Specialty Drug


TOCILIZUMAB is used to treat rheumatoid arthritis (RA) and certain types of arthritis in children. This medicine helps reduce joint pain and swelling. This medicine is often used with other medicines. Compare interleukin antagonists.

Actemra Side Effects

What should I watch for?

Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse.

Your condition will be monitored carefully while you are receiving this medicine.

You will be tested for tuberculosis (TB) before you start this medicine. If your doctor prescribes any medicine for TB, you should start taking the TB medicine before starting this medicine. Make sure to finish the full course of TB medicine.

Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

You may need blood work done while you are taking this medicine.


Interactions with Medications

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Abdominal or stomach pain

black, tarry stools

bloody or cloudy urine

blurred vision

body aches or pain

chest pain


cough producing mucus


difficult, burning, or painful urination

difficulty breathing

difficulty swallowing


ear congestion

fast heartbeat

feeling of warmth

fever or chills

frequent urge to urinate




loss of appetite

loss of consciousness

loss of voice

lower back or side pain

nasal congestion



pain or tenderness around the eyes and cheekbones

painful blisters on the trunk of the body

pale skin

pounding in the ears

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

redness of the face, neck, arms, and occasionally, upper chest

shortness of breath or troubled breathing

skin rash

slow or fast heartbeat


sore throat

stuffy or runny nose

sudden sweating

tightness of the chest or wheezing

ulcers, sores, or white spots in the mouth

unusual bleeding or bruising

unusual tiredness or weakness


Less common

Bladder pain

blurred vision

burning feeling in the chest or stomach


dark urine

decrease in height

difficulty moving

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, irregular, pounding, or racing heartbeat or pulse

feeling hot

frequent urge to urinate

general feeling of discomfort or illness



itching, pain, redness, swelling, tenderness, or warmth on the skin at the injection site

joint pain

light-colored stools

muscle aches and pains

muscle cramps or stiffness

pain in the back, ribs, arms, or legs

pain in the groin or genitals

pale skin

severe stomach pain

sharp back pain just below the ribs


stomach upset



swollen joints

swollen, painful, or tender lymph glands in the face, neck, armpit, or groin

tenderness in the stomach area

trouble with sleeping

troubled breathing with exertion

unexplained runny nose or sneezing

upper right abdominal or stomach pain


yellow eyes and skin


Acid or sour stomach


changes in skin color


coughing or spitting up blood


gaseous abdominal or stomach pain


neck pain

night sweats

noisy breathing


pain, swelling, or redness in the joints

rapid, shallow breathing

recurrent fever

red, tender, or oozing skin at incision

stomach bloating, burning, cramping, or pain

sudden high fever or low-grade fever for months

swelling of the foot or leg

swollen lymph nodes

weight loss

Incidence not known

Dilated neck veins

extreme fatigue

severe abdominal or stomach pain, cramping, or burning

swelling of the face, fingers, feet, or lower legs

vomiting of material that looks like coffee grounds, severe and continuing

weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Burning, dry, or itching eyes


discharge, excessive tearing

redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid

skin rash, encrusted, scaly and oozing

swelling or inflammation of the mouth

warmth on the skin

Less common

Abnormal or decreased touch sensation

accumulation of pus

back pain

bleeding gums

blemishes on the skin

bloody eye

chapped, red, or swollen lips


feeling of constant movement of self or surroundings

hives or welts

irritation in the mouth

loose teeth

persistent breath odor or bad taste in your mouth


redness and swelling of the gums

redness of the eye

redness of the skin

redness or swelling in the ear

scaling, redness, burning, pain, or other signs of inflammation of the lips

sensation of spinning


sore mouth or tongue

sores on the skin

stomach soreness or discomfort

swollen, red, or tender area of infection

unable to sleep

white patches in the mouth or on the tongue


Bleeding after defecation


bloody nose

burning, numbness, tingling, or painful sensations

change in hearing

continuing ringing or buzzing or other unexplained noise in the ears

coughing or spitting up blood

decreased vision or other changes in vision

dry mouth

ear drainage


flushed, dry skin

fruit-like breath odor

hearing loss

increased hunger

increased thirst

increased urination

itching ears

loss of consciousness

redness, swelling, or soreness of the tongue


uncomfortable swelling around the anus

unexplained weight loss

unsteadiness or awkwardness

weakness in the arms, hands, legs, or feet

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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