Actemra/Actemra SC Caution For Usage

Special Instructions for Use, Handling and Disposal: Intravenous tocilizumab: Parenteral medications should be inspected visually for particulate matter or discoloration prior to administration.
Only solutions which are clear to opalescent, colourless to pale yellow and free of visible particles must be infused.
Rheumatoid Arthritis: From a 100 mL infusion bag, withdraw a volume of 0.9% Sodium Chloride solution equal to the volume of the tocilizumab solution required for the patient's dose. Withdraw the required amount of tocilizumab (0.4 mL/kg) under aseptic conditions and dilute to a calculated tocilizumab concentration in a 100 mL infusion bag containing sterile, non-pyrogenic 0.9% Sodium Chloride solution. To mix the solution, gently invert the bag to avoid foaming.
pJIA and sJIA Patients ≥ 30 kg: From a 100 mL infusion bag, withdraw a volume of 0.9% Sodium Chloride solution equal to the volume of the tocilizumab solution required for the patient's dose. Withdraw the required amount of tocilizumab (0.4 mL/kg) under aseptic conditions and dilute to a calculated tocilizumab concentration in a 100 mL infusion bag containing sterile, non-pyrogenic 0.9% Sodium Chloride solution. To mix the solution, gently invert the bag to avoid foaming.
pJIA Patients below 30 kg: From a 50 mL infusion bag, withdraw a volume of 0.9% Sodium Chloride solution equal to 0.5 mL/kg of the patient's body weight and discard. This volume should be replaced in the saline bag with an equal volume of tocilizumab under aseptic conditions. To mix the solution, gently invert the bag to avoid foaming.
sJIA Patients below 30 kg: From a 50 mL infusion bag, withdraw a volume of 0.9% Sodium Chloride solution equal to 0.6 mL/kg of the patient's body weight and discard. This volume should be replaced in the saline bag with an equal volume of tocilizumab under aseptic conditions. To mix the solution, gently invert the bag to avoid foaming.
Subcutaneous tocilizumab: Do not use if the medicine is cloudy or contains particles, is any colour besides colourless to yellowish, or any part of the PFS+NSD appears to be damaged.
Disposal of syringes/sharps: The following points should be strictly adhered to regarding the use and disposal of the PFS+NSD: Syringes should never be reused.
Place all used syringes into a sharps container (puncture-proof disposable container).
Keep this container out of the reach of children.
Placing used sharps containers in the household waste should be avoided.
Dispose of the full container according to local requirements or as instructed by the healthcare provider.
For home use, patients should procure a puncture resistant container for the disposal of used syringes.
Disposal of unused/expired medicines: The release of pharmaceuticals in the environment should be minimized. Medicines should not be disposed of via wastewater, and disposal through household waste should be avoided. Use established 'collection systems' if available in the location.