Sounds like 'TOE-si-LIZ-ue-mab'

Tocilizumab is used to treat moderate-to-severe forms of rheumatoid arthritis. Find out how to take it safely and possible side effects. Tocilizumab is also called Actemra.

Type of medicine Also called
  • Biologics for rheumatoid arthritis
  • Biological disease modifying antirheumatic drugs (bDMARDs)
  • Actemra®

What is tocilizumab?

  • Tocilizumab is used to treat moderate-to-severe forms of rheumatoid arthritis, usually only after other medications have not worked. It can reduce joint pain and swelling.
  • Tocilizumab belongs to a group of medicines known as biologic medicines. These are medicines that target specific chemicals in your body involved in the inflammatory response that causes rheumatoid arthritis. Other examples of biologic medicines used for rheumatoid arthritis are rituximab and tumour necrosis factor (TNF) inhibitors (such as adalimumab, etanercept and infliximab).

How is tocilizumab given?

Tocilizumab is given by slow injection into a vein (called intravenous infusion), in your arm, every 4 weeks. The infusion usually takes an hour. Before the infusion, you will be prescribed other medication to prevent pain and to reduce fever and other effects that can be caused by the infusion. 

Monitoring and investigations

Tocilizumab can cause serious side effects, including the increased risk of infection. Before prescribing tocilizumab, your doctor will test for infections such as hepatitis and tuberculosis. To monitor the safety of tocilizumab and to observe how well it is working, your doctor will order blood tests.

Precautions — before taking tocilizumab

  • Do you have diverticular disease or diverticulosis (a condition in which small, bulging pouches develop in the bowel)?
  • Do you have any problems with the way your kidneys or liver work?
  • Are you pregnant or breast-feeding or planning to have a baby?

If so, it’s important that you tell your doctor before you start taking tocilizumab. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Side effects

Like all medicines, tocilizumab can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects What should I do?
  • During the infusion, you may experience low blood pressure, where you feel faint or dizzy.
  • Tell your nurse. 
  • Flu-like symptoms such as fever, chills, shivering, a runny nose or sneezing. 
  • Headache.
  • You may experience these symptoms during the infusion or anytime up to 2 weeks after the infusion.
  • Before the infusion you will be prescribed medication to reduce these effects.
  • Contact your doctor if troublesome.  
  • Problems with your tummy (stomach) such as tummy pain, cramps, dark-coloured stools (poo), bleeding, fever or changes in your bowel habits such as constipation. 
  • Tell your doctor immediately or ring HealthLine on 0800 611 116.
  • Allergic reaction such as a skin rash, itching, swelling of your lips, face and mouth or difficulty breathing.
  • Tell your doctor immediately or ring HealthLine on 0800 611 116.
  • Signs of an infections such as fever, cough, sore throat, diarrhoea or generally feeling weak and unwell. 
  • Tell your doctor immediately or ring HealthLine on 0800 611 116.

Learn more

Tocilizumab Rheuminfo
Medsafe Consumer Information Sheets
Tocilizumab Australian Rheumatology Association  


  1. Biologic medicines for the treatment of inflammatory conditions: What does primary care need to know? BPAC, December 2013
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 23 Jul 2017