Tofidence (Tocilizumab)

Description

Tofidence, known generically as tocilizumab-bavi, is a biosimilar to the drug Actemra. Tofidence works by blocking the activity of interleukin-6 (IL-6), a protein involved in the inflammatory process. It is classified as an IL-6 receptor antagonist and administered as intravenous (IV) infusion under the supervision of a healthcare provider. Tofidence may be used to treat various forms of arthritis, including rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, and systemic juvenile idiopathic arthritis.

Directions

Tofidence is administered as an IV infusion, which a healthcare provider typically oversees. The standard dosages can vary based on the conditions being treated such as rheumatoid arthritis or juvenile idiopathic arthritis. The dosage may also be adjusted according to patient-specific factors like weight and the severity of symptoms.

Tofidence should not be started in people with an absolute neutrophil count (ANC) under 2000 per mm³, a platelet count below 100,000 per mm³, or if liver enzyme levels – ALT or AST – are more than 1.5 times the upper limit of normal. Work closely with a healthcare provider who can monitor your health while receiving Tofidence.

Ingredients

The active ingredient in Tofidence is tocilizumab-bavi. However, it may include inactive ingredients that act as preservatives and help maintain the stability and pH of the solution. These inactive ingredients may include histidine, sucrose, polysorbate 80, and water for injection.

Contraindications

Tofidence should not be used in people with a history of allergies or hypersensitivity to tocilizumab or any ingredient of the medication.

Cautions

• Before taking Tofidence, tell your doctor about:
• All medications you take, including prescription, over-the-counter, and herbal medicines.
• Any medical conditions.
• If you have a known allergy to any medications.

• Tofidence has been linked with serious infections, potentially leading to hospitalization or death. These include tuberculosis (TB), bacterial, fungal, and viral infections. If you develop a serious infection while using Tofidence, the treatment should be temporarily stopped until the infection is effectively managed.
• Before starting Tofidence, you may need a test for latent TB. If you test positive, treatment for TB should be completed prior to starting Tofidence. Even if the initial TB test is negative, watch for signs of active TB during the course of treatment.
• Tofidence should not be used if you have an active infection present. In case of a serious infection, the use of Tofidence must be discontinued until the infection is under control.
• If you are at an elevated risk of gastrointestinal (GI) perforation, use caution when using Tofidence.
• Watch for signs of liver damage. Tofidence treatment may need to be adjusted or stopped if liver test results are consistently abnormal or if symptoms of liver disease appear.
• Regular laboratory tests are recommended due to potential changes in neutrophils, platelets, lipids, and liver enzymes that can occur due to treatment with Tofidence.
• Be aware of the possibility of hypersensitivity reactions, including anaphylaxis, which can be severe and occasionally fatal.
• While undergoing treatment with Tofidence, avoid receiving live vaccines.

Side Effects

Tofidence may cause various side effects. Common tocilizumab side effects include respiratory infections such as a common cold, headaches, high blood pressure, and injection site reactions like redness, itching, or pain.

Serious side effects of Tofidence can be more concerning and require immediate medical attention. These include a hepatitis B infection and allergic reactions. Seek medical attention if you experience signs of a hepatitis B infection, such as fatigue, vomiting, black or tarry stools, bloody or cloudy urine, and chills, or signs of an allergic reaction, such as dizziness, stomach pain, and difficulty breathing.

References:

Tofidence (Tocilizumab) Product Monograph. Cambridge, MA: Biogen MA Inc; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....