Glossary
Getting Started With Injections Getting Started With Injections

How to Inject ACTEMRA

If you’ve never had subcutaneous (SC) injections before, you may be wondering what to expect. Here are a few things that will happen before, during, and after treatment.

ACTEMRA for giant cell arteritis (GCA) is available in a prefilled syringe or the ACTPen® autoinjector

Your healthcare professional will train you or your caregiver to properly inject ACTEMRA. This way, you'll know the exact steps involved.

For a step-by-step guide on how to inject ACTEMRA SC, download the How to Use Your Prefilled Syringe Brochure or the How to Use Your ACTPen Brochure

After you've reviewed your brochure and the FDA-approved Instructions for Use, use the quick reference guides below as a reminder on how to inject.

Prefilled syringe quick reference guide

Please review the steps detailed in the FDA-approved Instructions for Use. Afterwards, you may use the following summary as a quick reference before injecting.

Prepare for your injection: Remove the prefilled syringe from the refrigerator and let it warm up for 30 minutes until it reaches room temperature. Inspect your prefilled syringe. The liquid should be clear and colorless to pale yellow. Prepare for your injection: Remove the prefilled syringe from the refrigerator and let it warm up for 30 minutes until it reaches room temperature. Inspect your prefilled syringe. The liquid should be clear and colorless to pale yellow.
Remove Cap: Hold the barrel of the syringe and remove the cap with the needle pointing down. After removing the cap, the prefilled syringe should be used within 5 min or disposed of. Remove Cap: Hold the barrel of the syringe and remove the cap with the needle pointing down. After removing the cap, the prefilled syringe should be used within 5 min or disposed of.
Pinch Skin: Wipe the section of your thigh or outer abdomen with an alcohol pad and pinch the skin firmly between your fingers. A caregiver may also use the outer area of the upper arms as an injection site. Pinch Skin: Wipe the section of your thigh or outer abdomen with an alcohol pad and pinch the skin firmly between your fingers. A caregiver may also use the outer area of the upper arms as an injection site.
Insert needle: Use a quick motion to insert the needle of the syringe into the pinched skin at a 45 to 90 degree angle. Insert needle: Use a quick motion to insert the needle of the syringe into the pinched skin at a 45 to 90 degree angle.
Inject Actemra SC: Gently let go of the pinched skin and slowly push the plunger of the syringe all the way down. Inject Actemra SC: Gently let go of the pinched skin and slowly push the plunger of the syringe all the way down.
Remove and Release: Keep holding the plunger down while removing the needle from your skin. Release the plunger once the needle has completely exited the skin. Remove and Release: Keep holding the plunger down while removing the needle from your skin. Release the plunger once the needle has completely exited the skin.
Dispose: Once finished, dispose the entire syringe in a sharps container. Dispose: Once finished, dispose the entire syringe in a sharps container.

ACTPen quick reference guide

Please review the steps detailed in the FDA-approved Instructions for Use. Afterwards, you may use the following summary as a quick reference before injecting.

Prepare for your injection: Remove the ACTPen from the refrigerator and let it warm up for 45 minutes until it reaches room temperature. Inspect your ACTPen. The liquid should be clear and colorless to pale yellow. Prepare for your injection: Remove the ACTPen from the refrigerator and let it warm up for 45 minutes until it reaches room temperature. Inspect your ACTPen. The liquid should be clear and colorless to pale yellow.
Twist and pull cap: Remove cap when you are ready to inject. After removing the cap, the ACTPen should used within 3 min or disposed of. Twist and pull cap: Remove cap when you are ready to inject. After removing the cap, the ACTPen should used within 3 min or disposed of.
Pinch Skin: Choose an injection site. Gently pinch the injection site, and place the ACTPen against your pinched skin at a 90 degree angle. Do not press the green activation button until step 5. Pinch Skin: Choose an injection site. Gently pinch the injection site, and place the ACTPen against your pinched skin at a 90 degree angle. Do not press the green activation button until step 5.
Compress to unlock: Push the ACTPen down until the needle shield is fully compressed against your pinched skin to unlock the button. Hold the ACTPen firmly in this position. Compress to unlock: Push the ACTPen down until the needle shield is fully compressed against your pinched skin to unlock the button. Hold the ACTPen firmly in this position.
Inject Actemra SC: Press the green activation button. A 'click' sound indicates the start of the injection. Keep the button pressed throughout the injection. The injection could take up to 10 seconds to complete. Inject Actemra SC: Press the green activation button. A 'click' sound indicates the start of the injection. Keep the button pressed throughout the injection. The injection could take up to 10 seconds to complete.
Watch and release: Hold the ACTpen in place  until the purple indicator has stopped moving. Lift the ACTPen straight off of your skin and release the green button. The needle shield will move out and lock in place. Watch and release: Hold the ACTpen in place  until the purple indicator has stopped moving. Lift the ACTPen straight off of your skin and release the green button. The needle shield will move out and lock in place.
Dispose: Once finished, dispose of the ACTPen in sharps container. Do not put the cap back on the ACTPen. Dispose: Once finished, dispose of the ACTPen in sharps container. Do not put the cap back on the ACTPen.

