8 mg/kg
• Frequency: once every 2 weeks

Actemra’s recommended infusion dosage for polyarticular juvenile idiopathic arthritis (pJIA) in children is as follows:

• Dose:
  • body weight less than 30 kg: 10 mg/kg
  • body weight of 30 kg or greater: 8 mg/kg
• Frequency: once every 4 weeks

Actemra’s recommended infusion dosage* for cytokine release syndrome (CRS) in children is as follows:

• Starting dosage:
  • body weight less than 30 kg: 12 mg/kg given once
  • body weight of 30 kg or greater: 8 mg/kg given once
• Maintenance dosage:
  • body weight less than 30 kg: 12 mg/kg given every 8 hours for up to 3 doses
  • body weight of 30 kg or greater: 8 mg/kg given every 8 hours for up to 3 doses
• Maximum dosage: 800 mg per infusion

* Your child may only receive a one-time starting dose of Actemra for CRS. Maintenance dosages of Actemra for CRS are typically given only if the symptoms of the condition haven’t eased after one dose.

Actemra injection

Actemra’s recommended injection dosage for sJIA in children is as follows:

• Dose: 162 mg
• Frequency:
  • body weight less than 30 kg: once every 2 weeks
  • body weight of 30 kg or greater: once every week

Actemra’s recommended injection dosage for pJIA in children is as follows:

• Dose: 162 mg
• Frequency:
  • body weight less than 30 kg: once every 3 weeks
  • body weight of 30 kg or greater: once every 2 weeks

Below are some things to consider about Actemra’s dosage.

• Missing a dose. If you miss a dose of Actemra, call your doctor. They can tell you whether to take the missed Actemra injection or skip it. Or they’ll help you reschedule your appointment for an Actemra infusion. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Length of treatment. Doctors typically prescribe Actemra as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

Like other medications, prices for Actemra may vary. The drug’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage
• the facility where you receive Actemra infusions

Here’s a list of things to consider when looking into the cost of Actemra.

• Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If your insurance company approves this option, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
• Need for prior authorization. Before insurance coverage for Actemra is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Actemra. Then the insurance company will decide if it will cover the drug. To find out if you need prior authorization for Actemra, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Actemra is available. Genentech USA, Inc., the manufacturer of the drug, offers Actemra Access Solutions. To learn more and see if you’re eligible for support, call 855-RA-COPAY (855-722-6729) or visit the manufacturer’s website. You can also read this article to learn about ways to save on prescription drugs.
• Use of a specialty pharmacy. Actemra is only dispensed from specialty pharmacies. These pharmacies are authorized to handle certain drugs considered specialty medications. These medications may be expensive or require help from healthcare professionals to be used safely and effectively. Ask your doctor which specialty pharmacy they’ll prescribe Actemra through.
• Use of a mail-order pharmacy. Actemra may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
• Availability of a biosimilar form. Actemra is a biologic drug. It’s not available in a biosimilar form. A biosimilar is like a generic drug, which is an identical copy of the active drug in a brand-name medication. Unlike drugs made from chemicals, it isn’t possible to copy biologics exactly. So instead of generics, biologics have biosimilar forms. Biosimilars often cost less than brand-name drugs.

Prescription drugs, such as Actemra, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

Actemra is approved to treat moderate to severe rheumatoid arthritis (RA) in adults.

RA is a condition that causes painful, swollen, and stiff joints. These symptoms typically affect joints on both sides of the body.

Doctors prescribe Actemra for RA that hasn’t improved after treatment with at least one disease-modifying antirheumatic drug (DMARD). For RA, you may take Actemra alone or in combination with DMARDs, such as methotrexate (Trexall).

Actemra is approved to treat giant cell arteritis (GCA) in adults.

GCA is a condition that causes inflammation in the lining of the arteries in your head. (Arteries are blood vessels that carry oxygen from your heart to the rest of your body.)

