Abatacept
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Sarilumab
Anti-IL-6 receptor monoclonal antibody · Disease-Modifying Antirheumatic Drug
START
200 mg SC every 2 weeks (after TB/HBV screen + baseline labs)
TYPICAL MAX
200 mg SC every 2 weeks
STOP IF
Serious infection, ANC <500, ALT >5× ULN, or GI perforation signs
WATCH
TB/HBV pre-screen, CBC, LFTs, lipids; alert to atypical infection presentations
CDSCO approvedSchedule HATC L04AC14
KDIGO 2024 + manufacturer label
- ONSET
- 12h · SC absorption
- PEAK
- 3d · serum Cmax
- t½
- 1.4w · t½ ~10 d
- DURATION
- 2w · q2w
EXCRETION
Proteolytic catabolism; not excreted intact
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Limited data; IgG1 transplacental transfer in 3rd trimester.
FDA category + note
Top interactionssee all 12 →
- AbataceptSevereDatabaseDDInter
- AdalimumabSevereDatabaseDDInter
- AnakinraSevereDatabaseDDInter
- BaricitinibSevereDatabaseDDInter
Mechanism
Fully human IgG1 monoclonal antibody that binds soluble and membrane-bound IL-6 receptors, blocking IL-6-mediated inflammatory signalling — used for rheumatoid arthritis and giant-cell arteritis (selected populations).
Indications
Moderately-to-severely active rheumatoid arthritis (after inadequate response to DMARDs)Polymyalgia rheumatica (selected, glucocorticoid-sparing)
Dosing
- Adult
- 200 mg SC every 2 weeks; reduce to 150 mg SC every 2 weeks for neutropenia / thrombocytopenia / transaminase rise.
- Pediatric
- Not established.
- Renal adjustment
- No adjustment.
- Hepatic adjustment
- Avoid initiating with ALT >1.5× ULN; hold/reduce for transaminase rise.
- Geriatric
- Higher infection risk; monitor closely.
- Max dose
- 200 mg SC every 2 weeks
Pharmacokinetics
Onset
Clinical improvement over weeks
Peak effect
~2–4 days (SC Cmax)
Duration
~2-week dosing interval
Half-life
~10 days (target-mediated, saturable)
Bioavailability
~80% (SC)
Protein binding
Not applicable
Metabolism
Proteolytic catabolism
Excretion
Catabolised; not excreted intact
Contraindications
- Active serious infection (incl. localised)
- ANC <2000/mm³, ALT >1.5× ULN, platelets <150 000/mm³
- Hypersensitivity
Side effects
Common
Injection-site reactionsUpper respiratory infectionNeutropenia / thrombocytopeniaHyperlipidaemiaTransaminase elevation
Serious
- Serious infections (incl. TB reactivation, boxed)
- Hepatotoxicity
- Severe neutropenia / thrombocytopenia
- GI perforation (esp. with diverticulitis history)
- Severe hypersensitivity
Pregnancy & lactation
Pregnancy
Limited data; IgG1 transplacental transfer in 3rd trimester.
Lactation
Likely low milk transfer; weigh benefit/risk.
Drug interactions
Adalimumab
Severe
Database
Drug interaction classified as: others
Source: DDInter
Anakinra
Severe
Database
Drug interaction classified as: others
Source: DDInter
Baricitinib
Severe
Database
Drug interaction classified as: others
Source: DDInter
Canakinumab
Severe
Database
Drug interaction classified as: others
Source: DDInter
Certolizumab
Severe
Database
Drug interaction classified as: others
Source: DDInter
Cladribine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Deferiprone
Severe
Database
Clinical effect not specified
Source: DDInter
Etanercept
Severe
Database
Drug interaction classified as: others
Source: DDInter
Fingolimod
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Golimumab
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Sarilumab
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Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20