Do you have a condition called rheumatoid arthritis , or rheumatoid arthritis? Or has your doctor prescribed you to start a medication called Tocilizumab? It's normal to feel a little scared and curious when you hear about this type of medication. You probably have a lot of questions in your mind, such as what this medication is for, what it does, and whether it has side effects . So today, let's talk about this medication called Tocilizumab, in a very simple way that you can understand.
What kind of medicine is Tocilizumab?
Simply put, Tocilizumab is a drug that controls some of the processes in your body's immune system, typically given as a shot. Our body's immune system sometimes becomes overactive and starts attacking our own cells. This drug is mainly used to control diseases that occur in such cases.
There are several main medical conditions for which doctors commonly prescribe this medication:
- Rheumatoid Arthritis: A condition that causes swelling, pain, and stiffness in the joints of adults.
- Juvenile Idiopathic Arthritis : A joint disease that occurs in children over 2 years of age.
- Giant Cell Arteritis: A condition that causes inflammation of the blood vessels .
- Cytokine Release Syndrome (CRS): A severe reaction that can occur during some cancer treatments.
- Systemic Sclerosis-Related Lung Disease: To control the decrease in lung function caused by certain medical conditions.
Your doctor may also prescribe this medication for other conditions not on this list.
Things you need to tell your doctor before starting medication
This is very important. Before you start taking Tocilizumab, it is important to tell your doctor about your complete health history . Especially if you have any of the following conditions:
| Health condition/problem | Why should you care? |
|---|---|
| Any type of infection (e.g. tuberculosis (TB), herpes, chickenpox, other bacterial or viral infections) | This medicine may worsen existing infections because it reduces immunity. |
| Liver diseases (e.g. Hepatitis B) | The drug can affect the liver, and old infections may reactivate. |
| Cancer condition or history of cancer | There is a belief that this medicine may increase the risk of some cancers. |
| Diabetes, heart disease, high blood pressure, high cholesterol | These conditions can increase the risk of infection and other complications. |
| Decreased blood counts (white blood cells, platelets, red blood cells) | Medication can further reduce these conditions. |
| Intestinal problems (e.g. Diverticulitis) | There is a risk of perforation (tears) in the stomach or intestines. |
| If you have recently received a vaccination or are scheduled to receive one in the future | In particular, live virus vaccines should be avoided. |
| If you are pregnant, trying to get pregnant, or breastfeeding | You should discuss with your doctor whether the medication may affect the child. |
How do you use this medicine?
The Tocilizumab vaccine is given in two ways: either into a vein or under the skin.
- In a hospital or clinic: Most often, this vaccine is given in a hospital or clinic by trained medical staff.
- Home administration: In some cases, your doctor will instruct you on how to administer the vaccine at home. If so, you should take the vaccine exactly as instructed, at the correct time, and in the correct dose. Never stop taking the vaccine unless your doctor tells you to.
Special note: Never throw your used needles and syringes in the trash. There is a special container for them (sharps container). If you don't have one, ask your doctor for one. This is very important to avoid harming the environment and others.
What do you do if you miss a medication appointment?
It is very important to take your medicine on time. If you cannot keep an appointment at the hospital, tell your doctor or the hospital immediately. If you are taking your medicine at home, if you miss a dose, take that dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at the same time. If you have any questions about this, ask your doctor.
Other medicines that should not be used with this medicine
Tocilizumab is a drug that can interact with other medications, so you should tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
- What you should never take: Do not receive live virus vaccines while taking this medicine.
- Other drugs that may interact:
- Other biologic medicines such as Abatacept, Adalimumab, Etanercept
- Birth control pills
- Some cholesterol-lowering medications, such as Atorvastatin and Simvastatin
- Cyclosporine, Omeprazole, Theophylline
- Steroid medicines such as Prednisone or Cortisone
- Blood-thinning medications such as Warfarin
This list is not complete, so it's safest to tell your doctor about everything you take.
Things to keep in mind when taking medication
- Tuberculosis Test (TB Test):You will be tested for tuberculosis before starting this medication. If your doctor prescribes medication for TB, you should start taking that medication and finish the entire prescription before starting Tocilizumab.
- Risk of infection:
- Blood tests: Your doctor will order regular blood tests to monitor your condition while you are taking the medication. Don't skip them.
- Cancer risk: There is some evidence that this medication may slightly increase the risk of some types of cancer. If you have any questions about this, please talk to your doctor.
- Tocilizumab is a powerful drug used to treat immune-related diseases such as rheumatoid arthritis.
- Before starting the medication, tell your doctor about all your medical conditions and other medications you are taking.
- There is an increased risk of infection while taking this medicine. If you develop symptoms such as fever, cough, or sore throat, seek medical advice immediately.
- If you experience symptoms such as severe allergic reactions, liver problems, or severe stomach pain, go to a hospital immediately.
- If you have any questions about this medicine, don't be afraid to ask your doctor.
Most importantly! This medicine reduces the activity of your immune system, so you are more likely to get infections easily. If you experience symptoms such as fever, chills, body aches, sore throat, cough, do not take paracetamol on your own, but call your doctor immediately. Stay away from people who are sick as much as possible.
What are the possible side effects of the medication?
Like all medicines, Tocilizumab can cause side effects, although not everybody gets them.
| Side effects and symptoms | |
|---|---|
| Things to report immediately to your doctor or the hospital's Emergency Department (ETU) | |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips or tongue, difficulty breathing. |
| Symptoms of liver damage | Dark yellow or brown urine, yellowing of the eyes or skin, pain in the upper right part of the stomach, extreme fatigue, loss of appetite. |
| Perforation of the stomach or intestines | High fever, severe stomach pain, sudden change in bowel habits. |
| Signs of infection | Fever, chills, sore throat, cough, urinary tract infection. |
| Symptoms of low blood count | Unusual bruising, bleeding, extreme fatigue, difficulty breathing, fainting. |
| Things that are usually not serious, but should be reported to the doctor if they persist | |
| Headache, dizziness | This usually goes away in a few days. |
| Pain, redness at the injection site | It is normal to experience slight pain or redness at the injection site. |
What if I take too much medicine?
If you think you have overdosed, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
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