anakinra (Rx)

Brand and Other Names:Kineret
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

prefilled syringes

  • 100mg/0.67mL
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Rheumatoid Arthritis

Indicated to reduce signs and symptoms, and slow structural damage progression in moderate-to-severe active rheumatoid arthritis in patients 18 years or older who have failed 1 or more disease modifying antirheumatic drugs (DMARDs)

May use alone or in combo with DMARDs (not TNF-blocking agents)

100 mg SC qDay

Cryopyrin-Associated Periodic Syndromes (CAPS)

Indicated for treatment of Neonatal-Onset Multisystem Inflammatory Disease (NOMID), also known as chronic infantile neurologic cutaneous articular syndrome (CINCA)

1-2 mg/kg SC qDay (initially); may increase by 0.5-1 mg/kg increments to control active inflammation, not to exceed 8 mg/kg

Once daily administration recommended; may be split into twice daily

Renal Impairment

CrCl <30 mL/min or ESRD: Consider every other day administration of prescribed dose

Dosing Considerations

Measure WBCs before initiating, then qMonth x3 months, then quarterly up to 1 year

Still Disease (Orphan)

Orphan designation for Still disease including systmic juvenile isiopathic arithritis and adult-onset Still disease

Sponsor

  • Swedish Orphan Biovitrum AB, SE-112; 75 Stockholm

Dosage Forms & Strengths

prefilled syringes

  • 100mg/0.67mL
more...

Rheumatoid Arthritis

Safety and efficacy not established

Cryopyrin-Associated Periodic Syndromes (CAPS)

Indicated for treatment of Neonatal-Onset Multisystem Inflammatory Disease (NOMID), also known as chronic infantile neurologic cutaneous articular syndrome (CINCA)

1-2 mg/kg SC qDay (initially); may increase by 0.5-1 mg/kg increments to control active inflammation, not to exceed 8 mg/kg

Once daily administration recommended; may be split into twice daily

Renal Impairment

CrCl <30 mL/min or ESRD: Consider every other day administration of prescribed dose

Dosing Considerations

Measure WBCs before initiating, then qMonth x3 months, then quarterly up to 1 year

Still Disease (Orphan)

Orphan designation for Still disease including systmic juvenile isiopathic arithritis and adult-onset Still disease

Sponsor

  • Swedish Orphan Biovitrum AB, SE-112; 75 Stockholm
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Interactions

Interaction Checker

and anakinra

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Rheumatoid arthritis

            • Injection-site reaction (71%)
            • Headache (12%)

            Neonatal-onset multisystem inflammatory disease

            • Most common during first 6 months of treatment
            • Injection site reaction (16.3%)
            • Headache (14%)
            • Vomiting (14%)
            • Arthralgia (11.6%)
            • Pyrexia (11.6%)
            • Nasopharyngitis (11.6%)

            1-10%

            Nausea (7%)

            Diarrhea (7%)

            <1%

            Neutropenia (0.3%) especially with TNF antagonists

            Postmarketing Reports

            Hepatobiliary disorders: Elevated transaminases, noninfectious hepatitis

            Cholesterol elevation

            Thrombocytopenia

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            Warnings

            Contraindications

            Hypersensitivity to anakinra, E. coli-derived proteins

            Cautions

            Renal impairment, chronic infections, immunosuppression, neutropenia

            In rheumatoid arthritis, discontinue if severe infection develops and do not initiate with active infection

            Use in combination with TNF blocker not recommended

            Use caution in geriatric patients because of higher incidence of infection

            Not for concomitant administration with live vaccines

            Neutrophil counts should be assessed prior to initiating therapy, and while receiving treatment, monthly for 3 months, and thereafter quarterly for a period of up to 1 year

            Hypersensitivity reactions, including angioedema and anaphylactic reactions reported

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: not known if excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Interleukin-1 receptor antagonist (recombinant E. coli-derived product)

            Blocks activity of IL-1 alpha and beta by competitively inhibiting IL-1 binding to the IL-1 type I receptor

            IL-1 production is induced in response to inflammatory stimuli and mediates various physiologic responses including inflammatory and immunological responses

            Proteolytic maturation and secretion of IL-1 beta has an important role in the systemic inflammation and manifestations of NOMID

            Absorption

            Bioavailability: 95%

            Peak Plasma Time: 3-7 hr (RA)

            Peak Plasma Concentration: 3,628 ng/mL (NOMID)

            Elimination

            Half-Life: 4-6 hr (RA); 5.7 hr (NOMID)

            Hemodialysis or CAPD: <2.5%

            Excretion: urine

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            Administration

            SC Injection

            Rotate injection site (thigh, abdomen, upper arm, upper buttocks)

            CAPS

            • Each syringe intended for single use (ie, new syringe must be used for each dose); discard unused portion after each dose
            • Graduated syringe allows for doses between 20 and 100 mg
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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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