GCA most often affects the arteries in your temples. Because of this, GCA is also called temporal arteritis.

Symptoms of GCA include:

• headache
• double vision or blurry vision
• fatigue
• pain in the scalp, tongue, jaw, throat, shoulders, or hips
• loss of appetite

For this use, doctors prescribe Actemra alone or in combination with steroids, such as prednisone (Rayos).

Actemra is approved to treat interstitial lung disease related to systemic sclerosis (SSc-ILD) in adults.

SSc-ILD is a condition that causes lung tissue to become hardened, thick, and scarred. This leads to symptoms such as chest pain, cough, and shortness of breath.

Doctors prescribe Actemra to reduce the lung damage caused by SSc-ILD.  

For this use, your doctor will recommend whether to use Actemra on its own or in combination with other treatments.

Actemra is approved to treat cytokine release syndrome (CRS) in adults and children ages 2 years and older.

CRS happens when the immune system becomes overactive. The condition leads to symptoms such as body aches, fever, and nausea or vomiting.

Doctors prescribe Actemra for CRS that is both:

• severe or life threatening, and
• caused by a form of cancer immunotherapy called chimeric antigen receptor (CAR) T cell therapy

For CRS, you may take Actemra alone or in combination with steroids, such as prednisone (Rayos).

For rheumatoid arthritis (RA), you may take Actemra alone or in combination with disease-modifying antirheumatic drugs (DMARDs). An example is methotrexate (Trexall).

For giant cell arteritis (GCA) or cytokine release syndrome (CRS), you may take Actemra alone or in combination with steroids. An example is prednisone (Rayos).

Your doctor will recommend whether to use Actemra on its own or with other drugs for your condition.

Actemra is approved to treat certain types of juvenile idiopathic arthritis (JIA). This is a condition that affects children. It causes painful, swollen, and stiff joints.

Read on to learn more about the specific types of JIA that Actemra is used to treat.

In addition to JIA, Actemra is approved to treat cytokine release syndrome (CRS) in children ages 2 years and older. For details about this condition, see “Using Actemra for cytokine release syndrome (CRS)” above.

Actemra is approved to treat systemic juvenile idiopathic arthritis (sJIA) in children ages 2 years and older.

In addition to the joint symptoms listed above, sJIA can also cause:

• fever
• rash
• problems with the heart and lungs

Actemra is approved to treat polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older.

pJIA affects at least five joints, usually in the hands and feet. Symptoms of pJIA typically occur in joints on both sides of the body.

Using Actemra for COVID-19

Actemra received emergency use authorization (EUA) from the FDA to treat COVID-19. The drug is used for this condition in adults and children ages 2 years and older who are in a hospital for care.

A doctor may prescribe Actemra for people taking corticosteroids for COVID-19 and also needing one of the following:

• oxygen therapy
• a ventilator to help them breathe
• use of a certain machine that increases oxygen levels in the body

EUA is given in emergency situations when there aren’t other treatment options available for a disease. With EUA, the FDA continues to look at available information about the benefits and risks of using a drug. Once more studies are done, and more information is known, the FDA can approve or deny the medication for this use.

To learn more about the latest developments with COVID-19, possible treatments, and expert tips, visit this COVID-19 hub.

If you’re interested in taking Actemra, you can find a doctor who may prescribe it by searching here. To prepare for your appointment, you may find it helpful to visit Healthgrades’ appointment guide for rheumatoid arthritis.

Doctors may prescribe drugs other than Actemra for your condition. Certain drugs may work better for you than others.

Actemra is used to treat rheumatoid arthritis (RA), as well as other conditions. Here’s a summary of other drugs that doctors sometimes prescribe for RA.

If you’d like to know more about some alternatives to Actemra, view the following articles:

• Actemra vs. Kevzara
• Actemra vs. Orencia

To learn more about alternatives to Actemra, ask your doctor. They can tell you about other medications they may prescribe for your condition.

