Tocilizumab is a humanised monoclonal antibody that blocks the interleukin-6 (IL-6) receptor, reducing inflammation associated with autoimmune and inflammatory diseases.

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It may be prescribed for:

☐ Rheumatoid Arthritis

☐ Giant Cell Arteritis

☐ Juvenile Idiopathic Arthritis

☐ Cytokine Release Syndrome

☐ Other specialist indication

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EXPECTED BENEFITS

Treatment may:

☐ Reduce inflammation

☐ Improve pain

☐ Improve joint function

☐ Reduce disease activity

☐ Reduce corticosteroid requirements

☐ Slow disease progression

☐ Improve quality of life

☐ Reduce hospitalisation

I understand that treatment response varies between individuals and cannot be guaranteed.

 

MY TREATMENT PLAN

☐ Intravenous infusion

Future treatment may include:

☐ Intravenous infusions

☐ Transition to subcutaneous injections if clinically appropriate

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ALTERNATIVE TREATMENTS

☐ Methotrexate

☐ Leflunomide

☐ Sulfasalazine

☐ TNF inhibitor therapy

☐ Abatacept

☐ Rituximab

☐ JAK inhibitor therapy

☐ Other biologic therapies

☐ Corticosteroids

☐ No treatment

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BEFORE STARTING TREATMENT

Before commencing Tocilizumab I understand my clinician may review:

☐ Full Blood Count (FBC)

☐ Liver Function Tests (LFTs)

☐ Kidney function

☐ Lipid profile

☐ Hepatitis B screening

☐ Hepatitis C screening

☐ Tuberculosis screening

☐ Pregnancy assessment

☐ Vaccination history

☐ Current medications

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I HAVE INFORMED MY CLINICIAN IF I HAVE

Current infection 

Fever 

Tuberculosis

Hepatitis B or C 

Diverticulitis

Bowel perforation

Liver disease

High cholesterol 

Cancer

Pregnancy 

Breastfeeding

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COMMON SIDE EFFECTS

☐ Headache

☐ Fatigue

☐ Nausea

☐ Mild infusion reactions

☐ Upper respiratory tract infection

☐ Nasopharyngitis

☐ Mild hypertension

☐ Elevated cholesterol

☐ Mild liver enzyme abnormalities

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MATERIAL RISKS

Although uncommon, Tocilizumab may increase my risk of:

☐ Serious infection

☐ Opportunistic infection

☐ Tuberculosis reactivation

☐ Hepatitis B reactivation

☐ Pneumonia

☐ Sepsis

☐ Reduced white blood cells (neutropenia)

☐ Reduced platelets (thrombocytopenia)

☐ Elevated liver enzymes

☐ Drug-induced liver injury

☐ Elevated cholesterol requiring treatment

☐ Gastrointestinal perforation (particularly in patients with diverticular disease)

☐ Infusion reactions

☐ Severe allergic reaction

☐ Anaphylaxis

☐ Requirement for hospital admission

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IMPORTANT INFORMATION

I understand Tocilizumab may:

☐ Suppress signs of infection such as fever.

☐ Delay recognition of serious infection.

☐ Require regular blood tests throughout treatment.

☐ Require temporary interruption if infection develops.

 

INFUSION REACTIONS

Infusion reactions may occur during or shortly after treatment.

Symptoms may include:

☐ Rash

☐ Itching

☐ Hives

☐ Flushing

☐ Fever

☐ Chills

☐ Chest tightness

☐ Wheezing

☐ Shortness of breath

☐ Facial swelling

☐ Low blood pressure

☐ Dizziness

☐ Collapse

If these symptoms occur, treatment may be slowed or stopped and emergency treatment commenced.

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PREGNANCY & BREASTFEEDING

I understand:

☐ Tocilizumab should be discussed with my treating specialist if I am pregnant or planning pregnancy. 

☐ I should notify my clinician immediately if I become pregnant.

☐ Breastfeeding should be discussed before treatment.

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VACCINATIONS

I understand:

☐ Vaccination status should be reviewed before commencing treatment.

☐ Live vaccines are generally not recommended during treatment unless specifically advised by my treating specialist.

☐ Vaccine responses may be reduced during treatment.

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WHEN SHOULD I SEEK URGENT MEDICAL REVIEW?

I should seek urgent medical attention if I develop:

☐ Fever or symptoms of infection

☐ Persistent cough

☐ Shortness of breath

☐ Severe abdominal pain

☐ Blood in stool

☐ Severe rash

☐ Facial swelling

☐ Yellowing of the skin or eyes

☐ Unexplained bruising or bleeding

☐ Any symptoms that concern me

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PATIENT ACKNOWLEDGEMENT

I acknowledge that:

☐ My diagnosis has been explained.

☐ The reason Tocilizumab has been recommended has been explained.

☐ Expected benefits have been discussed.

☐ Reasonable alternatives have been discussed.

☐ I understand the common side effects.

☐ I understand the material risks relevant to my circumstances.

☐ I understand my increased risk of infection.

☐ I understand the need for regular blood tests during treatment.

☐ I understand the risk of gastrointestinal perforation, particularly if I have diverticular disease.

☐ I understand emergency treatment may become necessary.

☐ I understand treatment effectiveness cannot be guaranteed.

☐ I have had sufficient opportunity to ask questions.

☐ My questions have been answered.

☐ I understand I may withdraw my consent before treatment commences.