Tocilizumab

Adults: Interrupting dosing may be needed to manage dose-related laboratory abnormalities, including elevated liver enzymes, neutropenia and thrombocytopenia. Rheumatoid Arthritis: Tocilizumab may be used as monotherapy, or together with methotrexate or other non-biologic DMARDs, as an intravenous infusion. Recommended Intravenous Dosage Regimen: For adults, the recommended dosage is given as a 60-minute single intravenous drip infusion. It starts at 4 mg per kg of body weight every 4 weeks, then goes up to 8 mg per kg of body weight every 4 weeks based on clinical response. Going back from 8 mg per kg to 4 mg per kg is recommended to manage certain dose-related laboratory changes, including elevated liver enzymes, neutropenia and thrombocytopenia. Doses exceeding 800 mg per infusion are not recommended in RA patients. Polyarticular Juvenile Idiopathic Arthritis: Tocilizumab may be used as an intravenous infusion or as a subcutaneous injection, alone or in combination with methotrexate. Don't change the dose based on a single body weight measurement alone, as weight may fluctuate. Recommended Intravenous Dosage Regimen: For PJIA patients, the recommended dosage is given once every 4 weeks as a 60-minute single intravenous drip infusion. Patients less than 30 kg weight: 10 mg per kg of body weight. Patients at or above 30 kg weight: 8 mg per kg of body weight. Systemic Juvenile Idiopathic Arthritis: Tocilizumab may be used as an intravenous infusion or as a subcutaneous injection, alone or in combination with methotrexate. Again, don't change a dose based on a single body weight measurement alone, as weight may fluctuate. Recommended Intravenous Dosage Regimen: For SJIA patients, the recommended dose is given once every 2 weeks as a 60-minute single intravenous drip infusion. Patients less than 30 kg weight: 12 mg per kg of body weight. Patients at or above 30 kg weight: 8 mg per kg of body weight. Coronavirus Disease 2019: The recommended dosage is a single 60-minute intravenous infusion. Patients less than 30 kg weight: 12 mg per kg of body weight. Patients at or above 30 kg weight: 8 mg per kg of body weight. If clinical signs or symptoms worsen or don't improve after the first dose, one more infusion may be given at least 8 hours after the first one. The maximum dosage in COVID-19 patients is 800 mg per infusion. Cytokine Release Syndrome: Use only the intravenous route to treat CRS. The recommended dose is given as a 60-minute intravenous infusion. Recommended Intravenous CRS Dosage Patients less than 30 kg weight: 12 mg per kg of body weight, alone or in combination with corticosteroids. Patients at or above 30 kg weight: 8 mg per kg of body weight, alone or in combination with corticosteroids. If the signs and symptoms of CRS don't improve clinically after the first dose, up to 3 additional doses may be given. The interval between consecutive doses should be at least 8 hours. Doses exceeding 800 mg per infusion are not recommended in CRS patients. Giant Cell Arteritis: For adults, the recommended dosage is 6 mg per kg of body weight every 4 weeks, given as a 60-minute single intravenous drip infusion in combination with a tapering course of glucocorticoids. Tocilizumab can be used alone after the glucocorticoids have been stopped. Doses exceeding 600 mg per infusion are not recommended in GCA patients. Systemic Sclerosis-Associated Interstitial Lung Disease: For adults with SSc-ILD, the recommended dose is 162 mg once every week as a subcutaneous injection. Intravenous administration is not approved for SSc-ILD. Administration of Intravenous Formulation: For adults with RA, GCA, CRS, PJIA and SJIA patients at or above 30 kg, dilute to 100 mL in 0.9% or 0.45% Sodium Chloride Injection, USP, for intravenous infusion, using aseptic technique. For PJIA, SJIA and CRS patients less than 30 kg, dilute to 50 mL in 0.9% or 0.45% Sodium Chloride Injection, USP, for intravenous infusion, using aseptic technique. Administer as a single intravenous drip infusion over 1 hour; do not administer as bolus or push.