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Pharmacologic class: Interleukin-1 (IL-1) blocker
Therapeutic class: Immunomodulator, antirheumatic
Pregnancy risk category B
Inhibits binding of IL-1 with IL type I receptors, thereby mediating immunologic, inflammatory, and other physiologic responses
Prefilled glass syringes: 100 mg/0.67 ml
Indications and dosages
➣ Moderately to severely active rheumatoid arthritis in patients ages 18 and older who don't respond to disease-modifying antirheumatics alone
Adults: 100 mg/day subcutaneously, given at same time each day
• Hypersensitivity to drug or Escherichia coli-derived protein
• Serious infections
Use cautiously in:
• immunosuppression, active infection, chronic illness, renal impairment
• elderly patients
• pregnant or breastfeeding patients
☞ Withhold drug and notify prescriber if patient shows signs or symptoms of active infection.
☞ Use extreme caution if patient is concurrently receiving drugs that block tumor necrosis factor (TNF), because of increased risk of serious infection.
• Give entire dose from prefilled syringe.
• Don't freeze or shake syringe.
GI: nausea, diarrhea, abdominal pain
Hematologic: thrombocytopenia, neutropenia
Respiratory: upper respiratory tract infection
Skin: rash, pruritus, injection site reaction or bruising, rash, erythema, inflammation
Other: flulike symptoms, infections
Drug-drug. Etanercept, infliximab, other drugs that block TNF: increased risk of serious infection
Live-virus vaccines: vaccine inefficacy
Drug-diagnostic tests. Neutrophils: decreased count
• Monitor CBC with white cell differential.
• Assess injection site for reactions.
☞ Tell patient to immediately report signs or symptoms of infection.
• Advise patient to report signs and symptoms of allergic response.
• Instruct patient to take drug at same time each day for best response.
• Teach patient about proper drug disposal (in puncture-resistant container). Also caution him against reusing needles, syringes, and drug product.
• Tell patient not to freeze or shake drug.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.