Tocilizumab
From IDWiki
Background
- IL-6 antagonist
- Indicated for COVID-19
Dosing
- Severe or critical COVID-19, as a single dose infused over 60 minutes
- Dose is typically reduced to 400 mg per dose during drug shortages
- A second dose is not recommended
| Patient Weight | Routine Dose | Drug Shortages Dose |
|---|---|---|
| ≤40 kg | 8 mg/kg | 8 mg/kg |
| >40 and ≤65 kg | 400 mg | 400 mg |
| >65 and ≤90 kg | 600 mg | |
| >90 kg | 800 mg |
Renal Dosing
- No dose adjustments
Hepatic Dosing
- No dose adjustments
Safety
Contraindications
- Contraindications and relative contraindications include hypersensitivity, co-existing infection, immunosuppression, increase liver enzymes.
Infections
- In one cohort study, serious bacterial infections occurred in about 7%, with no viral or fungal infections seen1
- Compared to TNF-α inhibitors, has a higher risk of serious bacterial infection, skin and soft tissue infection, and diverticulitis2
References
- ^ Veronika R. Lang, Matthias Englbrecht, Jürgen Rech, Hubert Nüsslein, Karin Manger, Florian Schuch, Hans-Peter Tony, Martin Fleck, Bernhard Manger, Georg Schett, Jochen Zwerina. Risk of infections in rheumatoid arthritis patients treated with tocilizumab. Rheumatology. 2011;51(5):852-857. doi:10.1093/rheumatology/ker223.
- ^ Ajinkya Pawar, Rishi J Desai, Daniel H Solomon, Adrian J Santiago Ortiz, Sara Gale, Min Bao, Khaled Sarsour, Sebastian Schneeweiss, Seoyoung C Kim. Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study. Annals of the Rheumatic Diseases. 2019;78(4):456-464. doi:10.1136/annrheumdis-2018-214367.
