Anakinra - Subcutaneous

Anakinra is used on its own or together with other medicines to treat signs and symptoms of rheumatoid arthritis (inflammation in the joints of fingers, wrists, feet, and ankles).

This medicine may also be used to treat cryopyrin-associated periodic syndromes (a group of very rare genetic diseases caused by a defect in a protein called cryopyrin and characterised by recurrent episodes of fever and symptoms of inflammation).

Anakinra may be used to treat other conditions as decided by your doctor.

Anakinra is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm, upper outer buttocks, 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 Anakinra 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.

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 near the navel (belly button) and into areas where the skin is tender, swollen, bruised, red, hard, scarred, or has stretch marks.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition and your response to medication.

Anakinra must be administered regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor.

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 Anakinra.

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 missed a dose, inject the missed dose as soon as you remember 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.

Do not use Anakinra if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any other medicines that are made using proteins from a certain organism called Escherichia coli.

Alert your doctor if you have low white blood cell count as Anakinra may not be suitable for you.

Inform your doctor if you have the following conditions:

• asthma
• current infection or history of recurring infections
• conditions that increase your risk of getting an infection e.g. diabetes
• cancer
• severe liver disease
• moderate or severe kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Anakinra to a child or the elderly. Children or elderly people may be more sensitive to the side effects.

Inform your doctor if you are scheduled to receive any vaccines or have been recently vaccinated. Do not receive any vaccinations without first asking your doctor.

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.

• Screening tests for TB (lung infection known as tuberculosis) and hepatitis B infection (contagious liver infection caused by a virus that is spread through contact with infected blood or other body fluids) must be done before treatment to know if this medicine is suitable for you to use.
• Routine tests (e.g. kidney and liver function, white blood cell 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 of signs and symptoms of infections and injection site reactions may also be needed.

Anakinra may cause any of the following side effects: headache, diarrhoea, vomiting, stomach pain, runny or stuffy nose, joint pain, and redness, swelling or pain at the injection site.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• persistent fever, chills, severe sore throat, persistent cough, excessive phlegm or changes in the colour of the phlegm, mouth sores, skin redness and tenderness
• rashes, breathlessness, swelling of the face, tongue, mouth, lips or throat

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are using certain medicines to treat inflammation in skin diseases or rheumatoid arthritis (e.g. etanercept).

Avoid vaccinations with live vaccines during treatment with this medicine. Inform your doctor if you have been recently vaccinated or if you are planning to get vaccinated.

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 Anakinra otherwise, it will no longer be effective and should not be used.

Keep the pre-filled syringes in their original carton to protect them from light.

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.