[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/) › Anakinra

[Pharmacology](https://durgical.com/en/pharmacology/) · [Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/)

# Anakinra

A copy of the body's own IL-1 blocker, injected under the skin every day, for rheumatoid arthritis and inherited autoinflammatory diseases.

Updated 2026-11-01

- Class: [Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/)
- Receptor: Interleukin-1 receptor type 1 (IL-1R1)
- ATC code: L04AC03

◎**Interleukin-1 receptor type 1 (IL-1R1)**Anakinra

ⓘ The figure shows the IL-1 receptor bound to the natural IL-1 receptor antagonist (IL-1Ra); anakinra is a recombinant form of that same protein.

**Target in 3D:** Interleukin-1 receptor type 1 (IL-1R1). PDB structure 1IRA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1IRA) · Drag to rotate · pinch to zoom

## Mechanism of action

Anakinra is a recombinant, non-glycosylated form of the human interleukin-1 receptor antagonist (IL-1Ra). It occupies the type 1 IL-1 receptor without activating it, so IL-1α and IL-1β cannot signal. This turns down fever, the acute-phase response and cartilage breakdown. The body makes IL-1Ra naturally, but not enough to offset the excess IL-1 of inflammatory disease.

- Recombinant IL-1 receptor antagonist
- Sits on IL-1R1 without activating it
- IL-1α and IL-1β cannot signal
- Less fever and inflammation

## Pharmacokinetics

**Absorption**
Subcutaneous injection

**Elimination**
Kidney disease is taken into account before and during treatment

## Indications

- Rheumatoid arthritis [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- Neonatal-onset multisystem inflammatory disease and deficiency of IL-1 receptor antagonist (DIRA) [Familial Mediterranean fever and other hereditary autoinflammatory syndromes →](https://durgical.com/en/conditions/familial-mediterranean-fever-and-other-hereditary-autoinflammatory-syndromes/)
- COVID-19 (emergency authorisation) [COVID-19 →](https://durgical.com/en/conditions/covid-19/)

## Adverse effects

### Common

- Injection-site redness, swelling, bruising or itching
- Headache
- Nausea, vomiting, diarrhoea, abdominal pain
- Runny nose; joint pain

### Serious (rare, important)

- Serious bacterial, viral and fungal infections; higher risk of tuberculosis
- Allergic reactions, including swelling of the face and difficulty breathing
- Lymphoma and skin cancer have been reported

## Contraindications

- Hypersensitivity to anakinra
- Active serious infection

## Key interactions

**TNF inhibitors (etanercept and others)**
More serious infections without added benefit; not combined.

**Live vaccines**
Risk of infection from the vaccine strain; avoided during treatment, and vaccines are updated before starting.

## What is monitored

- Signs of infection
- Latent tuberculosis test before starting
- Blood tests before and during treatment, as ordered
- Kidney function

## Administration and safety

- Subcutaneous injection from a prefilled syringe, rotating sites.
- The first dose is usually given in the clinic, with teaching for home injection.

## Nursing care

- Before the first dose, confirm the latent tuberculosis test (and hepatitis B screening where ordered) and that vaccines are up to date.
- Do not give the dose during an active infection; teach to report fever, cough, burning on urination or hot, red skin.
- Live vaccines are avoided during treatment; any vaccine is discussed with the team first.
- Ask about kidney disease.

## Pregnancy and breastfeeding

Human data are limited; the treating team weighs benefits and risks.

## Memory aid

anaKINra = the body's own IL-1 receptor antagonist, made in the lab: 'Kin' of IL-1Ra.

## Test yourself

Think of the answer, then tap the question to see it.

## What natural protein is anakinra a copy of?

The interleukin-1 receptor antagonist (IL-1Ra), which blocks the IL-1 receptor without activating it.

## Why is anakinra not combined with etanercept?

The combination raises serious infections without improving rheumatoid arthritis.

## Which group of diseases responds especially well to IL-1 blockade?

Autoinflammatory syndromes such as neonatal-onset multisystem inflammatory disease (a cryopyrin-associated syndrome) and DIRA.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/anakinra/)

## Related drugs

- [Tocilizumab](https://durgical.com/en/pharmacology/tocilizumab/)
- [Etanercept](https://durgical.com/en/pharmacology/etanercept/)
- [Colchicine](https://durgical.com/en/pharmacology/colchicine/)

## Related conditions

- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Familial Mediterranean fever and other hereditary autoinflammatory syndromes](https://durgical.com/en/conditions/familial-mediterranean-fever-and-other-hereditary-autoinflammatory-syndromes/)
- [COVID-19](https://durgical.com/en/conditions/covid-19/)

[← Back to the class: Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Anakinra: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a602001.html) (MedlinePlus (U.S. National Library of Medicine), 2025); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 39 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L04AC03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/anakinra/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/anakinra/