Kineret (anakinra) is an injectable medication used to treat rheumatoid arthritis (RA) when certain other medications haven't worked well. Kineret (anakinra) is unique in that it's the only FDA-approved RA medication that blocks a specific protein called interleukin-1 (IL-1) that's responsible for swelling and pain. Kineret (anakinra) can also be used to treat certain other auto-inflammatory conditions. It's injected under the skin, typically once daily.
In November of 2022, Kineret (anakinra) received Emergency Use Authorization (EUA) from the FDA to improve survival and shorten hospital stay for certain people hospitalized with coronavirus disease 19 (COVID-19).
Kineret (anakinra) is known as a biologic disease-modifying anti-rheumatic drug (DMARD). Specifically, it blocks a protein called interleukin-1 (IL-1). This is one of the proteins that cause inflammation.
Source: DailyMed
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 immediately if any of the following side effects occur:
More common
fever or chills
headache
itching, pain, redness, swelling, tenderness or warmth on the skin
joint pain
muscle aches and pains
nausea or vomiting
stomach pain
Less common
Difficulty with swallowing
swelling of the face or lips
unusual bruising or bleeding
unusual tiredness or weakness
Incidence not known
Black, tarry stools
bleeding gums
blood in the urine or stools
dizziness
fast heartbeat
hives or welts
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
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
Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
difficulty with moving
headache
muscle aches or stiffness
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.
Available as a prefilled syringe for easier administration
Injection can be given at home after proper training (but not for COVID-19)
Typically given once daily
Needs to be injected, not good for people who don't like needles
Can weaken the immune system and raise the risk for infections
Can take a month or more to see noticeable improvements in symptoms for RA
Your provider will likely have you give yourself your first dose of Kineret (anakinra) in their office or clinic to make sure you know how to give yourself the medication correctly. Refer to the instructions for use and contact your provider or pharmacist if you have any questions.
Store Kineret (anakinra) in the refrigerator and in its original packaging to protect it from light. When it's time for your dose, take a prefilled syringe out of the refrigerator and lay it on a flat surface to warm up to room temperature. This will take about 30 minutes. Don't try to warm up the medication any other way (e.g., microwave, under hot water) because you might damage it.
Before you inject Kineret (anakinra), always check to make sure the liquid is clear and colorless. If your medication is cloudy, discolored, or has chunks in it, don't use it. Contact your provider or pharmacist to get a replacement.
Inject Kineret (anakinra) under the skin in the front of your middle thighs, lower part of your stomach, upper outer areas of the buttocks, or your outer upper arms if someone else is giving you the injection. If you choose to inject into the stomach, inject 2 inches away from your belly button. Never inject into a muscle or vein.
To lower the risk of bruising and irritation, rotate between different injection sites each time so that the same area isn't used repeatedly. Don't inject Kineret (anakinra) into skin that's tender, red, bruised, swollen, hard, or has scars or stretch marks.
After giving yourself the medication, throw away the syringe and needle in a sharps container or something made of heavy-duty plastic (e.g., empty milk carton, laundry detergent bottle) to lower the risk of needlestick injuries. Don't throw away the syringe or needle in your trash can.
Each Kineret (anakinra) prefilled syringe provides a single dose of medication. You must throw away any leftover medication after each use, even if there's still some remaining in the syringe.
Kineret (anakinra) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Active, chronic (long-term), or recurrent infection | Other conditions that raise your risk of infection | Taking medications that weaken your immune system
Kineret (anakinra) can make it more difficult for your body to fight off infections. This raises your risk of bacterial, viral, or fungal infections. The risk is higher for people who are taking or have recently taken other medications that weaken the immune system. Additionally, Kineret (anakinra) might reactivate (wake up) certain viruses that are already in your body, such as tuberculosis (TB), which can be dangerous. If you develop an infection, your provider will likely ask you to stop taking Kineret (anakinra) until your body fights off the infection. Let your provider know if you experience symptoms of these infections, such as fever, cough, difficulty breathing, or weakness.
Kineret (anakinra) can sometimes cause your neutrophil (a type of white blood cell) count to drop. A low neutrophil count means your immune system might have more trouble fighting off an infection. Your provider will likely order blood work to check your neutrophil count before you start Kineret (anakinra). They'll continue to do so monthly during your first 3 months of treatment, and then every 3 months after that for up to a year.
Risk factors: DIRA
Severe allergic reactions to Kineret (anakinra) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). The risk of an allergic reaction is higher for people who are being treated for DIRA, especially during the first few weeks after starting Kineret (anakinra). If you notice dizziness, a choking sensation, nausea, swelling around your eyes, swelling of the lips or tongue, or difficulty breathing after using Kineret (anakinra), get medical attention right away.
There's limited information available on the effects of Kineret (anakinra) on your body's response to vaccines, including live vaccines. Make sure your shots are up-to-date before starting Kineret (anakinra). Talk with your provider before you receive any vaccines while receiving Kineret (anakinra) treatment. Avoid getting live vaccines while you're taking Kineret (anakinra) because there's a risk that you can get sick from them.
Rheumatoid arthritis: The typical dose is 100 mg injected under the skin once daily at the same time every day.
NOMID and DIRA: Your child's healthcare provider will determine their dose based on your child's body weight. The typical starting dose is 1 mg/kg to 2 mg/kg daily, given as an injection under the skin either once daily, or split into 2 smaller doses and given twice daily. Your child's provider might raise their dose over time. The maximum dose is 8 mg/kg daily.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to E. coli-derived proteins
Rheumatoid arthritis (RA)
Plaque psoriasis (PsO) and psoriatic arthritis (PsA)
Ankylosing spondylitis (AS)
Childhood arthritis (polyarticular juvenile idiopathic arthritis, JIA)
Moderate-to-severe rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults
Moderate-to-severe polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
Prevention of short-term graft versus host disease (GVHD) in combination with a calcineurin inhibitor and methotrexate in adults and children ages 2 years and older
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