If you have certain conditions that affect your immune system, your doctor might suggest Actemra (tocilizumab) as a treatment option for you. Along with other questions you may have about the drug, you could be wondering about its side effects.

Actemra is a prescription medication. It’s used in certain situations to treat the following conditions:

This drug comes as a liquid solution. It’s given as an injection under the skin or an infusion into a vein.

Actemra is a biologic medication, meaning it’s made from parts of living organisms. Actemra isn’t available in a biosimilar form. Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.

Actemra can be used as a long-term treatment. Your doctor will prescribe Actemra for the right amount of time needed to treat your condition.

For more information about Actemra, including details about its uses, see this in-depth article.

Like other drugs, Actemra can cause mild or serious side effects. Side effects are sometimes referred to as adverse effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Actemra treatment.

Examples of Actemra’s commonly reported side effects include:

* Actemra may be given as an injection under the skin or an infusion into a vein. The skin reactions listed here may happen with Actemra infusions. To learn about possible reactions with Actemra injections, see the “What are the serious side effects of Actemra?” section above.

These aren’t all the side effects Actemra may cause. Read on to learn about other possible side effects of the drug.

Actemra can cause mild side effects. Examples of mild side effects that have been reported with Actemra include:

* To learn more about this side effect, see the “Side effects explained” section below.
† Actemra may be given as an injection under the skin or an infusion into a vein. The skin reactions listed here may happen with Actemra infusions. To learn about possible reactions with Actemra injections, see the “What are the serious side effects of Actemra?” section above.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Actemra unless your doctor recommends it.

Actemra may cause mild side effects other than the ones listed above. See the Actemra medication guide for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Actemra, visit MedWatch.

Actemra may cause rare but serious side effects.

Serious side effects that have been reported with Actemra include:

* Actemra has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.
‡ Actemra may be given as an injection under the skin or an infusion into a vein. The skin reactions listed here may happen with Actemra infusions. To learn about possible reactions with Actemra injections, see the “What are the mild side effects of Actemra?” section above.

If you develop serious side effects while receiving Actemra, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Below are answers to some frequently asked questions about Actemra’s side effects.

Do Actemra’s side effects vary depending on whether I get the infusion or injection?

Yes, certain side effects of Actemra can vary depending on how you’re given the drug. You’ll be given Actemra either as an injection under the skin or an infusion into a vein.

You may have itching or rash after receiving Actemra as an injection or infusion. But you may also have different side effects with either the injection or infusion.

For example, with Actemra injections, you may have certain reactions in the area where the drug is injected. These include pain and redness or deepening of skin color.

But you may have different reactions with Actemra infusions, such as:

To learn more about what to expect with Actemra injections or infusions, talk with your doctor.

Is hair loss a side effect of Actemra?

No, Actemra isn’t known to cause hair loss. This side effect wasn’t reported in studies of the drug.

However, hair loss is a symptom of certain conditions Actemra is used to treat. These include rheumatoid arthritis and juvenile idiopathic arthritis. So you may have hair loss while using Actemra. But this could be caused by the condition you’re receiving Actemra to treat and not by the drug itself.

Talk with your doctor about your risk of hair loss while using Actemra.

Are there any long-term side effects that can result from using Actemra?

In most cases, Actemra’s side effects should be temporary. Most will go away soon after you start or stop receiving the drug.

But Actemra may cause serious side effects that lead to long-term problems. In some cases, these problems can take several weeks or months to resolve.

For example, Actemra may cause liver problems that can lead to liver disease. Actemra can also cause conditions that damage the protective covering around your nerves, such as multiple sclerosis (MS). And there currently isn’t a known cure for MS.

If you have questions about possible long-term side effects from using Actemra, talk with your doctor or pharmacist. But make sure you keep using Actemra until your doctor tells you it’s safe to stop.

Does Actemra cause any eye-related side effects?

In rare cases, Actemra may cause ocular (eye-related) side effects.

Pink eye is an eye-related side effect reported in studies of the drug.

Actemra may also cause liver problems. And liver problems can lead to jaundice, which may make the whites of your eyes turn yellow.

If you’re concerned about eye-related side effects with Actemra, talk with your doctor.

Can side effects occur from stopping Actemra treatment?

There aren’t any side effects that are known to happen if you stop Actemra treatment.

However, symptoms of the condition you’re using Actemra to treat might come back after you stop receiving the drug. It’s best to continue Actemra treatment until your doctor tells you it’s safe to stop it.

If you have questions about what to expect when you stop using Actemra, talk with your doctor or pharmacist.

Learn more about some of the side effects Actemra may cause.

Weight gain

Weight gain wasn’t a common side effect in initial studies of Actemra. But there have been reports of weight gain in people using Actemra after the drug came on the market. It’s unclear how often weight gain happens with Actemra or if the drug is truly the cause.

What might help

If you’re concerned about gaining weight while using Actemra, talk with your doctor. They can suggest healthy ways to manage your weight while using the drug.

Holes or tears in the stomach or intestines

Rarely, Actemra may cause holes or tears in your stomach or intestines. This can result in fever, severe belly pain, and changes in bowel habits.

