Actemra's Dosage: What to Know

Medically Reviewed By Victor Nguyen, PharmD, MBA

This drug has a boxed warning, 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 and sometimes fatal infections have occurred in people taking Actemra. These include tuberculosis (TB) and other bacterial, fungal, and viral infections. If a serious infection occurs, doctors typically stop Actemra treatment until the infection clears.

Actemra: Introduction

Actemra is a brand-name prescription medication that contains the active drug tocilizumab. It belongs to a class of drugs called interleukin-6 antagonists. Actemra is a biologic drug, and it’s not available in a biosimilar form.*

This medication has been approved by the Food and Drug Administration (FDA) to treat:

In this article, you’ll find additional information about Actemra’s dosage and details on how the drug is administered. For a comprehensive overview of Actemra, view this article.

* A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug).

Finding a healthcare professional

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

This article describes typical recommended dosages for Actemra. These dosages are provided by the drug’s manufacturer.

Your doctor will prescribe the dosage of Actemra that’s best for you.

Actemra: Dosage

Commonly recommended dosages for Actemra are shown below. However, your doctor will prescribe the Actemra dosage that’s right for you.

Actemra’s forms and strengths

Actemra comes in the following forms and strengths.

Form Strength
prefilled syringe of solution for subcutaneous injection 162 milligrams per 0.9 milliliters (mg/mL)
prefilled ACTPen auto-injector of solution for subcutaneous injection 162 mg/0.9 mL
vial of solution for IV infusion 20 mg/mL

The form you use will depend on your age and the condition you’re taking Actemra to treat. For Actemra IV infusion, a healthcare professional will administer the drug at a hospital, clinic, or infusion center. For details, see the “Actemra: How it is administered” section below.

Typical recommended dosages

Usually, doctors will prescribe a low dosage of Actemra at the start of treatment. Then, they’ll adjust the dosage over time if needed. Ultimately, your doctor will prescribe the smallest dosage of Actemra that gives the desired effect.

Below are Actemra dosage charts for adults by condition. Note that some IV infusion and subcutaneous injection dosages are based on body weight in kilograms (kg). For reference, 1 kg is 2.2 pounds (lb).

Actemra dosages for cytokine release syndrome (CRS)

Actemra for CRS is given as an IV infusion. The table below shows the recommended infusion dosages for Actemra in adults. Your doctor will prescribe the dosage that’s best for you.

Body weight Starting dosage Maintenance dosage Maximum dosage
less than 30 kg 12 milligrams per kg (mg/kg) given once 12 mg/kg given once every 8 hours for up to three doses, if necessary 800 mg per IV infusion
30 kg or more 8 mg/kg given once 8 mg/kg given once every 8 hours for up to three doses, if necessary 800 mg per IV infusion

Actemra dosages for giant cell arteritis (GCA)

Actemra for GCA is given as an IV infusion or subcutaneous injection. The table below shows the recommended dosages for GCA in adults. Your doctor will prescribe the dosage that’s best for you.

Administration Starting dosage Maintenance dosage Maximum dosage
IV infusion 6 mg/kg given once every 4 weeks 6 mg/kg given once every 4 weeks 600 mg per IV infusion
subcutaneous injection 162 mg given once every week 162 mg given once every 1 to 2 weeks 162 mg given once every week

Actemra dosage for interstitial lung disease related to systemic sclerosis (SSc-ILD)

For SSc-ILD, the recommended dosage for Actemra is a 162-mg subcutaneous injection once every week. However, your doctor will prescribe the dosage that’s best for you.

Actemra dosages for rheumatoid arthritis (RA)

Actemra for RA is given as an IV infusion or subcutaneous injection. The table below shows the recommended dosages for RA in adults. Your doctor will prescribe the dosage that’s best for you.

Administration Body weight Starting dosage Maintenance dosage Maximum dosage
IV infusion not based on body weight 4 mg/kg given once every 4 weeks 8 mg/kg given once every 4 weeks 800 mg per IV infusion
subcutaneous injection less than 100 kg 162 mg given once every other week 162 mg given once every week 162 mg given once every week
subcutaneous injection 100 kg or more 162 mg given once every week 162 mg given once every week 162 mg given once every week

Children’s dosages

Below are Actemra dosage charts for children by condition. Note that some IV infusion and subcutaneous injection dosages are based on body weight in kilograms (kg). For reference, 1 kg is 2.2 pounds (lb).

Actemra dosage for cytokine release syndrome (CRS)

Actemra for CRS is given as an IV infusion. The table below shows the recommended infusion dosages for CRS in children ages 2 years and older. The doctor will prescribe the dosage that’s best for your child.

