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Anakinra

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Anakinra, Kineret

  • Indications
  1. Severe active Rheumatoid Arthritis refractory to DMARDs
  • Contraindications
  1. Chronic or acute infection
  2. Concurrent use of TNF antagonists (infection risk)
    1. Adalimumab (Humira)
    2. Etanercept (Enbrel)
    3. Infliximab (Remicade)
  • Mechanism
  1. Interleukin-1 Receptor Antagonist
  • Dosing
  1. Adults: 100 mg SC qd with rotating injection sites
  • Cost
  1. Vial of 100 mg/0.67 ml (7 doses): $260
  • Adverse Effects
  1. Immunosuppression
    1. Use caution in any patient prone to infection
  2. Headache
  3. Injection site inflammation
  4. Gastrointestinal upset
  5. Leukopenia (including Neutropenia)
  • Monitoring
  1. Serum Creatinine
  2. Complete Blood Count with Neutrophil Count
    1. Baseline, then
    2. Monthly for 3 months, then
    3. Quarterly
  • References
  1. (2003) Lexicomp Drug Database