Preparing for your injection

Blood tests

Before you start on ACTEMRA SC injections, your healthcare professional will do a variety of blood tests. The chart below shows how often these tests will occur after you start treatment.

Review Important Side Effect Information & training

Before you start taking ACTEMRA SC injections, your healthcare professional should review the ACTEMRA Medication Guide, including Instructions for Use, with you. Reviewing the Medication Guide should help you to better understand the risks and benefits of your GCA treatment. After reviewing the Important Side Effect Information for ACTEMRA, you should be properly trained on using your preferred injection device.

Weighing in

Your healthcare professional should weigh you at each office visit. That way, they will ensure the right amount of ACTEMRA is prescribed for you.

Learn more about your ACTEMRA dose here.

Monitoring for ACTEMRA side effects at home

It’s important to pay close attention to how you’re feeling before, during, and after an injection. ACTEMRA may lead to serious allergic reactions, including death. Allergic reactions may happen during and after any injection, even if they have not happened before.

In case of emergency

Contact 911 immediately, as well as your healthcare professional, if you experience any of these allergic reactions:

  • Shortness of breath or trouble breathing
  • Swelling of lips, tongue, or face
  • Chest pain
  • Feeling dizzy or faint
  • Moderate or severe abdominal pain or vomiting

Receive Free Resources

Get your free ACTEMRA Travel Pack and sharps disposal container by calling 1-800-ACTEMRA (1-800-228-3672).

ACTEMRA Patient Support Line

Have questions about ACTEMRA?

Call 1-800-228-3672 to talk with a team member about ACTEMRA.

What does ACTEMRA treat?

ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor antagonist.

ACTEMRA is used to treat:

  • Adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease modifying antirheumatic drug (DMARD) has been used and did not work well
  • Adults with giant cell arteritis (GCA)
  • Patients with active polyarticular juvenile idiopathic arthritis (PJIA) 2 years of age and older 
  • Patients with active systemic juvenile idiopathic arthritis (SJIA) 2 years of age and older

It is not known if ACTEMRA is safe and effective in children with PJIA or SJIA under 2 years of age or in children with conditions other than PJIA or SJIA.

ACTEMRA can cause serious side effects

Serious Infections

ACTEMRA changes the way your immune system works. This can make you more likely to get infections or make any current infection worse. Some people have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during treatment with ACTEMRA.

Before starting ACTEMRA, tell your healthcare provider if you have:

  • an infection, think you may have an infection, are being treated for an infection, or get a lot of infections that return. Symptoms of an infection, with or without a fever, include sweating or chills; shortness of breath; warm, red or painful skin or sores on your body; feeling very tired; muscle aches; blood in phlegm; diarrhea or stomach pain; cough; weight loss; burning when you urinate or urinating more than normal
  • any of the following conditions that may give you a higher chance of getting infections: diabetes, HIV, or a weak immune system
  • tuberculosis (TB), or have been in close contact with someone with TB
  • live or have lived, or have traveled to certain parts of the United States where there is an increased chance of getting fungal infections. These parts include the Ohio and Mississippi River valleys and the Southwest
  • hepatitis B or have had hepatitis B

Who should not take ACTEMRA?

Do not take ACTEMRA if you are allergic to tocilizumab, or any of the ingredients in ACTEMRA.

Be sure to talk to your healthcare provider if you see any signs of these serious side effects:

Tears (perforation) of the Stomach or Intestines

If you have diverticulitis (inflammation in parts of the large intestine), talk to your healthcare provider before taking ACTEMRA. Some people taking ACTEMRA may develop a hole in the wall of their stomach or intestines (also known as a perforation). This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.

Tell your healthcare provider right away if you see any of these side effects: fever, stomach-area pain that does not go away, or if you see a change in your bowel habits.