Body weight Starting dosage Maintenance dosage Maximum dosage
less than 30 kg 12 milligrams per kg (mg/kg) given once 12 mg/kg given once every 8 hours for up to three doses, if necessary 800 mg per IV infusion
30 kg or more 8 mg/kg given once 8 mg/kg given once every 8 hours for up to three doses, if necessary 800 mg per IV infusion

Actemra dosage for polyarticular juvenile idiopathic arthritis (PJIA)

Actemra for this type of juvenile idiopathic arthritis is given as an IV infusion or subcutaneous injection. The table below shows the recommended dosages for PJIA in children ages 2 years and older. The doctor will prescribe the dosage that’s best for your child.

Administration Body weight Dosage
IV infusion less than 30 kg 10 mg/kg given once every 4 weeks
IV infusion 30 kg or more 8 mg/kg given once every 4 weeks
subcutaneous injection less than 30 kg 162 mg given once every 3 weeks
subcutaneous injection 30 kg or more 162 mg given once every 2 weeks

Actemra dosage for systemic juvenile idiopathic arthritis (SJIA) in children

Actemra for SJIA is given as an IV infusion or subcutaneous injection. The table below shows the recommended dosages for SJIA in children ages 2 years and older. Your child’s doctor will prescribe the form and dosage that’s best for your child.  

Administration Body weight Dosage
IV infusion less than 30 kg 12 mg/kg given once every 2 weeks
IV infusion 30 kg or more 8 mg/kg given once every 2 weeks
subcutaneous injection less than 30 kg 162 mg given once every 2 weeks
subcutaneous injection 30 kg or more 162 mg given once every week

Length of treatment

Doctors typically prescribe Actemra as a long-term treatment for most conditions. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

For CRS, doctors usually prescribe it as a one-time dose or for up to three additional doses, as needed.

Actemra: Common questions about dosage

Below are some common questions related to Actemra’s dosage.

Does Actemra have a recommended dosing calculator?

Yes, doctors sometimes calculate Actemra’s dose by your body weight. For details about the recommended dosages, see the “Actemra: Dosage” section above.

Doctors may consider other factors to determine the correct dose for you. For a list of these factors, see the “Actemra: Dosage considerations” section below.

If you have questions about the dosages for this drug, talk with your doctor or pharmacist.

If I have kidney (renal) problems, are there recommended renal dosing adjustments for Actemra?

No, there’s no recommended dosage adjustment for people with mild to moderate kidney problems. Actemra hasn’t been studied in people with severe kidney problems.

If you have kidney problems, talk with your doctor to find out whether Actemra is right for you.

Actemra: Dosage considerations

Your doctor will consider several factors when prescribing the dosage for Actemra. These factors include:

  • your age
  • your body weight
  • the condition you’re taking Actemra to treat
  • the severity of your condition
  • the form of Actemra you’re taking
  • any side effects you’re experiencing

Your prescribed dosage may also vary based on other medical conditions you may have.

Actemra: How it is administered

Actemra comes as a solution for IV infusion or subcutaneous injection.

You’ll receive the IV infusion in a hospital, clinic, or infusion center. A healthcare professional will administer it. The infusion takes about an hour.

You or a caregiver will give the subcutaneous injection after a healthcare professional shows you how to do it. You can inject Actemra in the following body sites:

  • abdomen, at least 2 inches (in) away from the belly button
  • front of the thigh
  • outer part of the upper arm if a caregiver injects it

You will need to choose a new area of skin for each injection. Make sure it’s at least 1 in away from the last injection site.

ACCESSIBLE DRUG LABELS AND CONTAINERS

If you find it challenging to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies provide medication labels with large print or braille. They may also offer labels containing a scannable code that your smartphone can convert from text to speech. If your pharmacy doesn’t provide these choices, your doctor or pharmacist may be able to recommend a pharmacy that does.

Actemra: Missing a dose

If you miss a dose of Actemra, you should call your doctor. They can tell you whether the missed dose needs administering. If you miss an IV infusion appointment, call to reschedule it.

View these medication reminder options to help avoid missing doses. You could also set an alarm or download a reminder app on your phone.

Actemra: Overdose

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

For a comprehensive overview of Actemra’s side effects, view this article.

For details about dosages in adults and children, review the “Actemra: Dosage“ section above.

What to do if too much Actemra is administered

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

Actemra: What to discuss with your doctor

Talk with your doctor or pharmacist for additional information about Actemra’s dosage. Keep in mind that the dosages presented in this article are typical dosages provided by the drug’s manufacturer. Your doctor will recommend the dosage of Actemra that’s right for you and your condition. Always follow the dosage that your doctor prescribes for you.

As with any medications you’re taking, do not change your Actemra dosage without a recommendation from your doctor. See the “Actemra: Dosage“ section above for typical recommended dosages.

In addition to discussing Actemra with your doctor, you may find the following articles helpful in learning more.

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.

Medical Reviewer: Victor Nguyen, PharmD, MBA
Last Review Date: 2022 Nov 27
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