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Canakinumab: Uses, Dosage, Side Effects & Injection Guide
Summary of Key Points
Canakinumab is a prescription medication used to treat various inflammatory conditions, including Familial Mediterranean fever, Systemic juvenile idiopathic arthritis, and Gout. It works by reducing inflammation in the body. Canakinumab is administered as a subcutaneous injection, with dosing tailored to the specific condition being treated. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions regarding Canakinumab treatment.
Names of Medication
US Brand Name: Ilaris
Generic Name: Canakinumab
The generic name refers to the active ingredient in the medication and is listed in parentheses next to the brand name.
Pharmacologic Category
Interleukin-1β (IL-1β) Inhibitor
Canakinumab Dosage
Canakinumab is used to treat several conditions, with dosage and frequency depending on the specific disease. Always follow your doctor’s instructions and consult your healthcare provider before making any changes to your medication. You can also schedule a telemedicine appointment with one of our providers for personalized advice on Canakinumab dosage.
Familial Mediterranean Fever
Adult Dose: 150 mg injected under the skin every 4 weeks.
Cryopyrin-Associated Periodic Syndromes (CAPS)
Adult Dose: 150 mg injected under the skin every 8 weeks.
Systemic Juvenile Idiopathic Arthritis (SJIA)
Adult Dose: 4 mg/kg (up to a maximum of 300 mg) injected under the skin every 4 weeks.
Adult-Onset Still’s Disease
Adult Dose: 150 mg injected under the skin every 4 weeks.
Gout
Adult Dose: 150 mg injected under the skin for one dose during a flare-up.
Periodic Fever Syndromes
Adult Dose: 150 mg injected under the skin every 4 to 8 weeks, depending on the specific syndrome.
Rheumatoid Arthritis
Adult Dose: Canakinumab is not typically used for rheumatoid arthritis but may be considered in certain cases. Consult your healthcare provider for more information.
Systemic Lupus Erythematosus
Adult Dose: Canakinumab is not commonly used for lupus but may be prescribed in certain situations. Speak with your doctor for guidance.
Psoriatic Arthritis
Adult Dose: Canakinumab is not a first-line treatment for psoriatic arthritis. Consult your healthcare provider for more details.
Behçet’s Disease
Adult Dose: 150 mg injected under the skin every 4 to 8 weeks, depending on the severity of the disease.
Dosage Forms and Strengths
Injection: 150 mg/mL in a single-use vial
Administration Instructions for Canakinumab Injection
Canakinumab is administered subcutaneously. If you are injecting at home, your healthcare provider will show you how to do it properly. Rotate injection sites to avoid irritation, and do not inject into areas that are red, swollen, or tender. If you miss a dose, contact your healthcare provider for instructions. Never double up on doses to make up for a missed injection.
Canakinumab Side Effects and Adverse Reactions
Like all medications, Canakinumab can cause side effects. Some are common, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately. Our telemedicine team is available to help manage any concerns related to Canakinumab side effects.
Common Side Effects
Injection site reactions: Redness, swelling, or pain at the injection site.
Upper respiratory infections: Symptoms such as a runny nose, sore throat, or cough.
Headache: Mild to moderate headaches may occur.
Serious Side Effects
Serious infections: Canakinumab may increase the risk of serious infections, including tuberculosis. Seek medical attention if you develop a fever, chills, or a persistent cough.
Allergic reactions: Signs include rash, itching, swelling, or difficulty breathing. This requires immediate medical attention.
Low white blood cell count: This can increase the risk of infections. Your doctor may monitor your blood counts during treatment.
Contraindications for Canakinumab
A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. In the case of Canakinumab, there are several conditions where the medication is not recommended due to potential risks.
Active or chronic infections: Canakinumab suppresses parts of the immune system, making it harder for your body to fight infections. If you have an active infection or a history of recurring infections, taking Canakinumab could worsen your condition or lead to severe complications.
Hypersensitivity or allergy to Canakinumab: If you have had an allergic reaction to Canakinumab or any of its components in the past, you should not take this medication. Allergic reactions can range from mild rashes to severe, life-threatening conditions like anaphylaxis.
History of tuberculosis (TB): Canakinumab can reactivate latent tuberculosis. If you have a history of TB or have been exposed to someone with TB, your healthcare provider may recommend a TB test before starting Canakinumab.
Immunosuppression: If you are already taking medications that suppress your immune system, such as corticosteroids or other biologics, Canakinumab may increase your risk of infections or other immune-related complications.
Drug-to-Drug Interactions with Canakinumab
Canakinumab may interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of either drug. Below are some medications that may interact with Canakinumab:
TNF inhibitors: Medications like infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel) can increase the risk of serious infections when taken with Canakinumab.
