Kevzara is a brand (trade) name for sarilumab, a biologic that can be used to treat adults suffering from rheumatoid arthritis (RA) or polymyalgia rheumatica (PMR).

Kevzara (sarilumab) works by inhibiting the actions of a protein known as interleukin-6. IL-6 is an inflammatory cytokine that is involved in a variety of bodily processes, including inducing the production of C-reactive protein (CRP) by the liver. IL-6 plays a significant role in the symptoms of RA and PMR. It is abundant in RA patients' synovial fluid and serum, and levels of IL-6 are higher during periods of increased disease activity and joint destruction.

It also contributes to other RA symptoms like fatigue, anemia, and osteoporosis. In people with PMR, IL-6 levels are elevated, and high levels are associated with disease activity and systemic inflammation.

Kevzara is a type of biologic medication that belongs to the interleukin-6 (IL-6) receptor antagonists (also known as IL-6 inhibitors) drug class.

Kevzara's side effects can range from minor to severe. Some of the most significant side effects that could happen while taking Kevzara are listed in the lists below. These lists do not cover every potential adverse effect. Consult your doctor or pharmacist for more details on Kevzara's potential side effects. They can offer you advice on how to handle any uncomfortable side effects.

More common side effects

• redness, rash, or itching at the injection site
• upper respiratory infections, such as a cold
• urinary tract infections
• increased levels of cholesterol or triglycerides (a type of fat)

Most of these side effects should subside within a few days or weeks. Consult your doctor or pharmacist if they become more severe or do not go away.

Serious side effects

Serious Kevzara side effects are uncommon, but they can occur. If you experience severe side effects, contact your doctor immediately. If your symptoms are life-threatening or you believe you are in a medical emergency, dial 911. The following are examples of serious side effects and symptoms:

• Blood conditions like thrombocytopenia (decreased levels of platelets, a type of blood cell that helps blood clot) and neutropenia (low levels of white blood cells). Some symptoms include: fever, diarrhea, cough, shortness of breath, belly pain, bruising easily, bleeding easily
• Increases in liver enzyme levels (a type of protein). Among the symptoms are: yellow tint to your skin or the whites of your eyes, belly pain, nausea, vomiting, dark urine, feeling tired
• Perforations in the gastrointestinal tract (tears in the lining of your intestines or stomach). Among the symptoms are: fever, severe belly pain, chills, nausea, vomiting
• Certain cancers, such as skin cancer and lymphoma. Among the symptoms are: feeling tired, fever, unexplained weight loss, swollen lymph nodes (swelling or lumps in your neck or armpits)
• Other serious side effects include: allergic reactions, serious infections such as tuberculosis (TB)

Kevzara's price, like all medications, can vary. The actual cost is determined by your insurance plan, your location, and the pharmacy you use.

Your insurance company may require you to obtain prior authorization before covering Kevzara. This means that your doctor will have to request that your insurance company cover the drug. The insurance company will review your request and inform you and your doctor whether your plan covers Kevzara.

If you are unsure whether you will need prior authorization for Kevzara, contact your insurance company.

Your doctor will usually start you on a low dose. Then they'll adjust it over time to find the right amount for you. Finally, your doctor will prescribe the smallest dose that produces the desired effect. The following information describes commonly used or recommended dosages. Take the dosage that your doctor has prescribed for you. Your doctor will determine the appropriate dosage for you.

Drug forms and strengths

Kevzara is administered as an injection just beneath the skin (subcutaneous). Your first dose will be administered by a medical professional. They can then teach you or your caregiver how to give injections at home.

Kevzara comes in the form of a prefilled syringe and a prefilled pen. You may find it easier to use one form over the other, so ask your doctor which is best for you. The syringe and pen are available in two strengths: 150 mg/1.14 mL and 200 mg/1.14 mL.

Kevzara can be used alone or in combination with a disease-modifying antirheumatic drug (DMARD) such as methotrexate.

Dosage for rheumatoid arthritis

For rheumatoid arthritis (RA), one 200-mg injection every two weeks is recommended. In some cases, your doctor may adjust your dose, such as if you:

• have neutropenia, or a low level of white blood cells
• have thrombocytopenia, a condition in which your platelet (a type of blood cell that helps blood clot) count is low
• have an increase in your liver enzyme levels (a type of protein)
• acquire an infection while taking Kevzara
  

Kevzara should be taken exactly as prescribed by your doctor or another healthcare professional. Kevzara is available as a prefilled pen or syringe that must be used only once. (You should never reuse a pen or syringe.) You may find it easier to use one form over another, so ask your doctor which is best for you. The medication is injected just beneath your skin (subcutaneous). A healthcare professional may demonstrate how to give Kevzara injections at home to you or your caregiver. You won't have to go to your doctor's office for your injections this way.

