Dosing and Administration Calculator

What type of patient are you treating?

Dose

4 mg/kg

8 mg/kg

Patient Weight

lb

or

kg

Adult Dose & Vial Combination

mg or mL

Unused Dose:

80
mg / 4mL

200
mg / 10mL

400
mg / 20mL

Patient Weight

lb

or

kg

Dose:

Recommended SJIA dosage every 2 weeks

Patients < 30kg 12 mg/kg
Patients ≥ 30kg 8 mg/kg

SJIA Dose & Vial Combination

mgor mL

Unused Dose:

80
mg / 4mL

200
mg / 10mL

400
mg / 20mL

Patient Weight

lb

or

kg

Dose:

Recommended PJIA dosage every 4 weeks

Patients < 30kg 10 mg/kg
Patients ≥ 30kg 8 mg/kg

PJIA Dose & Vial Combination

mgor mL

Unused Dose:

80
mg / 4mL

200
mg / 10mL

400
mg / 20mL

DISCLAIMER:

By using this resource, you agree to the following: This Dosing Calculator is being provided "AS IS" and is intended for use only by qualified healthcare providers. All calculations should be confirmed before use. Genentech makes no claims as to the accuracy of the information contained herein. The information being provided is not a substitute for clinical judgment. Neither Genentech, nor any other party involved in the preparation or publication of this site, shall be liable to you or others for any decisions made or actions taken by you or others in reliance on this information.

  • ACTEMRA should not be infused concomitantly in the same intravenous line with other drugs
  • ACTEMRA must be administered with an infusion set
  • Do not administer as an intravenous push or bolus
  • Dosing Calculator should not replace professional judgment or clinical experience
  • For additional dosing information please refer to the Dosing Guide
  • Doses exceeding 800 mg per infusion are not recommended
  • Dosing Calculator is not a substitute for medical examination

Please see Dosing Guide for more information.

CONTRAINDICATION

ACTEMRA should not be administered to patients with known hypersensitivity to ACTEMRA

Warnings and Precautions

Laboratory Parameters

Rheumatoid Arthritis

Neutrophils

Treatment with ACTEMRA was associated with a higher incidence of neutropenia. Infections have been uncommonly reported in association with treatment-related neutropenia in long-term extension studies and postmarketing clinical experience

  • It is not recommended to initiate ACTEMRA treatment in patients with a low neutrophil count, i.e., absolute neutrophil count (ANC) less than 2000 per mm3. In patients who develop an absolute neutrophil count less than 500 per mm3 treatment is not recommended
  • Neutrophils should be monitored every 4 to 8 weeks

Platelets

Treatment with ACTEMRA was associated with a reduction in platelet counts. Treatment-related reduction in platelets was not associated with serious bleeding events in clinical trials

  • It is not recommended to initiate ACTEMRA treatment in patients with a platelet count below 100,000 per mm3. In patients who develop a platelet count less than 50,000 per mm3 treatment is not recommended
  • Platelets should be monitored every 4 to 8 weeks. For recommended modifications based on platelet counts

Liver Function Tests

Treatment with ACTEMRA was associated with a higher incidence of transaminase elevations. These elevations did not result in apparent permanent or clinically evident hepatic injury in clinical trials. Increased frequency and magnitude of these elevations was observed when potentially hepatotoxic drugs (e.g., MTX) were used in combination with ACTEMRA. In one case, a patient who had received ACTEMRA 8 mg per kg monotherapy without elevations in transaminases experienced elevation in AST to above 10x ULN and elevation in ALT to above 16x ULN when MTX was initiated in combination with ACTEMRA. Transaminases normalized when both treatments were held, but elevations recurred when MTX and ACTEMRA were restarted at lower doses. Elevations resolved when MTX and ACTEMRA were discontinued.

