Makindo Medical Notes

About: Always check the BNF link here

• Check BNF or equivalent for UpToDate prescribing advice

Mode of action

• A humanised antihuman IL-6 receptor antibody of the IgG1 subclass. IL-6 is important for CRP production,

Indication/Dose

• Moderate to severe rheumatoid arthritis with Methotrexate or as monotherapy

Dose range:You must check with BNF or drug datasheet

Interactions

• See BNF

Cautions

• May have a normal CRP in presence of infection or inflammation
• Patients with latent tuberculosis should be treated with standard therapy before starting tocilizumab.
• Discontinue if absolute neutrophil count less than 0.5 x 10⁹/litre or platelet count less than 50 x 10³/microlitre.

Contraindications

• Do not initiate if absolute neutrophil count less than 2 x 10⁹/litre; severe active infection

Side effects

• Increase in serum total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
• Neutropenia and deranged LFTs

References

• See BNF