tocilizumab
Tocilizumab injection is used to treat certain autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) including the following: rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) giant cell arteritis (a condition that causes swelling of blood vessels, especially in the scalp and head) polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) systemic juvenile idiopathic arthritis (SJIA; a condition in children that causes inflammation in different areas of the body, causing fever, joint pain and swelling, loss of function, and delays in growth and development) systemic sclerosis-associated interstitial lung disease (SSc-ILD; also known as scleroderma-associated ILD: a lung disease that involves scarring of the lungs) Tocilizizumab injection is also used to treat cytokine release syndrome (a severe and possibly life-threatening reaction) and coronavirus disease 2019 (COVID-19 infection) caused by the SARS-CoV-2 virus in hospitalized adults who require supplemental oxygen or a ventilator Tocilizumab injection is in a class of medications called interleukin-6 (IL-6) receptor inhibitors. It work by blocking the activity of interleukin-6, a substance in the body that causes inflammation.
Full drug information on MedlinePlus →This information is for educational purposes only and is not a substitute for medical advice. Decisions about medication use during pregnancy or breastfeeding should be made with your healthcare provider.
Can taking tocilizumab affect fertility or make it harder to get pregnant?
According to the MotherToBaby fact sheet, it is not known whether tocilizumab can make it harder to become pregnant. If you have questions about fertility while using this medication, it is best to discuss them with your healthcare provider.
Does taking tocilizumab increase the risk of miscarriage?
Miscarriage can occur in any pregnancy. Some studies have suggested a possible increase in miscarriage with tocilizumab, but the people in these studies were often older, sometimes also took methotrexate (which itself can increase miscarriage risk), and some stopped tocilizumab once pregnancy was recognized, which could allow rheumatoid arthritis symptoms to worsen — itself linked to higher miscarriage risk. More research is needed, and these questions should be discussed with your healthcare provider.
Does taking tocilizumab increase the risk of birth defects?
Every pregnancy starts with a background 3–5% chance of a birth defect. The fact sheet notes that exposure to tocilizumab does not appear to significantly raise this chance above background, based on clinical trials and published studies including more than 200 pregnancies. Because tocilizumab is a large protein, only a very small amount is thought to cross the placenta in the first trimester. Individual circumstances should be reviewed with your healthcare provider.
Can taking tocilizumab during pregnancy cause other pregnancy-related complications?
More of the medication may cross the placenta in the second and third trimesters. Some studies have reported higher rates of preterm birth and low birth weight when tocilizumab is taken throughout pregnancy, though it is unclear whether this is due to the medication or to the underlying condition, since poorly controlled rheumatoid arthritis itself raises these risks. Published data on more than 600 pregnant people treated with tocilizumab for COVID-19 pneumonia also reported higher rates of pregnancy loss and preterm birth, though severe illness and other medications may have contributed. These considerations should be discussed with your healthcare provider.
Can taking tocilizumab during pregnancy affect the child's brain development, learning, or behavior?
The fact sheet states that no studies have looked at whether tocilizumab causes problems with a child's behavior or learning. It is also unknown whether tocilizumab use in pregnancy influences the baby's developing immune system. Any concerns should be raised with your healthcare provider.
Is it safe to breastfeed while taking tocilizumab?
Tocilizumab passes into breast milk in small amounts, and no adverse effects have been reported in nursing infants in the roughly 10 published cases available. Because it is a large protein, very little is thought to enter milk, and infant absorption is unlikely because it would be broken down in the gastrointestinal tract — though preterm or very young infants have less developed digestion, which may allow more to be absorbed. Decisions about breastfeeding should be made together with your healthcare provider, and any concerns about the baby should be brought to the child's provider.
Source: MotherToBaby Fact Sheet
tocilizumab