Immunosuppressants: Drugs such as methotrexate (Trexall) or cyclosporine (Neoral) may increase the risk of infections when combined with Canakinumab.
Live vaccines: Vaccines such as the MMR (measles, mumps, rubella) or varicella (chickenpox) vaccines should not be given while taking Canakinumab, as the immune system may not respond effectively, and the live virus could cause an infection.
Canakinumab in Pregnancy
Is it Safe to Take Canakinumab During Pregnancy?
Information on the use of Canakinumab during pregnancy is limited. While animal studies have not shown direct harm to the fetus, there is a lack of comprehensive human studies. Since Canakinumab affects the immune system, it may carry potential risks for both the mother and the developing baby. If you are pregnant or planning to become pregnant, it is crucial to discuss the possible benefits and risks of Canakinumab with your healthcare provider. They can help you carefully evaluate your options and decide whether to continue or modify your treatment plan.
Canakinumab While Breastfeeding
Is it Safe to Take Canakinumab While Breastfeeding?
It is currently unknown whether Canakinumab passes into breast milk. Given its effects on the immune system, there may be potential risks to a breastfeeding infant. If you are breastfeeding or planning to breastfeed, it is important to consult your healthcare provider about the potential risks and benefits of continuing Canakinumab. Your provider may suggest alternative treatments or recommend monitoring your baby closely for any signs of immune-related issues.
Estimated Cost of Canakinumab
The cost of Canakinumab can be significant, especially without insurance coverage. With a GoodRx coupon, the estimated price for a 30-day supply ranges from $16,000 to $18,000. Prices may vary depending on the pharmacy and location. It is advisable to check with your healthcare provider or pharmacist for the most accurate and up-to-date pricing information regarding Canakinumab.
Possible Alternatives to Canakinumab
Depending on your condition, there may be alternative medications or lifestyle changes that can help manage your symptoms. It is important to consult your healthcare provider before making any changes to your treatment plan. Below are some alternatives for conditions commonly treated with Canakinumab:
- Familial Mediterranean fever: Colchicine is a common alternative. Lifestyle modifications, such as managing stress and avoiding certain foods, may also help control symptoms.
- Cryopyrin-associated periodic syndromes (CAPS): Anakinra (Kineret) and rilonacept (Arcalyst) are other biologic options. Regular exercise and a balanced diet may help reduce inflammation.
- Systemic juvenile idiopathic arthritis (SJIA): Methotrexate or tocilizumab (Actemra) are potential alternatives. Physical therapy and regular exercise can improve joint function and alleviate pain.
- Adult-onset Still’s disease: Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are often used. Staying active and maintaining a healthy weight can help manage symptoms.
- Gout: Allopurinol (Zyloprim) and febuxostat (Uloric) are common alternatives. Dietary changes, such as reducing red meat and alcohol intake, can help prevent flare-ups.
- Periodic fever syndromes: Colchicine or anakinra (Kineret) may be used as alternatives. Keeping a fever diary and identifying triggers can help manage symptoms.
- Rheumatoid arthritis: Methotrexate, sulfasalazine, or biologics like adalimumab (Humira) are alternatives. Regular exercise and a balanced diet can help reduce inflammation and improve joint function.
- Systemic lupus erythematosus (SLE): Hydroxychloroquine (Plaquenil) and corticosteroids are common alternatives. Sun protection and stress management are important lifestyle changes for managing SLE.
- Psoriatic arthritis: Methotrexate or biologics like secukinumab (Cosentyx) may be used. Regular physical activity and maintaining a healthy weight can help reduce symptoms.
- Behçet’s disease: Corticosteroids and immunosuppressants like azathioprine (Imuran) are alternatives. Avoiding triggers such as stress and certain foods may help prevent flare-ups.
Recent Updates on Canakinumab Research
Recent studies have explored Canakinumab’s potential beyond its current uses. Notably, research is ongoing to investigate its role in reducing cardiovascular events in patients with a history of heart disease. A large clinical trial, known as the CANTOS trial, demonstrated that Canakinumab significantly lowered the risk of heart attacks in patients with elevated levels of inflammation. However, further studies are needed to confirm these findings and determine whether Canakinumab should be more widely used in cardiovascular care.
Additionally, researchers are investigating the use of Canakinumab in treating certain cancers, such as lung cancer, due to its ability to reduce inflammation, which can contribute to tumor growth. While these studies are still in the early stages, they offer promising insights into the broader potential of Canakinumab.
If you have any questions about Canakinumab or are considering it as part of your treatment plan, we encourage you to speak with one of our healthcare providers through telemedicine. We’re here to help you make informed decisions about your health.
