Parenteral Manual

Tocilizumab

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ACTEMRA
Classification: 
Interleukin-6 Receptor Antagonist (Anti IL-6)
Original Date: 
December 2008
Revised Date: 
July 2012
Indications: 

  • Rheumatoid arthritis and Castleman's Disease in adults

  • Systemic juvenile idiopathic arthritis and polyarticular juvenile idiopathic arthritis in children

Reconstitution and Stability: 
  • Available as 20 mg/mL solution
  • Store vials under refrigeration at 2°C to 8°C (36°F to 46°F). Do not freeze.
  • Protect from light.
  • DO NOT shake

  • Infusion solution stable 24 hours refrigerated and 6 hours at room temperature

  • Infusion must be administered at ROOM TEMPERATURE

Compatibility: 

- Solution Compatible:  0.9% NaCl

- Additives/buretrol Compatible:  No information

- Y-site Compatible:  No information

Incompatible:   No information

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion

YES  -administer via peripheral line over 1 hour.  Allow solution to come to room temp 1-2 hours prior to administration

INFUSION GUIDELINES:

For a patient < 30 kg: 

  50 mL bag - infuse at 10 mL/hr for 15 min. then increase to 65mL/hr,  then flush with 10 mL NS

For a patient > 30 kg:  100 mL bag - infuse at 10 mL/hr for 15 min. then increase to 130mL/hr,  then flush with 20 mL NS
IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

-Children   < 30 kg:  12 mg/kg
                > 30 kg:  8 mg/kg

Potential hazards of parenteral administration: 

·          Increased susceptibility to infection such as nasopharyngitis, pneumonia, cellulitis and infrequently opportunistic infections

·          GI conditions including gastritis, enteritis, GI perforations

·          Decreases in mean WBC counts, usually due to a decrease in neutrophil counts

·          Dermatological:  rash, dermatitis, urticaria, pruritis

·          Hypertension

·          Infusion reactions are uncommon and generally mild  - medications for treatment of hypersensitivity reactions should be available for immediate use

Notes: 

Monitor: haematological, immunological, hepatic function and lipid metabolism parameters

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