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Indications - Rheumatoid Arthritis (RA): Tocilizumab is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs). Giant Cell Arteritis (GCA): Tocilizumab is indicated for the treatment of giant cell arteritis (GCA) in adult patients. Polyarticular Juvenile Idiopathic Arthritis (PJIA): Tocilizumab is indicated for the treatment of active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older. Systemic Juvenile Idiopathic Arthritis (SJIA): Tocilizumab is indicated for the treatment of active systemic juvenile idiopathic arthritis in patients 2 years of age and older. Cytokine Release Syndrome (CRS): Tocilizumab is indicated for the treatment of chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome in adults and pediatric patients 2 years of age and older.

Dosage & Administration - General (IV or SC Injection): Substitution by any other biological medicinal product requires the consent of the prescribing physician. For adult patients with RA, tocilizumab may be administered as an IV infusion or a SC injection. For patients with pJIA and sJIA, tocilizumab is administered as an IV infusion. Tocilizumab IV formulation should be diluted by a healthcare professional with sterile 0.9% w/v sodium chloride solution using aseptic technique (see Caution for Usage). Tocilizumab is recommended for IV infusion over 1 hr. Tocilizumab SC formulation is administered with a single-use PFS+NSD or pre-filled pen. The 1st injection should be performed under the supervision of a qualified healthcare professional. The recommended injection sites (abdomen, thigh and upper arm) should be rotated and injections should never be given into moles, scars or areas where the skin is tender, bruised, red, hard or not intact. SC Injection: Adults: Rheumatoid Arthritis (RA): Recommended Dose: 162 mg given once every week as a SC injection. Tocilizumab can be used alone or in combination with MTX and/or other DMARDs. Patients transitioning from tocilizumab IV therapy to SC administration should administer the 1st SC dose at the time of the next scheduled IV dose under the supervision of a qualified healthcare professional. Tocilizumab SC formulation is not intended for IV administration. Assess suitability of patient for SC home use and instruct patients to inform a healthcare professional if they experience symptoms of allergic reaction before administering the next dose. Patients should seek immediate medical attention if developing symptoms of serious allergic reactions

Side Effects - Rheumatoid Arthritis: Patients Treated with Subcutaneous Tocilizumab: The safety of SC tocilizumab in RA was study in SC-I. The study compared the efficacy and safety of tocilizumab 162 mg administered every week SC versus 8 mg/kg IV in 1,262 subjects with adult RA. All patients in the study received background non-biologic DMARD(s). The safety and immunogenicity observed for tocilizumab administered SC was consistent with the known safety profile of tocilizumab IV and no new or unexpected adverse drug reactions were observed (see Table 7). A higher frequency of injection site reactions was observed in the SC arms compared with placebo SC injections in the IV arms

Contraindications - Hypersensitivity to tocilizumab or to any of the excipients.

Others - Pregnancy & Lactation Pregnancy Category- C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks Lactation: Unknown whether distributed in breast milk, do not breast feed