  • It is not recommended to initiate ACTEMRA treatment in patients with elevated transaminases ALT or AST greater than 1.5x ULN. In patients who develop elevated ALT or AST greater than 5x ULN treatment is not recommended.
  • ALT and AST levels should be monitored every 4 to 8 weeks. When clinically indicated, other liver function tests such as bilirubin should be considered. For recommended modifications based on transaminases

Lipids

Treatment with ACTEMRA was associated with increases in lipid parameters such as total cholesterol, triglycerides, LDL cholesterol, and/or HDL cholesterol

  • Assessment of lipid parameters should be performed approximately 4 to 8 weeks following initiation of ACTEMRA therapy, then at approximately 24 week intervals.
  • Patients should be managed according to clinical guidelines [e.g., National Cholesterol Educational Program (NCEP)] for the management of hyperlipidemia.

Polyarticular and Systemic Juvenile Idiopathic Arthritis

A similar pattern of liver enzyme elevation, low neutrophil count, low platelet count and lipid elevations is noted with ACTEMRA treatment in the PJIA and SJIA populations. Neutrophils, Platelets, ALT and AST should be monitored at the time of the second infusion and thereafter every 4 to 8 weeks for PJIA and every 2 to 4 weeks for SJIA. Lipids should be monitored as above for RA

For your patients with RA

  • ACTEMRA may be used as monotherapy or concomitantly with methotrexate (MTX) or other disease-modifying antirheumatic drugs (DMARDs) for the treatment of adult patients with moderately to severely active RA who have had an inadequate response to one or more DMARDs
  • The recommended dose of ACTEMRA for adult patients is given once every 4 weeks as a 60-minute single intravenous drip infusion

Recommended RA dosing every 4 weeks

Adult patients who have had an inadequate response to one or more DMARDs
4 mg per kg followed by an increase to 8 mg per kg based on clinical response.

ACTEMRA RA dosing-related safety information

  • Reduction of dose from 8 mg/kg to 4 mg/kg is recommended for management of certain dose-related laboratory changes including elevated liver enzymes, neutropenia and thrombocytopenia
  • ACTEMRA must not be used in combination with biologic DMARDs such as TNF antagonists, IL-1R antagonists, anti-CD20 monoclonal antibodies and selective costimulation modulators because of the possibility of increased immunosuppression and increased risk of infection
  • Doses exceeding 800 mg per infusion are not recommended
  • ACTEMRA treatment should be interrupted if a patient develops a serious infection until the infection is controlled
For your patients with PJIA

ACTEMRA may be used alone or in combination with MTX. The recommended dose of ACTEMRA for PJIA patients is given once every 4 weeks as a 60-minute single intravenous drip infusion.

Recommended PJIA dosing every 4 weeks

Patients less than 30 kg weight
10 mg per kg

Patients at or above 30 kg weight
8 mg per kg

ACTEMRA PJIA dosing-related safety information
  • A change in dose should not be made based solely on a single-visit body weight measurement, as weight may fluctuate
  • Interruption of dosing may be needed for management of dose-related laboratory abnormalities including elevated liver enzymes, neutropenia and thrombocytopenia
  • Dose reduction has not been studied in the PJIA population
  • ACTEMRA treatment should be interrupted if a patient develops a serious infection until the infection is controlled
  • If appropriate, concomitant MTX and/or other medications should be dose modified or stopped and ACTEMRA dosing interrupted until the clinical situation has been evaluated
  • In PJIA the decision to discontinue ACTEMRA for a laboratory abnormality should be based on medical assessment of the individual patient
For your patients with SJIA

ACTEMRA may be used alone or in combination with methotrexate. The recommended dose of ACTEMRA for SJIA patients once every 2 weeks as a 60-minute single intravenous drip infusion is:

Recommended SJIA dosing every 2 weeks

Patients less than 30 kg weight
12 mg per kg

Patients at or above 30 kg weight
8 mg per kg

ACTEMRA SJIA dosing-related safety information
  • A change in dose should not be made based solely on a single visit body weight measurement, as weight may fluctuate
  • Interruption of dosing may be needed for management of dose-related laboratory abnormalities including elevated liver enzymes, neutropenia, and thrombocytopenia
  • ACTEMRA treatment should be interrupted if a patient develops a serious infection until the infection is controlled
  • If appropriate, concomitant MTX and/or other medications should be dose modified or stopped and ACTEMRA dosing interrupted until the clinical situation has been evaluated
  • In SJIA the decision to discontinue ACTEMRA for a laboratory abnormality should be based on medical assessment of the individual patient
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