Anakinra, Injection an-a-KIN-ra

What are other names for this medicine?

Type of medicine: antirheumatic

Generic and brand names: anakinra, injection; Kineret

What is this medicine used for?

This medicine is given by injection (shot) to reduce the pain and swelling from rheumatoid arthritis in adults over 18 years of age. It is usually given when other medicines have not worked. It may be used alone or with other medicines.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine or to latex
• a blood disorder
• a weakened immune system from diseases such as HIV/AIDS or from cancer chemotherapy, radiation therapy, or steroid medicine
• asthma
• chronic infections
• kidney disease

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine comes in prefilled sterile syringes with needles ready for use. There are 7 syringes in each box, one for each day of the week. Read and carefully follow the instructions that come in the medicine package.

The shots are given just under the skin. Your healthcare provider will determine the exact dosage. If your healthcare provider is giving you the shots, keep all your appointments.

Sometimes you can give yourself these shots or have someone at home give them to you. Be sure you know how and when to have shots and how much medicine to use. Use each syringe and needle only once and dispose of them safely, following your healthcare provider's instructions.

Carefully read and follow the directions that come in the package of medicine for preparing the shots. Remove the prefilled syringe from the box that matches the day of the week. Place the remaining syringes back in the refrigerator. Do not shake the prefilled syringe. Do not use the medicine if it looks cloudy or has particles floating in it. Wash your hands before using this medicine. Follow these steps to give yourself the shots:

1. Your healthcare provider will tell you where you can give yourself the shots (abdomen, thigh, or other sites). If you are giving the shot in your abdomen, choose a site around the belly button but not into the belly button. Each day, choose a different spot for the shot to lessen irritation.
2. Use an alcohol swab to clean the skin where you will give yourself the shot.
3. Gently pinch up the skin and insert the needle into the skin at a 45° angle. After you insert the needle completely, release your grasp of the skin.
4. Slowly push the plunger down into the syringe until it stops
5. After you have given yourself the shot, withdraw the syringe and press dry gauze on the spot where the shot was given. Do not use an alcohol wipe.
6. Discard the syringe. Use the syringes ONLY ONCE. Throw them away after use. Put used syringes in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters.

If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

An acute overdose of this medicine is not likely to cause life-threatening symptoms. If you think that you or anyone else may have taken too much of this medicine, call the poison control center at 800-222-1222.

What should I watch out for?

If you develop any signs of an infection such as a fever, chills, cough, or mouth sores, stop using the medicine and contact your healthcare provider right away.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are using this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue or throat).

Serious (report these to your healthcare provider right away): Signs of an infection such as a fever, chills, cough, or mouth sores; unusual bleeding or bruising; chest pain; increased pain, swelling, or redness around your joints.

Other: Irritation, swelling, or redness on the skin where the injection was given; fatigue; headache; stomach pain; nausea; diarrhea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• adalimumab (Humira)
• chemotherapy or medicines to treat cancer
• echinacea
• etanercept (Enbrel)
• infliximab (Remicade)
• vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine (in syringes with needles) in the refrigerator. Do not freeze. Do not use a syringe that has been left at room temperature for longer than 24 hours. Do not shake the syringes. Protect from heat, high humidity, and bright light. Do not use beyond the expiration date shown on the carton. Do not use prefilled syringes if the solution is discolored or if there are particles in the solution.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.