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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 SC 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.

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. You can also watch step-by-step videos within each tab below to learn how to inject ACTEMRA using the prefilled syringe or ACTPen autoinjector.

ACTEMRA ACTPen® Autoinjector Prefilled Syringe

ACTEMRA ACTPen® Autoinjector

ACTPen autoinjector 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.

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.

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.

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.

How to inject with the ACTEMRA ACTPen^® autoinjector

Prefilled Syringe

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.

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.

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.

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.

How to inject with the ACTEMRA prefilled syringe

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.

Liver function, neutrophil count, and platelet count

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 support icon

ACTEMRA Patient Support Line

Have questions about ACTEMRA?

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

Next Page: Getting Started With IV Infusions

A biologic is a type of medicine developed using processes that are similar to what happens in your body naturally. Biologics can be used to interact with certain parts of your body, like your immune system. They can also fight inflammation in certain diseases, like GCA.
An inflammation of the blood vessels. The cause is often unknown.
When a part of the body becomes swollen and painful.
A flare is a sudden worsening of your disease. It can happen after you haven’t experienced symptoms for a long time. It’s also known as a relapse.
A chemical messenger that tells the immune system to attack harmful bacteria and viruses. When your body produces too much IL-6, it causes the immune system to attack healthy cells.
A decrease or disappearance in signs and symptoms.
Under the skin.
A sample of cells taken from the body in order to examine them more closely. A healthcare professional will recommend a biopsy when a test suggests an area of tissue in the body isn’t normal.
A genetic predisposition means that a person may be more likely to develop a disease based on their genes. However, they may not see any symptoms unless something in the environment triggers the disease.
Steroids, including cortisone and prednisone, are a type of medicine used temporarily to reduce inflammation.
Biologics, a type of DMARD, are a class of arthritis treatments designed to target your immune system.
The immune system is a complex network of organs and cells that protects the body from foreign substances such as bacteria, fungi, and viruses.

INDICATIONS

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
To treat adults with giant cell arteritis (GCA)
To treat patients with active polyarticular juvenile idiopathic arthritis (PJIA) 2 years of age and older
To treat patients with active systemic juvenile idiopathic arthritis (SJIA) 2 years of age and older
For slowing the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD) (also known as scleroderma-associated ILD).
To treat hospitalized adult and pediatric patients aged 2 years and older with coronavirus disease 2019 (COVID-19) receiving systemic corticosteroids and requiring supplemental oxygen or mechanical ventilation.
ACTEMRA is not approved for subcutaneous use in people with COVID-19.

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 assess you for TB before starting, during and after treatment with ACTEMRA (except if you have COVID-19).

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

If you have COVID-19, your healthcare provider should monitor you for signs and symptoms of new infections during and after treatment with ACTEMRA.

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, new onset 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), or systemic sclerosis-interstitial lung disease (SSc-ILD) 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. Stop taking ACTEMRA, contact your healthcare provider, and get emergency help right away if you have any of the following signs of a serious allergic reaction:

swelling of the face, lips, mouth, or tongue
trouble breathing
wheezing
severe itching
skin rash, hives, redness, or swelling outside of the injection site area
dizziness or fainting
fast heartbeat or pounding in your chest (tachycardia)
sweating

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

Tell your healthcare provider about any side effect that bothers you or does not go away. These are not all the possible side effects of ACTEMRA.

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.

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

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