[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/) › Canakinumab

# Canakinumab

## Interleukin inhibitors?

Interleukin inhibitors

A human antibody against interleukin-1β, injected under the skin, for periodic fever syndromes, Still's disease and hard-to-treat gout flares.

Updated Nov 1, 2026

## Quick facts

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

**Target**
Interleukin-1β (IL-1β)

**Used for**
Cryopyrin-associated periodic syndromes

**Key effects**
Injection-site pain · Nausea · Stuffy nose

**Monitor**
Latent tuberculosis test before starting

**ATC**
L04AC08

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**Interleukin-1β (IL-1β)**Canakinumab

ⓘ The figure shows human IL-1β bound to the Fab fragment of canakinumab (the antibody's antigen-binding arm).

**Target in 3D:** Interleukin-1β (IL-1β). PDB structure 4G6J (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4G6J) · Drag to rotate · pinch to zoom

Canakinumab is a human IgG1 monoclonal antibody that binds interleukin-1β and keeps it from activating the IL-1 receptor. IL-1β drives the fever, rash, joint pain and acute-phase response of autoinflammatory diseases, so these flares settle when it is neutralised.

- Antibody binds circulating interleukin-1β
- IL-1β can no longer activate the IL-1 receptor
- Less fever and acute-phase response
- Autoinflammatory and gout flares settle

## Indications

- Cryopyrin-associated periodic syndromes (familial cold autoinflammatory syndrome, Muckle-Wells syndrome)
- TRAPS and mevalonate kinase deficiency (hyper-IgD syndrome)
- Familial Mediterranean fever [Familial Mediterranean fever and other hereditary autoinflammatory syndromes →](https://durgical.com/en/conditions/familial-mediterranean-fever-and-other-hereditary-autoinflammatory-syndromes/)
- Adult-onset Still's disease [Adult-onset Still disease →](https://durgical.com/en/conditions/adult-onset-still-disease/)
- Systemic juvenile idiopathic arthritis [Juvenile idiopathic arthritis →](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/)
- Gout flares when other treatments failed or cannot be used [Gout →](https://durgical.com/en/conditions/gout/)

## Adverse effects

### Common

- Injection-site pain, redness, swelling or itching
- Nausea, vomiting, diarrhoea or abdominal pain
- Stuffy nose, headache, dizziness
- Back, muscle or joint pain

### Serious (rare, important)

- Serious bacterial, viral and fungal infections, including tuberculosis
- Macrophage activation syndrome in Still's disease and systemic juvenile arthritis
- Severe allergic reactions
- Possible higher risk of some cancers

## Contraindications

- Hypersensitivity to canakinumab
- Active serious infection

## Key interactions

**Other medicines that suppress the immune system**
Added immunosuppression and infection risk.

**Vaccines, especially live vaccines**
Avoided during treatment unless the team agrees; age-appropriate vaccines are given before starting.

## What is monitored

- Latent tuberculosis test before starting
- Signs of infection at every visit
- New or worsening fever, rash or malaise in Still's disease (macrophage activation syndrome)
- Laboratory tests ordered by the team

## Administration and safety

- Injected under the skin by a doctor or nurse.
- Age-appropriate vaccines are completed before the first dose, where possible.
- The dose is not given during an active infection without the team's review.

## Pregnancy and breastfeeding

Human data are limited. Exposure in pregnancy may weaken the baby's response to vaccines, so the baby's doctor is told.

## Nursing care

- Confirm the latent tuberculosis test and vaccine status before the first dose.
- Check for fever, sore throat, cough or painful skin before each injection.
- Teach to report new or worsening symptoms quickly in Still's disease: macrophage activation syndrome can be life-threatening.
- If the drug was given in pregnancy, remind the family to tell the baby's doctor before infant vaccines.

## Pharmacokinetics

**Absorption**
Subcutaneous injection given by a doctor or nurse

**Metabolism**
Broken down like other antibodies

## Memory aid

CANakinumab CAN cool IL-1β: Cold and periodic fevers, Adult and juvenile Still's, Nasty gout flares.

## Test yourself

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

## What does canakinumab bind?

Interleukin-1β itself (anakinra, by contrast, blocks the IL-1 receptor).

## Which life-threatening complication is watched for in Still's disease treated with canakinumab?

Macrophage activation syndrome.

## Which infection screening test is done before starting canakinumab?

A test for latent tuberculosis.

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

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

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

## Related conditions 4

- [Familial Mediterranean fever and other hereditary autoinflammatory syndromes](https://durgical.com/en/conditions/familial-mediterranean-fever-and-other-hereditary-autoinflammatory-syndromes/)
- [Adult-onset Still disease](https://durgical.com/en/conditions/adult-onset-still-disease/)
- [Juvenile idiopathic arthritis](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/)
- [Gout](https://durgical.com/en/conditions/gout/)

[← 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: [Canakinumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a622024.html) (MedlinePlus (U.S. National Library of Medicine), 2023); [RCSB PDB - 4G6J: Crystal structure of human IL-1beta in complex with the therapeutic antibody binding fragment of canakinumab](https://www.rcsb.org/structure/4G6J) (RCSB Protein Data Bank, 2012); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L04AC08) (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.

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