Formulary
Anakinra: Indications, Dosing, Side Effects and Interactions
Anakinra clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Anakinra: Indications, Dosing, Side Effects and Interactions
Anakinra clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Rheumatoid arthritis (in combination with methotrexate) which has not responded to methotrexate alone (specialist use only)**
- **Adult** (By Subcutaneous Injection): 100 mg once daily.
**Cryopyrin-associated periodic syndromes (specialist use only)**
- **Adult** (By Subcutaneous Injection): 1-2 mg/kg daily, for severe cryopyrin-associated periodic syndromes, usual maintenance is 3-4 mg/kg daily, up to a maximum of 8 mg/kg daily.
**Still's disease (specialist use only)**
- **Adult** (By Subcutaneous Injection): (body-weight 50 kg and above) 100 mg daily.
**Cryopyrin-associated periodic syndromes (specialist use only) for anakinra**
- **Child 8 months-17 years (body-weight 10 kg and above)** (By subcutaneous injection): 1-2 mg/kg daily, for severe cryopyrin-associated periodic syndromes, usual maintenance is 3-4 mg/kg daily, up to a maximum of 8 mg/kg daily.
**Still's disease (specialist use only) for anakinra**
- **Child 8 months-17 years (body-weight 10-49 kg)** (By subcutaneous injection): 1-2 mg/kg daily, increased if necessary up to 4 mg/kg daily.
- **Child 8 months-17 years (body-weight 50 kg and above)** (By subcutaneous injection): 100 mg daily, increased if necessary up to 4 mg/kg daily.
Cautions
Elderly; history of asthma (increased risk of serious infection); history of recurrent infection; predisposition to infection
Contraindications
Active infection; neutropenia (absolute neutrophil count less than 1.5 x 10 9 /litre)-do not initiate; pre-existing malignancy
Side effects
Common or very common Headache; infection; neutropenia; thrombocytopenia Uncommon Skin reactions Frequency not known Hepatitis Side-effects, further information Neutropenia reported commonly-discontinue if neutropenia develops.
Interactions
**Severe interactions:**
- Concurrent Kineret and TNF- antagonist treatment In a clinical study with RA patients receiving background methotrexate, patients treated with Kineret and etanercept were observed to have a higher...
**Other interactions (4):**
- Concurrent Kineret and etanercept treatment has not demonstrated increased clinical benefit.
- The concurrent use of Kineret with etanercept or any other TNF- antagonist is not recommended (see section 4.4).
- Thus, it may be expected that for an IL-1 receptor antagonist, such as anakinra, the formation of CYP450 enzymes could be normalized during treatment.
- This would be clinically relevant for CYP450 substrates with a narrow therapeutic index (e.g.
Pregnancy
Manufacturer advises avoid.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises caution in severe impairment.
Renal impairment
Manufacturer advises caution in moderate impairment. Dose adjustments Manufacturer advises consider alternate day dosing in severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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