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Drug Interactions With Tocilizumab

General Drug Interactions

Most medications are metabolized (broken down) in the body by enzymes in the liver known as CYP enzymes. Tocilizumab may indirectly stimulate these CYP enzymes. Tocilizumab works by binding to a specific set of receptors known as interleukin-6 (IL-6) receptors in the body. This action prevents the interleukin-6 (which is a natural inflammatory protein) from binding to the receptor, thereby reducing the symptoms of rheumatoid arthritis.
Because IL-6 naturally suppresses CYP enzymes, tocilizumab may indirectly stimulate the CYP enzymes by blocking IL-6. This may cause the body to metabolize drugs more quickly. For many medications, this change is probably insignificant. However, some medications are very sensitive to small changes.
For instance, small changes in the way the body metabolizes warfarin (Coumadin®, Jantoven®) can cause dangerous changes, such as an increased risk of bleeding or of blood clots. Therefore, if you take a medication that requires frequent monitoring (warfarin), that is particularly toxic (such as many arrhythmia medications), or has actions that are very important to you (such as birth control pills), you should discuss this with your healthcare provider before taking tocilizumab.
If you are taking a drug that could potentially interact with tocilizumab in a serious way, your healthcare provider may have several options for you. Perhaps frequent monitoring is all that is necessary. Or perhaps your healthcare provider may suggest a medication change. In the most serious of situations, perhaps tocilizumab should be avoided.

Final Thoughts

It is possible that not all tocilizumab drug interactions were discussed in this article. Therefore, you should talk with your pharmacist or healthcare provider about any specific interactions that may apply to you.
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