Actemra is approved to treat the conditions below in certain situations:

• rheumatoid arthritis (RA)
• giant cell arteritis (GCA)
• interstitial lung disease related to systemic sclerosis (SSc-ILD)
• cytokine release syndrome (CRS)
• systemic juvenile idiopathic arthritis (sJIA)
• polyarticular juvenile idiopathic arthritis (pJIA)

To learn more about these conditions, see the “Actemra: Uses” section above.

The conditions above may be caused by inflammation in the body. A protein called interleukin-6 (IL-6) is thought to play a role in causing inflammation.

Actemra belongs to a group of drugs called IL-6 antagonists. The drug’s mechanism of action (how it works) is to block the IL-6 protein. This helps reduce inflammation, which then eases the symptoms of the conditions Actemra treats.

Actemra starts working right after your first dose. However, it may take several doses of Actemra for your symptoms to ease.

The exact length of time it takes Actemra to work could depend on the condition you’re using the drug for. For details about what to expect with Actemra, including how long it takes to work for GCA, talk with your doctor.

Actemra likely stays in your system for about 13 weeks after your last dose.

This is because Actemra has a half-life of about 2.5 weeks. (A drug’s half-life is the time it takes your body to get rid of half of a drug’s dose.) In other words, it takes almost 3 weeks for your body to get rid of half of a dose of Actemra.

Typically, it takes about five half-lives for a drug to leave your body completely. For Actemra, this means the drug stays in your system for about 13 weeks.

Here are some common questions about Actemra and brief answers to them. If you’d like to know more about these topics, ask your doctor.

No, Actemra isn’t a tumor necrosis factor (TNF) inhibitor. Instead, Actemra belongs to a group of drugs called interleukin-6 (IL-6) antagonists.

TNF is a protein in the body that causes inflammation. TNF inhibitors work by blocking TNF, helping to reduce inflammation. TNF inhibitors are used to treat conditions such as rheumatoid arthritis and juvenile idiopathic arthritis. Examples include adalimumab (Humira) and infliximab (Remicade).

Like TNF inhibitors, Actemra works by blocking a protein that causes inflammation. However, instead of blocking TNF, Actemra blocks a protein called IL-6. For more information, see the “Actemra: How it works” section above.

Actemra isn’t approved to treat polymyalgia rheumatica (PMR). However, in some cases, doctors may prescribe Actemra off-label for this use. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

PMR is a condition that causes severe muscle stiffness and muscle pain. The condition often affects the neck, shoulders, and hips.

A 2020 review looked at several studies of Actemra for the treatment of PMR. The study results showed that Actemra may be an effective treatment for PMR in certain situations.

If you have PMR and are interested in taking Actemra, talk with your doctor. They can discuss your treatment options with you. And they’ll advise whether Actemra is the right treatment for your condition.

It isn’t likely. Hair loss wasn’t reported as a side effect in clinical studies of Actemra.

However, hair loss can be a symptom of certain conditions Actemra is used to treat. These include juvenile idiopathic arthritis and rheumatoid arthritis. You may have hair loss with Actemra because of the conditions you’re using the drug to treat. The drug itself may not cause hair loss. 

If you’re concerned about hair loss with Actemra or your condition, talk with your doctor.

Actemra isn’t currently approved to treat depression. However, doctors may prescribe Actemra off-label for this use. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

At least one study Trusted Source Wiley Peer reviewed journal Go to source has shown that Actemra may relieve symptoms of depression and anxiety in people who have rheumatoid arthritis. But more studies are needed to know if Actemra is effective for this use.

If you’re interested in learning more about treatment options for depression, talk with your doctor. They can advise the treatment that’s best for you.

Your doctor will recommend how you should take Actemra. It’s important that you take the drug exactly as your doctor instructs.

Actemra comes as a solution that’s given as a subcutaneous injection or an IV infusion.

