Sarilumab is used on its own or together with other medicines to treat moderate to severe rheumatoid arthritis (inflammation in the joints of fingers, wrists, feet, and ankles).
Sarilumab is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm, or abdomen area).
Your doctor or nurse will administer the injection for you. If you or your caregiver had been given the proper training on the preparation and injection techniques of this medicine, you or your caregiver may do the administration.
Use Sarilumab exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor.
This medicine is available as a pre-filled pen or syringe. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject at least 2 inches around the navel (belly button).
Do not administer into areas where the skin is tender, damaged, bruised, or scarred.
The dose of Sarilumab will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition and your response to the medication.
Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Sarilumab.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
If you or a caregiver had been trained to administer this medicine and it has been 3 days or less since the missed dose, inject the missed dose as soon as you remember and return to your normal dosing schedule.
If it has been 4 days or more since the missed dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Inform your doctor or pharmacist immediately if you forgot to administer your dose.
Alert your doctor if you have active infections, including localised infections as Sarilumab may not be suitable for you.
Alert your doctor if you have been recently vaccinated. You must avoid any vaccinations with live vaccines without consulting with your doctor.
Do not use Sarilumab with other biologic medicines used to treat rheumatoid arthritis such as etanercept, anakinra, and rituximab.
Inform your doctor if you have the following conditions:
- long-term or recurring infections
- HIV infection
- liver disease
- history of stomach or bowel ulcer
- history of diverticulitis (condition when the small, bulging pouches that form in the lining of your large intestine got inflamed or infected)
Let your doctor know if you are pregnant or breastfeeding.
It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods during Sarilumab therapy and for up to 3 months after stopping the treatment. Birth control medicines taken orally may not be effective. You may wish to discuss other reliable methods of birth control with your doctor.
Be sure to check with your doctor or pharmacist before giving Sarilumab to the elderly. Elderly people may be more sensitive to the side effects.
Inform your doctor if you have resided in or travelled to areas with endemic cases of TB or fungal infections.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your doctor may conduct screening tests for TB (an infection known as tuberculosis) before treatment to know if Sarilumab is suited for you to use.
- Routine tests (e.g. liver function, cholesterol levels, blood count) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs of infection, bowel problem, and allergic reactions may also be needed.
Sarilumab may cause any of the following side effects: nasal congestion, runny nose, sore throat, cold sores, rash, and itching or redness at the site of injection.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of allergic reaction e.g. rashes, breathlessness, swelling of the face, eyes or mouth
- signs and symptoms of infection e.g. fever, sweating, chills, cough, shortness of breath, tiredness
- signs and symptoms of bowel problems e.g. persistent abdominal pain accompanied by fever
Sarilumab may cause the level of your white blood cells and platelets to drop.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Avoid vaccinations with live vaccines during treatment with this medicine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.
Do not use Sarilumab with other biologic medicines used to treat rheumatoid arthritis such as etanercept, anakinra, and rituximab.
Inform your doctor and pharmacist if you are taking any of these medicines:
- theophylline (asthma medicine)
- warfarin (blood-thinning medicine)
- cholesterol-lowering medicines e.g. atorvastatin, lovastatin, simvastatin
- NSAIDs (medicines for pain and inflammation)
- birth control pills
This list does not include all medicines that may interact with Sarilumab.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in the refrigerator, between 2-8°C. Do not freeze Sarilumab otherwise, it will no longer be effective and should not be used.
Keep the pre-filled pen or syringe in their original package to protect from light.
If needed, the pre-filled pens or syringes may be stored at room temperature not exceeding 25°C for up to 14 days. Use this medicine within 14 days after removing it from the refrigerator.
Do not shake.
If you notice that the injection has changed colour or has become cloudy, do not use it. Throw it away and use a new injection.
Medicines must not be used past the expiry date.
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