Anakinra

Anakinra is a prescription medication used to treat the symptoms of Rheumatoid Arthritis, Cryopyrin-Associated Periodic Syndromes (CAPS), and Deficiency of Interleukin-1 Receptor Antagonist.

• Anakinra is available under the following different brand names: Kineret

Adult and pediatric dosage

Prefilled syringes

• 100mg/0.67mL

Rheumatoid Arthritis

Adult dosage

• 100 mg SC every day

Cryopyrin-Associated Periodic Syndromes (CAPS)

Adult and pediatric dosage

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

Deficiency of Interleukin-1 Receptor Antagonist

Adult dosage

• 1-2 mg/kg SC every day initially; may increase by 0.5- to 1-mg/kg increments to control active inflammation, not to exceed 8 mg/kg/day

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Anakinra include:

• worsening of rheumatoid arthritis symptoms,
• nausea,
• vomiting,
• diarrhea,
• stomach pain,
• headache,
• joint pain,
• flu symptoms,
• stuffy nose,
• sneezing,
• sore throat, and
• redness, bruising, pain, or swelling at the injection site.

Serious side effects of the Anakinra include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe dizziness,
• sweating,
• severe itching,
• wheezing,
• fast or pounding heartbeats,
• fainting,
• fever,
• sweating,
• chills,
• tired feeling,
• shortness of breath,
• cough,
• sore throat,
• sores in the mouth and throat,
• body aches, and
• weight loss

Rare side effects of the Anakinra include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Anakinra has severe interactions with the following drugs:
  • lenalidomide
  • thalidomide
• Anakinra has serious interactions with at least 72 other drugs.
• Anakinra has moderate interactions with at least 23 other drugs.
• Anakinra has minor interactions with the following drug:
  • cat's claw

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to E coli-derived proteins, Kineret, or any component of the product

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Anakinra?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Anakinra?”

Cautions

• The impact of treatment on active and/or chronic infections and the development of malignancies is unknown
• Decreases in neutrophil counts have been reported; assess neutrophil counts before initiation, monthly for 3 months during treatment, and quarterly thereafter for up to 1 year
• Serious infections
  • Increased incidence of serious infections reported; if serious infection develops in RA patients, discontinue treatment
  • Weigh against potential risks versus benefits of continued treatment in NOMID and DIRA patients
  • Should not be initiated in patients with active infections
  • Safety and efficacy in immunosuppressed patients or patients with chronic infections have not been evaluated
• Hypersensitivity reactions
  • Hypersensitivity reactions, including anaphylactic reactions and angioedema, have been reported
  • If a severe hypersensitivity reaction occurs, discontinue treatment and initiate appropriate therapy
  • Increased risk of allergic reactions may occur in patients with DIRA, especially in the initial first several weeks of treatment; closely monitor during this period
  • If a severe allergic reaction occurs, initiate appropriate treatment and consider discontinuation
• Drug interaction overview
  • Immunizations
    • Avoid coadministration of live vaccines
    • Data are unavailable on either effect of live vaccination or secondary transmission of infection by live vaccines in treated patients
• TNF-blocking agents
  • Use not recommended with anakinra
  • A higher rate of serious infections has been associated with concurrent treatment anakinra and etanercept therapy compared to etanercept alone

Pregnancy and Lactation

• Insufficient data available on use in pregnant females to identify drug-associated risks of major birth defects, miscarriage, or maternal and fetal adverse events
• Clinical consideration
  • Published data suggest the risk of adverse pregnancy outcomes in females with rheumatoid arthritis or CAPS is associated with increased disease activity
  • Adverse pregnancy outcomes include preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 grams), and small for gestational age at birth
• Lactation
  • There are no data on drug presence in either human or animal milk or effects on milk production
  • Limited clinical data during lactation precludes a clear determination of risks to infants during lactation