Actemra infusions are given by a healthcare professional, usually in a hospital, clinic, or infusion center. Actemra infusions usually take 1 hour. You won’t give yourself Actemra infusions.

However, you can give Actemra injections to yourself. Or a caregiver can give them to you instead. For details about where to inject Actemra, see “Actemra injection sites” directly below.

For cytokine release syndrome, a healthcare professional gives Actemra by IV infusion. To learn more about how Actemra is administered for its other uses, visit the drug manufacturer’s website for these conditions:

• rheumatoid arthritis
• giant cell arteritis
• interstitial lung disease related to systemic sclerosis
• systemic juvenile idiopathic arthritis
• polyarticular juvenile idiopathic arthritis

To learn more about the conditions themselves, view the “Actemra: Uses” section above.

Actemra can be injected into the following areas of the body:

• thigh
• abdomen, at least 2 inches away from the belly button
• upper arm, if injected by a caregiver

Your doctor will show you or a caregiver how to inject Actemra.

Here’s a list of common questions related to taking Actemra.

• When should I take Actemra? You can take Actemra any time of day. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Is there a best time of day to take Actemra? No, there isn’t a best time of day to take Actemra. You can take this drug any time of day.

There are no known interactions between alcohol and Actemra. If you drink alcohol, talk with your doctor about whether there’s an amount that’s safe to consume during Actemra treatment.

Here’s some information about Actemra’s expiration date, as well as how to store and dispose of the drug.

• Expiration. Your pharmacist will add an expiration date to the label on Actemra’s packaging. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
• Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. You should store Actemra syringes and autoinjectors in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C). A healthcare professional will use Actemra vials for IV infusions. You won’t store Actemra vials at home.
• Disposal. Dispose of any used syringes, needles, or autoinjectors right after using them. You can safely dispose of these items in an FDA-approved sharps container Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source . Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps them avoid harm from needles. If you’d like to buy a sharps container, you can find options online. Or ask your doctor, pharmacist, or health insurance company where you can purchase one. Your pharmacist can give you more information about disposing of Actemra. You can also see this page for several tips on safe medication disposal.

It isn’t known if Actemra is safe to use while pregnant. There haven’t been enough studies of the drug in human pregnancy.

Animal studies have shown harm to offspring when pregnant animals were given the drug. However, animal studies don’t always predict what happens in humans.

If you’re pregnant or planning a pregnancy, talk with your doctor before using Actemra. They can advise on your treatment options while pregnant.

If you use Actemra while you’re pregnant, your doctor may recommend that you enroll in the drug’s pregnancy registry. Pregnancy registries gather information about the safety of a medication when used during pregnancy. To learn more, call 877-311-8972 or visit the registry’s website. Your doctor can also discuss the registry with you.

Doctors aren’t sure whether it’s safe to take Actemra during pregnancy. Talk with your doctor about your birth control needs with Actemra if you’re sexually active and you or your partner can become pregnant.

Your doctor can recommend whether you should use birth control with this medication. Certain birth control medications may interact with Actemra. Your doctor can advise which type of birth control you should use while taking this drug.

It isn’t known if Actemra passes into breast milk. If you’re breastfeeding or planning to do so, talk with your doctor before using Actemra. They can advise on the risks and benefits of using the drug while breastfeeding.

Actemra may interact with other medications and certain vaccines. It isn’t known to interact with any supplements or foods.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