You may have a higher risk of this side effect if you take the following medications with Actemra:

What might help

If you have symptoms of this side effect, tell your doctor right away. They’ll likely give you an X-ray or CT scan to check for holes or tears in your stomach and intestines.

And be sure your doctor knows about all medications you take before starting Actemra. They can tell you if any of your medications might increase your risk of this side effect.

Risk of serious infections

Actemra has a boxed warning for risk of serious infections, including tuberculosis (TB). A boxed warning is the most serious warning from the FDA.

Some infections from Actemra may be serious enough to cause you to stay in the hospital. In rare cases, infections from Actemra can be fatal.

Serious infections, such as TB, can cause the following symptoms:

  • chills
  • cough that won’t go away
  • fatigue (lack of energy)
  • fever
  • weight loss

What might help

Before starting Actemra treatment, tell your doctor if you have TB or if you’ve had it in the past. They’ll test you for TB before you start treatment. If you have a positive TB test, your doctor will treat your TB before starting Actemra.

Your doctor may keep testing you for TB from time to time while you use Actemra. Be sure to tell them if you have any symptoms of infection while using the drug. If you have TB or another type of infection, they’ll likely have you stop receiving the drug until your infection has been treated.

High cholesterol

High cholesterol is a common side effect of Actemra.

Most people don’t have any symptoms from high cholesterol. But your doctor can give you a cholesterol test to check your cholesterol levels.

What might help

Your doctor will check your cholesterol level every 1 to 2 months while you’re receiving Actemra. If they find that you have high cholesterol, they may recommend a low cholesterol diet for you. Or they may prescribe drugs that can help lower your cholesterol.

Allergic reaction

Like most drugs, Actemra can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage your symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a topical product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Actemra, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Actemra, they may have you switch to a different treatment.

Keeping track of side effects

During your Actemra treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Actemra affects you. And your doctor can use this information to adjust your treatment plan if needed.

Actemra has several warnings that may affect whether you can safely use this drug.

Boxed warning: Risk of serious infections

Actemra has a boxed warning for risk of serious infections. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Actemra may cause serious infections such as tuberculosis (TB). Some infections from Actemra may be serious enough to require a hospital stay. In rare cases, infections from Actemra can be fatal.

To learn more, see the “Side effects explained” section above.

Other warnings

Actemra may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you use Actemra. The list below includes factors to consider.

Conditions that affect your nervous system, such as multiple sclerosis (MS). Actemra may cause conditions that damage the protective covering around your nerves, such as MS. Before starting Actemra, tell your doctor if you have any conditions that affect your nervous system. They can tell you if it’s safe to use Actemra.

Hepatitis B. Tell your doctor if you currently have the hepatitis B virus (HBV) or if you’ve had it in the past. HBV is a type of liver virus. Actemra may activate HBV in your body, which could cause you to have symptoms of hepatitis B. Your doctor may check your blood for HBV before you start Actemra and while you’re using the drug.

Liver problems. Actemra may cause liver problems, such as high levels of liver enzymes and liver disease. Before receiving Actemra, tell your doctor if you already have liver problems. They may recommend a different treatment option for you.

Tuberculosis (TB). Actemra may cause serious infections, including TB. Before starting Actemra, tell your doctor if you have TB or if you’ve had it in the past. They’ll test you for TB before you start treatment. If you have a positive TB test, your doctor will treat your TB before your start Actemra treatment. And they may keep testing you for TB from time to time while you receive the drug.

Ulcers or inflammation in your stomach or intestines. Tell your doctor about any ulcers (painful sores) you’ve had in your stomach or intestines. Also tell them if you’ve had diverticulitis (inflammation in your intestines). Actemra may cause holes or tears in the stomach or intestines. So your doctor may want to prescribe a different drug for you if you’ve had these conditions.

Allergic reaction. If you’ve had an allergic reaction to Actemra or any of its ingredients, you should not receive Actemra. Ask your doctor what other medications are better options for you.

Infection that hasn’t been treated or keeps coming back. Actemra may cause serious infections. If you have an infection that hasn’t been treated or keeps coming back, tell your doctor before you receive the drug. They’ll likely wait until your infection has been treated to start your Actemra treatment. Or they may prescribe a different drug for you.

Alcohol use and Actemra

It should be safe to drink alcohol while you’re using Actemra.

If you drink alcohol, talk with your doctor about the amount that’s safe to drink while using Actemra.

Pregnancy and breastfeeding while using Actemra

It may not be safe to use Actemra while you’re pregnant or breastfeeding.

Before starting Actemra, tell your doctor if you’re pregnant or breastfeeding, or if you’re planning to become pregnant or to breastfeed. They can discuss your options with you.

If you receive Actemra during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information about the safety of Actemra when used during pregnancy. For more information, visit the registry’s website or call 866-626-6847.

Actemra is used to treat certain conditions that affect your immune system. Some people may have mild side effects. In rare cases, this drug can also cause serious side effects, such as serious infections.

If you have questions about Actemra’s side effects, talk with your doctor or pharmacist. Here are a few examples of questions you may want to ask:

  • Can you recommend ways to treat the side effects I’m experiencing with Actemra?
  • Will the side effects I have from Actemra affect the dosage I’m prescribed?
  • Are there any side effects of Actemra that I should tell you about right away?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.