You will typically receive a Kevzara injection every two weeks. Make sure to take the remaining doses on the same day and time each week. For instance, if you took your first dose on a Monday morning, you should also take your subsequent dose on a Monday morning two weeks later. Set a reminder on your phone to make sure you don't forget to take a dose. You could also schedule your injections using a calendar.

When combined with Kevzara, drugs that interact with it either lessen its effect, shorten its duration of action, exacerbate side effects, or have no effect at all. Even though it is not always necessary to stop taking one of the drugs, sometimes there is an interaction between two drugs. Consult your doctor to learn how to handle drug interactions.

Typical drugs with which Kevzara may interact are as follows:

• aminophylline
• anticonvulsants, such as phenobarbital or phenytoin
• antipsychotics, such as clozapine
  
• benzodiazepines, such as alprazolam or clonazepam
• corticosteroids (such as prednisone or dexamethasone)
• heart medications such as amiodarone or flecainide
• herbals, such as echinacea or black cohosh
• hormones such as levonorgestrel or norgestrel
• immunosuppressants such as azathioprine, cyclosporine, or tacrolimus
• live vaccines and some other vaccines, such as BCG, cholera, measles, hepatitis b vaccines, yellow fever, or live influenza vaccines
• methotrexate
• opioids, such as fentanyl or oxycodone
• other biologics, such as adalimumab, etanercept, golimumab, or infliximab
• probiotics, such as lactobacillus
• statins, such as atorvastatin or simvastatinn
• theophylline
• warfarin
• zinc.

Any medication that is metabolized by CYP450 enzymes, particularly those with a narrow therapeutic index (such as cyclosporine or warfarin), has the potential to interact with Kevzara. This is because increased levels of certain cytokines (such as IL-1, IL-6, IL-10, and IL-17) during chronic inflammation can alter the formation of CYP450 enzymes. Because Kevzara prevents IL-6 from interacting with the IL-6 receptor, it may restore CYP450 enzyme formation. Keep an eye out for any changes in effect and consider any dosage changes.

It should be noted that this list is not exhaustive and only includes common medications that may interact with Kevzara. For a complete list of interactions with Kevzara, consult the prescribing information.

Can I take Kevzara with another biologic drug for RA?

It's not advised, so no. Although Kevzara has not been studied in combination with other biologic medications for RA, you should avoid doing so. A biologic is a medication created using living materials like proteins or DNA. Kevzara is a biologic substance.

Numerous biologics can impair your immune system and raise your susceptibility to infection. Your body's defense against infections is your immune system. Therefore, taking two biologics increases your risk of developing serious infections.

Tumor necrosis factor (TNF) blockers are one class of additional biologic drugs used to treat RA. These medications reduce inflammation (swelling) by blocking a protein called TNF. When taking Kevzara, you should refrain from taking TNF blockers like:

• adalimumab (Humira)
• etanercept (Enbrel)
• infliximab (Remicade)
• golimumab (Simponi)

Can Kevzara cause hair loss?

Hair loss was not a side effect that Kevzara users experienced in clinical trials. However, the use of additional rheumatoid arthritis (RA) medications may be associated with hair loss.

Methotrexate in particular is one RA medication that can make people lose their hair. Methotrexate works by slowing down cell growth, which reduces inflammation (swelling). Among these cells are those in your hair follicles (sacs under your skin that hold the roots of your hair). Your hair could start to fall out if these cells stop growing. The Arthritis Foundation reports that 1% to 3% of methotrexate users experience hair loss.

Methotrexate can also lower folic acid levels in the body. Folic acid promotes the health of your hair. Methotrexate, if used in conjunction with Kevzara, may be the cause of your hair loss. Leflunomide (Arava), etanercept (Enbrel), and adalimumab (Humira) are other RA medications that can cause hair loss.

Consult your doctor if you are concerned about hair loss or how to prevent it while taking Kevzara.

What if I miss a dose?

As long as it is not almost time for your next dose of Kevzara, take the missed dose as soon as you remember. Ask your doctor when you should receive your next injection if you miss a dose. Set a reminder on your phone to make sure you don't forget to take a dose. You could also schedule your injections using a calendar.

Will I need to use this drug long-term?

Kevzara is intended to be used as a long-term RA treatment. If you and your doctor decide that Kevzara is safe and effective for you, you will most likely continue to take it.