1. Treatment of adults with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response to one or more disease-modifying antirheumatic drugs (DMARDs).
2. Treatment of active systemic juvenile idiopathic arthritis in patients 2 years and older.
3. Treatment of active polyarticular juvenile idiopathic arthritis in patients 2 years and older.

Antagonist of the interleukin-6 (IL-6) receptor. Endogenous IL-6 is induced by inflammatory stimuli and mediates a variety of immunological responses. Inhibition of IL-6 receptors by tocilizumab leads to a reduction in cytokine and acute phase reactant production. 

Absorption: 100%; Elimination half life: terminal, single dose: 6.3 days (concentration-dependent; may be increased up to 13 days in adults at steady state)

Hypersensitivity to tocilizumab or any component of the formulation; serious infections; Active TB.

C

Excretion in breast milk unknown/not recommended

Headache, hypertension, nasopharyngitis, respiratory-tract infections, hypercholesterolaemia, and increased liver enzyme values; Conjunctivitis, dizziness, gastritis, mouth ulceration, pruritus, and rash.

1. COVID-19, hospitalized patients: IV: 8 mg/kg once (maximum dose: 800 mg) as part of an appropriate combination regimen; For use in hospitalized patients with significant oxygen requirements (eg, high-flow oxygen, noninvasive ventilation, mechanical ventilation, or extracorporeal membrane oxygenation) and those with lower but increasing oxygen requirements and evidence of systemic inflammation; Do not initiate if ANC <1,000/mm3, platelets <50,000/mm3, or ALT or AST >10 times ULN. <20231212>
2. Cytokine release syndrome: IV: 8 mg/kg once (maximum dose: 800 mg).
3. Giant cell arteritis (adjunctive agent) : IV: 6 mg/kg (maximum dose: 600 mg) once every 4 weeks in combination with glucocorticoids.
4. Kidney transplant, antibody-mediated rejection (off-label use) : IV: 8 mg/kg (maximum: 800 mg per dose) once every 4 weeks until resolution.
5. Kidney transplant, pretransplant desensitization (adjunctive agent) (off-label use) : IV: Months prior to transplant: 8 mg/kg once monthly as part of a combination regimen (eg, immune globulin).
6. Neuromyelitis optica, relapse prevention (alternative agent) (off-label use) : IV: 8 mg/kg once every 4 weeks.
7. Rheumatoid arthritis: IV: Initial: 4 mg/kg once every 4 weeks; may be increased to 8 mg/kg once every 4 weeks based on clinical response (maximum dose: 800 mg).

Not recommended for use in patients with active hepatic disease or hepatic impairment.

Store unused vials in original packaging refrigerated between 2？C and 8？C, protect from light.