• Actemra and other medications. Because Actemra may interact with the following drugs, your doctor may recommend that you do not take it with these drugs. Examples include:
  • the gastroesophageal reflux disease (GERD) drug omeprazole (Prilosec)
  • the cholesterol drug simvastatin (Zocor, FloLipid)
  • the cough suppressant drug dextromethorphan (Delsym)
• Actemra and hormonal contraceptives. Hormonal contraceptives, such as birth control pills, are safe to take with Actemra. However, they may be less effective at preventing pregnancy if used with Actemra. Because of this, your doctor will likely recommend that you use a second birth control method as well, such as condoms.
• Actemra and herbs and supplements. No herbs or supplements are known to interact with Actemra. However, before taking any of these products with Actemra, talk with your doctor or pharmacist.
• Actemra and foods. Actemra isn’t known to interact with any foods. If you have questions about eating certain foods with Actemra, talk with your doctor or pharmacist.
• Actemra and vaccines. It’s recommended that you don’t receive live vaccines while taking Actemra. Live vaccines are made from a weakened form of the bacteria or virus the vaccine protects against. Examples of vaccines to avoid with Actemra include:
  • chickenpox
  • measles, mumps, rubella (MMR)
  • yellow fever

This drug comes with several precautions.

This drug has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Serious infections. In rare cases, Actemra may increase your risk of getting serious infections caused by bacteria, fungi, or viruses. Examples of these infections include tuberculosis (TB), pneumonia, and shingles.

Infections with Actemra may be serious enough to cause you to stay in the hospital. In rare cases, these infections may be fatal.

Your doctor will likely test you for TB before starting Actemra treatment and periodically while you take the drug. If you have TB before taking Actemra, your doctor will treat your TB before having you start the medication.

If you have TB or any other infection while taking Actemra, your doctor may have you stop the drug until your infection has been treated. If the infection is serious, your doctor will have you stop Actemra until the infection has been treated.

Tell your doctor about your health history before starting treatment with Actemra. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Infections, including tuberculosis (TB). Actemra may increase your risk of serious infections. Before taking Actemra, tell your doctor if you currently have an infection or have infections that keep coming back. Also, tell them if you have TB or if you’ve had it in the past. Your doctor will likely test you for TB before having you start Actemra. If you have TB or other infections before taking Actemra, your doctor will treat your infections before starting the drug. Or they may prescribe a drug other than Actemra for you.
• Liver problems, including hepatitis B. Before taking Actemra, tell your doctor if you have liver problems or hepatitis B virus (HBV). The drug may cause liver problems. Actemra may also reactivate HBV, which could lead to symptoms of hepatitis B. (With reactivation, a virus that’s already inside your body flares up and causes symptoms.) If you have liver problems or HBV, your doctor can advise whether Actemra is right for you.
• Ulcers in your intestines or stomach. Actemra may cause gastrointestinal perforation (tears or holes in the intestines or stomach). Be sure to tell your doctor if you have ulcers in your intestines or stomach. Also tell them if you have diverticulitis. Actemra may worsen these conditions. Your doctor can tell you whether Actemra is safe to use.
• Conditions that affect your nerves, such as multiple sclerosis (MS). Before taking Actemra, tell your doctor if you have conditions that affect your nerves. This includes MS. Actemra may damage the protective covering around your nerves, which could worsen these conditions. Your doctor will likely watch your condition closely while you take Actemra.
• Allergic reaction. Your doctor will likely not prescribe Actemra if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
• Pregnancy. It’s not known whether Actemra is safe to use during pregnancy. If you’d like more information about taking Actemra while pregnant, view the “Actemra: Using while pregnant” section above.
• Breastfeeding. It isn’t known whether Actemra passes into breast milk. If you’d like more information about taking Actemra while breastfeeding, view the “Actemra: Using while breastfeeding” section above.

To learn more about effects of Actemra that could be harmful, see the “Actemra: Side effects” section above.

For some drugs, taking more than the recommended dosage may lead to unwanted side effects or overdose. Do not use more Actemra than your doctor advises.

Call your doctor if you think you’ve taken too much of this drug. Or you can call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

If you have questions about Actemra, talk with your doctor. They can advise you on whether Actemra could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

• What factors determine whether I should get Actemra as an injection or an infusion?
• How do I give myself Actemra injections?
• How is Actemra different from other medications that treat my condition?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for rheumatoid arthritis (RA). And see our selection of videos about RA.

Disclaimer: Healthgrades 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.