[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/) › Tocilizumab [Pharmacology](https://durgical.com/en/pharmacology/) · [Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/) # Tocilizumab An antibody against the IL-6 receptor, given by infusion or injection, for rheumatoid arthritis, giant cell arteritis and cytokine release syndrome. Updated 2026-11-01 - Class: [Interleukin inhibitors](https://durgical.com/en/pharmacology/classes/interleukin-inhibitors/) - Receptor: Interleukin-6 receptor (IL-6R), soluble and membrane-bound - ATC code: L04AC07 ◎**Interleukin-6 receptor (IL-6R), soluble and membrane-bound**Tocilizumab ⓘ The figure shows the IL-6 receptor bound to the tocilizumab Fab (cryo-electron microscopy). **Target in 3D:** Interleukin-6 receptor (IL-6R), soluble and membrane-bound. PDB structure 8J6F (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8J6F) · Drag to rotate · pinch to zoom ## Mechanism of action Tocilizumab is a humanised IgG1 monoclonal antibody that binds both the soluble and the membrane form of the IL-6 receptor. IL-6 can then no longer signal through gp130 and JAK-STAT, so hepatic acute-phase proteins, fever, B-cell and T-cell activation and joint inflammation fall. - Antibody binds the IL-6 receptor - IL-6 cannot signal through gp130 and JAK-STAT - Less acute-phase response and fever - Joint and vessel inflammation settles ## Pharmacokinetics **Absorption** Intravenous infusion or subcutaneous injection **Metabolism** Broken down like other antibodies ## Indications - Rheumatoid arthritis [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/) - Giant cell arteritis [Giant cell arteritis →](https://durgical.com/en/conditions/giant-cell-arteritis/) - Polyarticular and systemic juvenile idiopathic arthritis [Juvenile idiopathic arthritis →](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/) - Interstitial lung disease of systemic sclerosis [Systemic sclerosis (scleroderma, including CREST) →](https://durgical.com/en/conditions/systemic-sclerosis/) - Cytokine release syndrome - COVID-19 in hospitalised adults who need oxygen or a ventilator [COVID-19 →](https://durgical.com/en/conditions/covid-19/) ## Adverse effects ### Common - Headache - Runny nose, sneezing - Injection-site reactions - Constipation or diarrhoea ### Serious (rare, important) - Serious infections, including tuberculosis and hepatitis B reactivation - Bowel perforation, especially with diverticulitis - Serious liver injury - Low neutrophil and platelet counts; raised cholesterol and triglycerides - Anaphylaxis and severe allergic reactions ## Contraindications - Hypersensitivity to tocilizumab - Active serious infection ## Key interactions **Other biologic immunosuppressants (TNF inhibitors, abatacept, anakinra)** Added immunosuppression and infection risk. **Live vaccines** Risk of infection from the vaccine strain; avoided during treatment, and vaccines are updated before starting. ## What is monitored - Latent tuberculosis and hepatitis B before starting - Neutrophils, platelets and liver tests - Lipids - Abdominal pain with fever or change in bowel habit ## Administration and safety - Intravenous infusion in a clinic, or subcutaneous injection; the two forms are different products. - Vaccines are brought up to date before starting, where possible. ## 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 diverticulitis or bowel ulcers; report new abdominal pain with fever. - Teach to report yellow skin or eyes, dark urine or right upper abdominal pain. ## Pregnancy and breastfeeding Human data are limited; the treating team weighs benefits and risks. ## Memory aid TOCIlizumab TOuChes the IL-6 receptor: Infections, Liver, Lipids, Low counts, Leaky bowel (perforation). ## Test yourself Think of the answer, then tap the question to see it. ## What does tocilizumab bind? The interleukin-6 receptor (soluble and membrane), not IL-6 itself. ## Which gastrointestinal complication is a warning with tocilizumab? Bowel perforation, especially in people with diverticulitis. ## Which vasculitis is treated with tocilizumab? Giant cell arteritis. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/tocilizumab/) ## Related drugs - [Anakinra](https://durgical.com/en/pharmacology/anakinra/) - [Adalimumab](https://durgical.com/en/pharmacology/adalimumab/) - [Tofacitinib](https://durgical.com/en/pharmacology/tofacitinib/) ## Related conditions - [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/) - [Giant cell arteritis](https://durgical.com/en/conditions/giant-cell-arteritis/) - [Juvenile idiopathic arthritis](https://durgical.com/en/conditions/juvenile-idiopathic-arthritis/) - [Systemic sclerosis (scleroderma, including CREST)](https://durgical.com/en/conditions/systemic-sclerosis/) - [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: [Tocilizumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a611004.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=L04AC07) (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/tocilizumab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/tocilizumab/