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Tocilizumab - Side Effects, Precautions, and Contraindications

What side effects can Tocilizumab cause?

Common side effects include:

  • Infections: symptoms include colds, sinusitis, urinary tract infections and skin infections
    • If you develop a fever, sore throat or feel generally unwell, see a doctor immediately. The doctor whom you consult should be told that you are on Tocilizumab.
  • Injection site reactions: symptoms include transient bruising, redness, itching, pain and swelling
    • If you are using subcutaneous injection, rotate the injection site each time.
  • Infusion reactions: symptoms include flushing, chills, chest tightness, shortness of breath, low blood pressure or high blood pressure
    • Medications may be given before the infusion to prevent these reactions.
    • You will also be monitored closely during and after the infusion.
  • Low blood cell count (platelet, red and/or white blood cell)
  • Headache
  • Stomach or bowel discomfort
  • Skin rash or itch
  • Reversible increase liver enzymes level
  • Reversible increase in cholesterol level
It is important to monitor the effects of your new treatment, particularly during the first few months of treatment. For your safety, you need to do regular blood tests for man ito ring by your doctor.

Some rare but serious side effects include:
  • Combined low blood cell count (symptoms include infection, feeling very tired or weak, sudden uncontrolled bleeding)
  • Tear in the stomach or intestine (symptoms include severe abdominal pain or cramps, bleeding during passing motion, nausea and vomiting)
  • Liver injury (symptoms include yellowing of eye whites or skin, dark or tea-coloured urine or constant abdominal pain) 
The symptoms of a drug allergy include one or more of the following:
  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body 
If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Tocilizumab , what precautions must I follow?

  • Inform your healthcare professional if:
    • You are allergic to this medication or any of the other ingredients of this medication.
    • You plan to start a family or to breastfeed.
    • You are taking any other medications, including over-the-counter medicines. supplements. traditional medications and herbal remedies.
    • You have any existing infections.
    • You have a history of diverticulitis or any stomach/intestinal ulcers.
    • You have a condition that affects the nervous system. such as multiple sclerosis.

  • Avoid overcrowded places and stay away from people who are sick to prevent getting an infection.

  • Reactivation of infections such as tuberculosis (TB) and hepatitis B may happen when you are on this medication, hence, your doctor will check for such infections before starting Tocilizumab.

What food or medicine must I avoid when I take Tocilizumab ?

Avoid eating raw, undercooked or half-cooked food.

Tocilizumab may interact w ith other medicines or supplements that you are taking. These include:

  • Over-the-counter medications
  • Nutritional supplements
  • Traditional or herbal remedies

Inform the doctor, pharmacist or specialty nurse before starting on a new medicine or supplement.

Pneumococcal, influenza (flu} and Hepatitis B vaccinations are safe and may be given if required. Avoid live vaccines such as MMR (measles. mumps and rubella), OPV (oral polio vaccine}, yellow fever or BCG (tuberculosis). Discuss with your doctor before receiving any vaccines. Also, direct contact with persons who have taken oral polio vaccine or those with infections should be avoided.

  • Updated on 10/31/2023 12:00:00 AM
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth


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