| Rheumatoid Arthritis

Actemra vs Celebrex

Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.

Deep comparison between: Actemra vs Celebrex with Prescriber.AI

AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.

Safety signalsCelebrex has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Celebrex but not Actemra, including UnitedHealthcare

Category

Actemra

Celebrex

At A Glance

RouteIV infusion or SC injection

FrequencyEvery 4 weeks (IV) or Every week to Every other week (SC)

ClassIL-6 receptor antagonist

RouteOral

FrequencyOnce or twice daily

ClassCOX-2 inhibitor

Indications

Rheumatoid Arthritis
Giant Cell Arteritis
Lung disease with systemic sclerosis
Juvenile polyarthritis
Systemic onset juvenile chronic arthritis
Cytokine Release Syndrome
COVID-19 Virus Disease

Degenerative polyarthritis
Rheumatoid Arthritis
Juvenile rheumatoid arthritis
Ankylosing spondylitis
Primary dysmenorrhea

Dosing

Rheumatoid Arthritis IV: 4 mg/kg every 4 weeks, increase to 8 mg/kg every 4 weeks based on response; SC: 162 mg every other week (for <100 kg) or every week (for >=100 kg), increase to every week based on response.

Giant Cell Arteritis IV: 6 mg/kg every 4 weeks with tapering glucocorticoids; SC: 162 mg every week with tapering glucocorticoids (may use every other week based on clinical considerations).

Systemic Sclerosis-Associated Interstitial Lung Disease SC: 162 mg every week.

Polyarticular Juvenile Idiopathic Arthritis IV: 10 mg/kg every 4 weeks (<30 kg) or 8 mg/kg every 4 weeks (>=30 kg); SC: 162 mg every 3 weeks (<30 kg) or every 2 weeks (>=30 kg).

Systemic Juvenile Idiopathic Arthritis IV: 12 mg/kg every 2 weeks (<30 kg) or 8 mg/kg every 2 weeks (>=30 kg); SC: 162 mg every 2 weeks (<30 kg) or every week (>=30 kg).

Cytokine Release Syndrome IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single dose, alone or with corticosteroids; up to 3 additional doses at least 8 hours apart if no improvement.

COVID-19 IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single 60-minute infusion; one additional dose at least 8 hours later if clinical signs worsen or do not improve.

Degenerative polyarthritis 200 mg once daily or 100 mg twice daily, oral.

Rheumatoid Arthritis 100 mg to 200 mg twice daily, oral.

Juvenile rheumatoid arthritis 50 mg twice daily for patients 10-25 kg; 100 mg twice daily for patients >25 kg, oral.

Ankylosing spondylitis 200 mg once daily or 100 mg twice daily, oral; if no effect after 6 weeks, may trial 400 mg daily.

Primary dysmenorrhea 400 mg initially, followed by 200 mg if needed on day 1; 200 mg twice daily on subsequent days, oral.

Contraindications

Known hypersensitivity to tocilizumab

Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to celecoxib or any components of the drug product
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
Setting of CABG surgery
Demonstrated allergic-type reactions to sulfonamides

Drug Interactions

856View drug interactions

1343View drug interactions

Adverse Reactions

Most common (>=5%) Upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions (SC only).

Serious Serious infections (pneumonia, urinary tract infection, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis, bacterial arthritis), gastrointestinal perforations, hypersensitivity reactions including anaphylaxis.

Postmarketing Fatal anaphylaxis, Stevens-Johnson Syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), pancreatitis, drug-induced liver injury, hepatitis, hepatic failure, jaundice, hypofibrinogenemia.

Most common (>=2%) Headache, dyspepsia, upper respiratory infection, diarrhea, sinusitis, abdominal pain, nausea, back pain, peripheral edema, rhinitis, pharyngitis, rash, flatulence, dizziness, insomnia.

Serious Cardiovascular thrombotic events, GI bleeding/ulceration/perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, hematologic toxicity.

Postmarketing Vasculitis, deep venous thrombosis, angioedema, liver necrosis, hepatic failure, agranulocytosis, aplastic anemia, pancytopenia, aseptic meningitis, fatal intracranial hemorrhage, interstitial nephritis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, AGEP, fixed drug eruption.

Pharmacology

Tocilizumab is a humanized IgG1 kappa monoclonal antibody that binds to soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated signaling involved in inflammatory and immune processes.

Celecoxib is a selective COX-2 inhibitor that reduces prostaglandin synthesis in peripheral tissues and the CNS, producing analgesic, anti-inflammatory, and antipyretic effects; at therapeutic doses it does not inhibit platelet aggregation or prolong bleeding time.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Actemra