[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/) › Sarilumab

# Sarilumab

## Interleukin inhibitors?

Interleukin inhibitors

A human antibody against the IL-6 receptor, injected under the skin, for rheumatoid arthritis, polymyalgia rheumatica and juvenile arthritis.

Updated Nov 1, 2026

## Quick facts

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

**Target**
Interleukin-6 receptor (IL-6R)

**Key effects**
Stuffy or runny nose

**Monitor**
Latent tuberculosis test before starting

**ATC**
L04AC14

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-6 receptor (IL-6R)**Sarilumab

ⓘ The figure shows the human IL-6 receptor bound to the sarilumab Fab (cryo-electron microscopy).

**Target in 3D:** Interleukin-6 receptor (IL-6R). PDB structure 8IOW (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8IOW) · Drag to rotate · pinch to zoom

Sarilumab is a human IgG1 monoclonal antibody that binds the soluble and membrane IL-6 receptor, like tocilizumab. IL-6 can no longer signal through gp130 and JAK-STAT, so the acute-phase response, fever and joint inflammation fall.

- Antibody binds the IL-6 receptor
- IL-6 cannot signal through gp130
- Acute-phase response falls
- Joint pain, stiffness and swelling ease

## Indications

- Rheumatoid arthritis after an inadequate response to DMARDs [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- Polymyalgia rheumatica when other treatments failed [Polymyalgia rheumatica →](https://durgical.com/en/conditions/polymyalgia-rheumatica/)
- Polyarticular juvenile idiopathic arthritis [Juvenile idiopathic arthritis →](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/)

## Adverse effects

### Common

- Stuffy or runny nose
- Redness or itching at the injection site

### Serious (rare, important)

- Serious bacterial, viral and fungal infections, including tuberculosis (boxed warning)
- Liver injury
- Easy bleeding or bruising
- Severe allergic reactions

## Contraindications

- Hypersensitivity to sarilumab
- Active serious infection

## Key interactions

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

**Aspirin and other NSAIDs**
Named on the patient information: easy bruising or bleeding is watched for.

**Live vaccines**
Avoided during treatment; vaccines are updated before starting.

## What is monitored

- Latent tuberculosis test before starting
- Laboratory tests ordered by the team
- Signs of infection during and after treatment

## Administration and safety

- Injected under the skin; the first dose is often given in a clinic, later doses at home.
- Not given during an active infection.
- Surgeons and dentists are told about the treatment before procedures.

## Pregnancy and breastfeeding

Human data are limited; if it was used in pregnancy, the infant's clinician is told before vaccines.

## Nursing care

- Confirm the tuberculosis test and ask about diabetes, HIV, hepatitis, diverticulitis and ulcers.
- Teach to report fever, chills, cough or painful skin, even if mild.
- Teach to report easy bruising or bleeding, and stomach pain or vomiting.
- If exposed in pregnancy, remind the family to tell the infant's clinician before vaccines.

## Pharmacokinetics

**Absorption**
Subcutaneous injection from a prefilled syringe or pen

**Metabolism**
Broken down like other antibodies

## Memory aid

SARIlumab and tocilizumab Sit on the IL-6 Receptor: watch Infection, Liver and easy Bleeding.

## Test yourself

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

## What does sarilumab bind?

The interleukin-6 receptor (soluble and membrane), like tocilizumab.

## Which risk is in the boxed warning of sarilumab?

Serious infections (bacterial, viral and fungal, including tuberculosis), some of them fatal.

## Besides rheumatoid arthritis, which rheumatic disease is treated with sarilumab?

Polymyalgia rheumatica (also polyarticular juvenile idiopathic arthritis).

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

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

## Connections

## Related drugs 3

- [Tocilizumab](https://durgical.com/en/pharmacology/tocilizumab/)
- [Baricitinib](https://durgical.com/en/pharmacology/baricitinib/)
- [Adalimumab](https://durgical.com/en/pharmacology/adalimumab/)

## Related conditions 3

- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Polymyalgia rheumatica](https://durgical.com/en/conditions/polymyalgia-rheumatica/)
- [Juvenile idiopathic arthritis](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/)

[← 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: [Sarilumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617032.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [RCSB PDB - 8IOW: Cryo-EM structure of the sarilumab Fab/IL-6R complex](https://www.rcsb.org/structure/8IOW) (RCSB Protein Data Bank, 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L04AC14) (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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Source: https://durgical.com/en/pharmacology/sarilumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sarilumab/