Liver problems (Hepatotoxicity)

Some people have experienced serious life-threatening liver problems, which required liver transplant or led to death. Your healthcare provider may tell you to stop taking ACTEMRA if you develop new or worsening liver problems during treatment with ACTEMRA. Tell your healthcare provider right away if you have any of the following symptoms:

  • feeling tired (fatigue)
  • lack of appetite for several days or longer (anorexia)
  • yellowing of your skin or the whites of your eyes (jaundice)
  • abdominal swelling and pain on the right side of the stomach-area
  • light colored stools
  • weakness
  • nausea and vomiting
  • confusion
  • dark “tea-colored” urine

Changes in Blood Test Results

Your healthcare provider should do blood tests before you start receiving ACTEMRA. If you have rheumatoid arthritis (RA) or giant cell arteritis (GCA) your healthcare provider should do blood tests 4 to 8 weeks after you start receiving ACTEMRA for the first 6 months and then every 3 months after that. If you have polyarticular juvenile idiopathic arthritis (PJIA) you will have blood tests done every 4 to 8 weeks during treatment. If you have systemic juvenile idiopathic arthritis (SJIA) you will have blood tests done every 2 to 4 weeks during treatment. These blood tests are to check for the following side effects of ACTEMRA:

  • Low neutrophil count: neutrophils are white blood cells that help the body fight infection
  • Low platelet count: platelets are blood cells that help with clotting, which stops bleeding
  • Increase in liver function test levels
  • Increase in blood cholesterol levels: your cholesterol levels should be checked 4 to 8 weeks after you start receiving ACTEMRA.

Your healthcare provider will determine how often you will have follow-up blood tests. Make sure you get all your follow-up blood tests done as ordered by your healthcare provider.

You should not receive ACTEMRA if your neutrophil and platelet counts are too low or your liver function test levels are too high. Changes in blood test results may cause your healthcare provider to stop your ACTEMRA treatment for a time or change your dose.

Cancer

ACTEMRA may increase your risk of certain cancers by changing the way your immune system works.

Hepatitis B Infection

If you have or are a carrier of the hepatitis B virus (a virus that affects the liver), the virus may become active while you use ACTEMRA. Your healthcare provider may do blood tests before you start treatment with ACTEMRA and while you are using ACTEMRA. Tell your healthcare provider if you have any signs of these symptoms:

  • feel very tired
  • skin or eyes look yellow
  • little or no appetite
  • vomiting
  • clay-colored bowel movements
  • fevers
  • chills
  • stomach discomfort
  • muscle aches
  • dark urine
  • skin rash

Serious Allergic Reactions

Serious allergic reactions, including death, can happen with ACTEMRA. These reactions can happen with any infusion or injection of ACTEMRA, even if they did not occur with an earlier infusion or injection. Tell your healthcare provider before your next dose if you had hives, rash or flushing after your injection.

Contact 911 immediately, as well as your healthcare provider, if you experience any of these reactions:

  • shortness of breath or trouble breathing 
  • swelling of the lips, tongue, or face 
  • chest pain 
  • feeling dizzy or faint 
  • moderate or severe abdominal pain or vomiting

Nervous System Problems

While rare, Multiple Sclerosis has been diagnosed in people who take ACTEMRA. It is not known what effect ACTEMRA may have on some nervous system disorders.

What should I tell my healthcare provider before receiving ACTEMRA?

ACTEMRA may not be right for you. Before receiving ACTEMRA, tell your healthcare provider if you:

  • have an infection 
  • have liver problems 
  • have any stomach-area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines 
  • have had a reaction to tocilizumab or any of the ingredients in ACTEMRA before 
  • have or had a condition that affects your nervous system, such as multiple sclerosis 
  • have recently received or are scheduled to receive a vaccine 
  • plan to have surgery or a medical procedure 
  • have any other medical conditions 
  • plan to become pregnant or are pregnant. It is not known if ACTEMRA will harm your unborn baby. 
  • plan to breast-feed or are breast-feeding. You and your healthcare provider should decide if you will take ACTEMRA or breast-feed. You should not do both. 
  • are taking any medications, including prescription and nonprescription medicines, vitamins, and herbal supplements.

The most common side effects of ACTEMRA include:

  • upper respiratory tract infections (common cold, sinus infections)
  • headache
  • increased blood pressure (hypertension)
  • injection site reactions

ACTEMRA & Pregnancy

Tell your healthcare provider if you are planning to become pregnant, are pregnant, plan to breast-feed, or are breast-feeding. You and your healthcare provider should decide if you will take ACTEMRA or breast-feed. You should not do both. If you are pregnant and taking ACTEMRA, join the pregnancy registry. The purpose of this registry is to check the health of the pregnant mother and her baby. To learn more, call 1-877-311-8972 or talk to your healthcare provider to register.

Tell your healthcare provider if you have any side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555.

For more Important Safety Information, please see full Prescribing Information and the Medication Guide, including Serious Side Effects.