| Rheumatoid Arthritis
Actemra vs Naprelan
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Actemra vs Naprelan 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 signalsNaprelan has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Naprelan but not Actemra, including UnitedHealthcare
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Category
Actemra
Naprelan
At A Glance
IV infusion or SC injection
Every 4 weeks (IV) or Every week to Every other week (SC)
IL-6 receptor antagonist
Oral
Daily
NSAID
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
- Rheumatoid Arthritis
- Degenerative polyarthritis
- Ankylosing spondylitis
- Tendinitis
- Bursitis
- Gout
- 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.
Rheumatoid Arthritis, Degenerative polyarthritis, Ankylosing spondylitis 750 mg or 1,000 mg once daily; may be increased to 1,500 mg once daily for limited periods when a higher level of anti-inflammatory/analgesic activity is required.
Tendinitis, Bursitis, Primary dysmenorrhea 1,000 mg once daily; for patients requiring greater analgesic benefit, 1,500 mg may be used for a limited period; total daily dose should not exceed 1,000 mg thereafter.
Gout 1,000-1,500 mg once daily on the first day, followed by 1,000 mg once daily until the attack subsides.
Contraindications
- Known hypersensitivity to tocilizumab
- Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen or any components of the drug product
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- Coronary artery bypass graft (CABG) surgery
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 (>=10%) headache, dyspepsia, flu syndrome
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
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.
Naproxen is an NSAID with analgesic, anti-inflammatory, and antipyretic properties that acts by inhibiting cyclooxygenase (COX-1 and COX-2), thereby reducing prostaglandin synthesis in peripheral tissues.
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Most Common Insurance
Anthem BCBS
Actemra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Naprelan
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (5/12) · Qty limit (10/12)
UnitedHealthcare
Actemra
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Naprelan
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Actemra
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Naprelan
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Actemra.
No savings programs available for Naprelan.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.