What are the possible risks and side-effects of tocilizumab?
The most common side-effects of tocilizumab aren't usually serious. They include:
- a cough, sore throat, blocked or runny nose
- headaches or dizziness
- mouth ulcers
- conjunctivitis (eye inflammation)
- high blood pressure
- weight gain or swollen ankles
- skin rashes, infections or itching
- stomach irritation or abdominal pain
- inflammation around the drip site.
Tell your doctor or rheumatology nurse straight away if you have a reaction during or after an infusion or injection.
Tocilizumab can sometimes increase cholesterol levels and you may be asked to see your GP for treatment to reduce these levels. It can also affect liver function tests or reduce the numbers of white cells, or sometimes platelets, in your blood. You might sometimes need to miss one or more treatments, but it's rare to have to stop the drug altogether.
If you have intestinal ulcers or diverticulitis you may be at more risk of infection, which can sometimes lead to bowel perforation. Tell your doctor immediately if you develop stomach pain, particularly if you have a temperature and you notice changes in your bowel habits, such as passing blood.
The long-term side-effects of tocilizumab aren't yet fully understood because it's a relatively new drug. There may be a slightly increased risk of certain cancers when using drugs that affect the immune system, though research so far hasn't confirmed this.
Tocilizumab can make you more likely to pick up infections. It can also make them harder to spot. Tell your doctor or rheumatology nurse if you develop a sore throat or fever, have unexplained bruising, bleeding or paleness, or any other new symptoms that concern you. If any of these symptoms are severe, you should stop taking tocilizumab and see your doctor straight away.
You should also see your doctor if you develop chickenpox or shingles or come into contact with someone who has chickenpox or shingles. These illnesses can be severe if you're on tocilizumab. You may need antiviral treatment, and your tocilizumab may need to be stopped until you're better.
Reducing the risk of infection
- Try to avoid close contact with people with severe active infections.
- For advice on avoiding infection from food, visit the NHS Choices Food Poisoning website.