Tocilizumab is a monoclonal antibody drug that targets the interleukin-6 (IL-6) receptor, a protein that plays a key role in inflammation. It is used to treat a variety of autoimmune and inflammatory conditions, including rheumatoid arthritis, juvenile idiopathic arthritis, giant cell arteritis, and cytokine release syndrome. While tocilizumab is generally considered safe and effective, it can cause a range of side effects, some of which can be serious or life-threatening. In this answer, we will discuss the most common and serious side effects of tocilizumab.
Common side effects of tocilizumab
The most common side effects of tocilizumab include:
Upper respiratory tract infections: Tocilizumab can increase the risk of upper respiratory tract infections, such as the common cold or flu. Symptoms of an upper respiratory infection can include cough, sore throat, runny nose, and fever.
Headache: Headache is a common side effect of tocilizumab. It can range from mild to severe and can be accompanied by other symptoms such as nausea or sensitivity to light.
Hypertension: Tocilizumab can cause an increase in blood pressure, which can lead to hypertension. This side effect is more common in people who already have high blood pressure.
Gastrointestinal symptoms: Tocilizumab can cause gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain.
Injection site reactions: Tocilizumab is given as an injection, and injection site reactions such as pain, redness, and swelling can occur.
Elevated liver enzymes: Tocilizumab can cause an increase in liver enzymes, which can indicate liver damage. Regular monitoring of liver function is necessary during treatment with tocilizumab.
Serious side effects of tocilizumab
While the above side effects are generally mild and manageable, tocilizumab can also cause more serious side effects that require immediate medical attention. These include:
Infections: Tocilizumab can increase the risk of serious infections, including bacterial, viral, and fungal infections. These infections can be life-threatening and require prompt treatment with antibiotics or antifungal medication. Symptoms of an infection can include fever, chills, cough, shortness of breath, and fatigue.
Allergic reactions: Tocilizumab can cause allergic reactions, which can be serious or life-threatening in some cases. Symptoms of an allergic reaction can include hives, itching, swelling of the face, lips, or tongue, difficulty breathing, and low blood pressure.
Liver toxicity: Tocilizumab can cause liver toxicity, which can lead to liver failure in some cases. Symptoms of liver toxicity can include yellowing of the skin or eyes, dark urine, abdominal pain, and fatigue.
Blood disorders: Tocilizumab can cause a decrease in white blood cells, red blood cells, and platelets, which can lead to an increased risk of infections, anemia, and bleeding disorders.
Heart failure: Tocilizumab can cause heart failure in some people, especially in those with pre-existing heart conditions. Symptoms of heart failure can include shortness of breath, fatigue, swelling of the ankles or legs, and rapid or irregular heartbeat.
Malignancies: Tocilizumab can increase the risk of certain types of cancer, including lymphoma and non-melanoma skin cancer.
Interstitial lung disease: Tocilizumab can cause interstitial lung disease, a condition in which the lung tissue becomes inflamed and scarred. Symptoms of interstitial lung disease can include cough, shortness of breath, and chest pain.
Tocilizumab is a potent medication that can be effective in treating a range of autoimmune and inflammatory conditions. However, it is important to be aware of the potential side effects, both common and serious, before starting treatment. Regular monitoring of symptoms and laboratory tests is necessary to ensure that any side effects are detected early and treated promptly. If you experience any side effects while taking tocilizumab, it is important to contact your healthcare provider immediately.